Bredesen Protocol

From ApoE4.Info Wiki
Jump to: navigation, search


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.

Diet Strategies

Optimize diet

Enhance autophagy and ketogenesis

Improve GI Health

Lifestyle Strategies

Reduce stress

Optimize sleep


Rule out sleep apnea

Optimize mitochondrial function

Lab Tests to Track and Treat


B vitamins


Insulin sensitivity (insulin and blood glucose)


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)


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:

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 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)
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

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


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

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,

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

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: