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  • Writer's pictureMartha Calihan MD

If You Have Your Mind, You Have Everything

My mother used to quote her older relatives, whose wisdom she didn’t understand until much later in life, saying “If you have your health, you have everything”. As a child, she didn’t understand this at all, because it ignored all the things that a child would see as crucial components of “having everything”.


But with age comes wisdom, and she, and now I, understand this saying. And in fact, I would expand it to say, “if you have your mind, you have everything”.


Dementia remains one of the most feared, most dreaded afflictions of old age. And in our country, we are barreling towards a tsunami of dementia; with estimates reporting as many as 7 million people over the age of 65 having dementia in 2020, and possibly 12 million by 2040. Alzheimer’s is the most common type of dementia.


For years, it has been taught that Alzheimer’s is an incurable, progressive condition that leads ultimately to death. And certainly, that can be true. But with the recent advances as seen in the work of Dr Dale Bredesen and others, we now have increasing evidence of the ability to slow and even reverse this process, improving cognition and wellbeing!


We are pleased to be able to offer the Bredesen protocol at Five Stones and to work with patients who are enrolled in the Bredesen sponsored Apollo health programs.


So what, exactly, does this look like? Patients can participate in either the ReCode or the PreCode programs, depending on whether they are working on treatment or prevention. In either case, we work to identify factors that are contributing to a person’s impaired cognition and help to restore balance to the system.


Dr Bredesen divides Alzheimer’s into 6 types, based on the underlying physiology and findings. Type I (inflammation) and Type 1.5 (glycotoxicity) are ones I commonly see. Each of these types, as well as the remaining 4 subtypes, features bodywide processes that ultimately impact the health of the brain.


With inflammation, the body is putting out inflammatory signals that can negatively affect the brain. These signals are reflected in lab markers of increased inflammation, including the hs-crp. Chronic elevation of this marker can indicate chronic inflammation which can contribute to cognitive decline. This inflammation can be due to chronic infections, poor oral health, increased gut permeability, food sensitivities, eating trans fats and other factors.


The Type 1.5, called Glycotoxicity, is a combination of Types 1 and 2, inflammation and atrophic. In type 1.5, chronically high levels of glucose can cause tissue damage, leading to increased inflammation. The insulin receptors then become less responsive, creating insulin resistance. With the increasing rates of diabetes and pre-diabetes in our country, this type 1.5 is very common.


Type 2 is called atrophic and refers to levels of hormones, vitamins, and other nutrients which can impact brain health, from thyroid hormone to vitamin D.


Type 3 is called Toxicity, referring to what Dr Bredesen called “dementogens”….including metals, chemicals and biotoxins such as mold toxins.


Type 4 is called vascular and reflects the health of the vasculature, lipid levels, oxygenation, etc.


Finally, Type 5 is Traumatic, reflecting the impact of brain injury on cognition.


So having identified the subtypes, what do we do to address this condition? That’s the beauty of this emerging work and this protocol; there is lots to be done!


We start with a full assessment of the variables as outlined above, identifying the areas of vulnerability and then address each of the identified contributors with a full functional medicine approach. We look for the underlying causes and use lifestyle interventions, medical treatments, and nutritional supplements to restore balance and health. The goal is to remove any contributing factor such as inflammation, toxins or infections, restore proper nutrient, vitamin and hormone levels, improve vascular health and address brain inflammation.


One of the cornerstones of the treatment approach is the diet, and the Bredesen protocol strongly supports the use of a ketogenic diet to improve brain health and to reduce inflammation.


Adequate quantity and quality of sleep is another cornerstone of the treatment protocol, along with addressing stress and the impact of excess stress on physiology.


And finally, brain exercises are also included as an important part of the protocol. It is so rewarding to see a patient’s cognitive performance improve as they implement the protocol and do the brain training exercises.


Some of these parts of the protocol seem fairly obvious, others less so. They each involve work on the part of the patient and our team to support them, but we have seen fabulous and exciting results; literally changing people’s lives.


I think my mother was right!


Work with us! Dr Martha Calihan and Lara Lattman, Nutritionist, are both certified in the Bredesen Protocol. Contact our office today for more information, or head to the Apollo Health Website to learn more about the full program.


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