Reversal at Last in early AD

Finally, a system wide health protocol used in early dementia that worked to reverse cognitive decline in a small UCLA study. This reference gives all the study details in scientific language. Below is simple summary for case one:

• eliminating all simple carbohydrates, gluten and processed food from her diet, and eating more vegetables, fruits and non-farmed fish
• meditating twice a day and beginning yoga to reduce stress
• sleeping seven to eight hours per night, up from four to five
• taking melatonin, methylcobalamin, vitamin D3, fish oil and coenzyme Q10 each day
• optimizing oral hygiene using an electric flosser and electric toothbrush
• reinstating hormone replacement therapy, which had previously been discontinued
• fasting for a minimum of 12 hours between dinner and breakfast, and for a minimum of three hours between dinner and bedtime
• exercising for a minimum of 30 minutes, four to six days per week

The following chart gives more of the complex basis for the rationale of this protocol.

Table 1. Therapeutic System 1.0

Goal	Approach	Rationale and References
Optimize diet: minimize simple CHO, minimize inflammation.	Patients given choice of several low glycemic, low inflammatory, low grain diets.	Minimize inflammation, minimize insulin resistance.
Enhance autophagy, ketogenesis	Fast 12 hr each night, including 3 hr prior to bedtime.	Reduce insulin levels, reduce Aβ.
Reduce stress	Personalized—yoga or meditation or music, etc.	Reduction of cortisol, CRF, stress axis.
Optimize sleep	8 hr sleep per night; melatonin 0.5mg po qhs; Trp 500mg po 3x/wk if awakening. Exclude sleep apnea.	[36]
Exercise	30-60' per day, 4-6 days/wk	[37, 38]
Brain stimulation	Posit or related	[39]
Homocysteine <7	Me-B12, MTHF, P5P; TMG if necessary	[40]
Serum B12 >500	Me-B12	[41]
CRP <1.0; A/G >1.5	Anti-inflammatory diet; curcumin; DHA/EPA; optimize hygiene	Critical role of inflammation in AD
Fasting insulin <7; HgbA1c <5.5	Diet as above	Type II diabetes-AD relationship
Hormone balance	Optimize fT3, fT4, E2, T, progesterone, pregnenolone, cortisol	[5, 42]
GI health	Repair if needed; prebiotics and probiotics	Avoid inflammation, autoimmunity
Reduction of Aβ	Curcumin, Ashwagandha	[43-45]
Cognitive enhancement	Bacopa monniera, MgT	[46, 47]
25OH-D3 = 50-100ng/ml	Vitamins D3, K2	[48]
Increase NGF	H. erinaceus or ALCAR	[49, 50]
Provide synaptic structural components	Citicoline, DHA	[51].
Optimize antioxidants	**Mixed tocopherols and tocotrienols, Se, blueberries, NAC, ascorbate, α-lipoic acid	[52]
Optimize Zn:fCu ratio	Depends on values obtained	[53]
Ensure nocturnal oxygenation	Exclude or treat sleep apnea	[54]
Optimize mitochondrial function	CoQ or ubiquinol, α-lipoic acid, PQQ, NAC, ALCAR, Se, Zn, resveratrol, ascorbate, thiamine	[55]
Increase focus	Pantothenic acid	Acetylcholine synthesis requirement
Increase SirT1 function	Resveratrol	[32]
Exclude heavy metal toxicity	Evaluate Hg, Pb, Cd; chelate if indicated	CNS effects of heavy metals
MCT effects	Coconut oil or Axona	[56]

CHO, carbohydrates; Hg, mercury; Pb, lead; Cd, cadmium; MCT, medium chain triglycerides; PQQ, polyquinoline quinone; NAC, N-acetyl cysteine; CoQ, coenzyme Q; ALCAR, acetyl-L-carnitine; DHA, docosahexaenoic acid; MgT, magnesium threonate; fT3, free triiodothyronine; fT4, free thyroxine; E2, estradiol; T, testosterone; Me-B12, methylcobalamin; MTHF, methyltetrahydrofolate; P5P, pyridoxal-5-phosphate; TMG, trimethylglycine; Trp, tryptophan

SIDEBAR: Note that some of the nutrients were given in slightly higher amounts than recommended in the new vitamin criteria. These are therapeutic amounts for a recognized progressive dementia condition. For maintaining health before dementia, the amounts in the new vitamin criteria should prove protective and safe. Many of the recommended lifestyle and dietary changes are quite similar. The side effects of this protocol are simply greater health overall.

**See this article on vitamin E family levels in AD.