Can the Bredesen Protocol offer hope to patients with Alzheimer’s?
A diagnosis of Alzheimer’s disease is frightening. The cognitive impairment, memory loss, and inevitable cognitive decline can seem like a death sentence to both patients and loved ones.
The standard reductionist approach seeks to boil every problem down to its most basic components. Most modern medicine is looking for a single silver bullet cure found in monotherapeutic treatment (translation: one medication that will cure Alzheimer’s).
This approach does not take into account the fact that Alzheimer’s disease “manifests from the confluence of multiple factors” (Bredesen, 2020, p. xiii). Treating Alzheimer’s disease requires the equally multi-faceted response of functional medicine. “Holism considers any and all options available if there’s something positive to offer” (Bredesen, 2020, p. xiii).
In other words, there is no single drug that can treat Alzheimer’s… But perhaps a protocol that addresses the many factors that lead to Alzheimer’s can make a difference.
Who is Dale Bredesen? Dr. Dale Bredesen is a neurologist who created a twenty-first-century approach to predict and prevent cognitive decline through holistic lifestyle changes.
Dr. Bredesen is endeavoring to introduce new holistic principles of medicine toward a brighter 22nd century. His work identifies the multi-faceted causes of Alzheimer’s disease and outlines a multi-pronged approach to its prevention.
What is the Bredesen Protocol?
What is Dr. Bredesen’s protocol? The Bredesen Protocol is a personalized approach to prevent and reverse cognitive decline through a PreCODE and ReCODE process. It begins with a “cognoscopy” at the age of 45, if possible.
This consists of a set of simple blood tests and a cognitive assessment that can be taken online. This gives the doctor the ability to customize a treatment plan for better brain health.
The overall goal of the Bredesen Protocol is to remove exposure triggers that lead to cognitive decline, optimize health support, and rebuild the neural network.
First, burning fat is crucial. Alzheimer’s is associated with a decrease in glucose utilization. A three-pronged approach to begin burning fat includes:
- Eating a plant-rich, fiber-rich, low carbohydrate diet, high in healthy fats
- Fasting overnight for at least 12 hours
- Exercising regularly, ideally for 30 minutes, 5 times weekly
Addressing Insulin Sensitivity
Second, the Bredesen Protocol addresses insulin resistance and restoring insulin sensitivity. Insulin is a key growth factor for neurons.
Insulin sensitivity can be restored by the following:
- Combining the KetoFLEX 12/3 diet and lifestyle
- Optimizing essential nutrients, such as zinc
- Exercising regularly
- Reducing stress
- Treating sleep apnea if present
- Taking a supplement such as berberine, cinnamon, alpha-lipoic acid, or chromium picolinate, if needed
Third, it is important to optimize all nutrient, hormone, and trophic (growth factor) support. This support means we can create resilience, optimize our immune systems, support our mitochondria, and begin to rebuild our brains’ synaptic networks.
Low levels of trophic factors (growth factors) such as vitamin B1 (thiamine), vitamin B12, vitamin D, testosterone, estrogen, and nerve growth factor are all associated with cognitive decline.
Other necessary nutrients for optimal cognitive function include vitamin C, vitamin E, vitamin K2, omega-3 fats, choline, and other neurotransmitter precursors, key metals such as zinc, magnesium, copper, and selenium.
Optimum hormone levels are critical for making and maintaining synapses. Optimal nutrition and lifestyle will lead to optimal hormone production for many of us.
However, other patients will need to support optimal brain function by achieving the healthiest levels of thyroid, pregnenolone, estradiol, progesterone, testosterone, DHEA, and cortisol.
Fourth, we want to optimize the way the body uses inflammation. It’s important to allow the body to increase inflammation when it’s actually necessary, but also to resolve inflammation when it’s no longer needed.
The Bredesen Protocol also emphasizes minimizing inflammation without a purpose, which is often referred to as “chronic inflammation.” Amyloids often associated with Alzheimer’s disease are part of our body’s inflammatory response.
Leaky gut is the most common cause of chronic inflammation. This can be caused by:
- Excessive sugar intake
- Processed foods
- Aspirin and related anti-inflammatories
- Soft drinks
- PPIs (used to treat reflux or heartburn)
- Other damaging agents
We need to know the status of our gut health.
Chronic inflammation with or without a leaky gut may also be caused by periodontitis, gingivitis from suboptimal dentition, or an infection of a root canal in your mouth.
In fact, chronic periodontitis, an inflammatory condition of the gums, may be a direct cause of Alzheimer’s disease.
Other causes include chronic sinus infections, or ongoing infection with pathogens such as Borrelia, or metabolic syndrome (insulin resistance, high blood pressure, high triglycerides, and inflammation, often accompanied by obesity).
There are also cases of chronic inflammation due to ongoing exposure to air pollution or mold toxins. Determining the root cause of inflammation is just the first step.
Next, the inflammatory agent or cause should be removed. Once that’s resolved, preventing further inflammation is essential. Several excellent anti-inflammatory alternatives to drugs (NSAIDs) include curcumin, fish oil or krill oil (omega-3 fats), ginger, and cinnamon.
Fifth, we must treat chronic pathogens. Chronic undiagnosed infection can be a contributing factor in cognitive decline. It needs to be identified and targeted. We all live with more than a thousand different species of microbes.
Even the brain may harbor bacteria, viruses, spiral bacteria, fungi, or parasites. Our brain’s protective response to these pathogens causes the very changes we call Alzheimer’s disease. The goal here is to reach and maintain a balance of these microbes.
Addressing Toxin Exposure
Sixth, the Bredesen Protocol emphasizes the need to identify and remove toxins. Metals such as mercury, organics like toluene and benzene, and biotoxins like mold toxins (mycotoxins) can lead directly or indirectly to cognitive decline.
The final Bredesen Protocol is to rule out sleep disorders and optimize sleep. The amount of oxygen saturation in our blood as we sleep can plummet, which affects our brain’s optimum functioning. Oxygen saturation can be a significant contributor to cognitive decline.
Thankfully, it’s also easily addressed. A dental device or CPAP device can improve oxygen intake through the night. On the other hand, simply reducing inflammation or weight can improve many people’s oxygen saturation and cognition.
That’s why it’s necessary to have a personalized program implemented by a qualified practitioner based on individual lab and other testing results.
Identifying and targeting the various contributing factors, even down to genetics, with a plan for removal, resilience, and rebuilding can tip the scale in preventing and even reversing Alzheimer’s disease. Early identification and treatment show the greatest promise.
The Bredesen Protocol is based on 40 years of research and the Amyloid Hypothesis, which has found that beta-amyloid accumulates and finds its way into synaptic clefts. This protein interferes with synaptic communication.
The amyloid then collects, forming plaques that activate enzymes. This leads to the formation of neurofibrillary tangles (NFTs) inside the neuron. NFT formation activates immune cells called microglia surrounding plaques, promoting microglial activation and local inflammatory response and contributing to neurotoxicity.
Bredesen’s 6 Alzheimer’s Subtypes
- Type 1 Alzheimer’s disease is inflammatory, or hot
- Ongoing or chronic inflammation puts you at greater risk for developing Alzheimer’s
- Type 2 Alzheimer’s disease is atrophic, or cold
- Sub-optimal levels of nutrients, hormones, trophic factors (cell growth factors like NCF, nerve growth factor) increases your risk for Alzheimer’s disease.
- Type 1.5 Alzheimer’s disease is glycotoxic, or sweet
- High blood sugar or high fasting insulin levels increase your risk for Alzheimer’s disease. It is termed Type 1.5 because it has features of both Type 1 and Type 2. High cholesterol may also come into play.
- Type 3 Alzheimer’s disease is toxic, or vile
- Exposure to toxins such as mercury, toluene, or mycotoxins (made by certain types of mold) leads to an increased risk for Alzheimer’s disease. Although we all experience this exposure to a greater or lesser degree, the key is to minimize it by identifying and removing or minimizing exposures.
- Type 4 Alzheimer’s disease is vascular, or pale
- If you have cardiovascular disease, you are at an increased risk of Alzheimer’s disease. Vascular leakiness is one of the earliest changes identified in Alzheimer’s disease.
- Type 5 Alzheimer’s disease is traumatic, or dazed
- A history of head trauma — from accidents, falls, or repeated sports-related head injuries — increases your risk for Alzheimer’s disease.
Most patients with Alzheimer’s disease have more than one type and present multiple risk factors.
Does the Bredesen Protocol work?
Perhaps this is best answered as a few separate questions about how, and if, this Alzheimer’s treatment protocol works.
What is the Bredesen Protocol used for? The Bredesen Protocol is a multi-faceted, holistic, and functional approach used to enhance cognition and reverse cognitive decline.
The treatments called for in the Bredesen Protocol are very individualized and have shown success in clinical trials of Alzheimer’s disease patients.
Does the Bredesen Protocol work? When the lifestyle changes and treatment plan are implemented at the onset of symptoms, the Bredesen Protocol may work to slow the progression of the disease.
Can the Bredesen Protocol reverse or cure Alzheimer’s disease? There is no cure for Alzheimer’s disease. However, Dr. Dale Bredesen’s research has culminated in the first program to prevent and reverse some cognitive decline for many participants following the treatment plan’s rigorous lifestyle, nutrition, and health/environmental changes.
However, not everyone agrees. According to the University of California, this is due to the sometimes subjective nature of the research and apparent improvement.
How much does the Bredesen protocol cost? The Bredesen protocol isn’t a “program” or “treatment plan” that comes at a specific cost. Depending on your provider, location, and what parts of the protocol you choose to follow, the cost will vary greatly.
Research indicates, however, that traditional informal care for Alzheimer’s disease is estimated at $10,400 to $34,517 per patient per year.
Is the Bredesen Protocol as effective as current pharmacological treatments for Alzheimer’s disease? The Bredesen Protocol is effective in different levels depending on the patient. Patients with subjective cognitive impairment and mild cognitive impairment (at the onset of symptoms) see the most vivid improvement.
Current treatments for neurodegenerative diseases like Alzheimer’s disease have only shown limited improvement for a small percentage of patients’ symptoms. Yet, they show no positive effect on the progression of the disease.
Strategy #1: Diet
The human brain is “enormous in comparison to our body size. About 500 trillion synapses in our brains act as neuron cell connectors, mediating communication. This nonstop activity demands a constant and steady fuel source” (Bredesen, 2020, p. 86).
Since we now know a great deal more about what drives cognitive decline as well as obesity, insulin resistance, diabetes, and hypertension, it’s time for a new food pyramid — the Brain Food Pyramid. It will help meet the nutritional needs of our metabolically demanding brains.
What is the Bredesen diet? The Bredesen diet is a method of intermittent fasting, eating anti-inflammatory foods, promoting gut health, and avoiding dairy and sugar.
Can Alzheimer’s be reversed with diet? Diet can’t reverse Alzheimer’s, but it can have a significant impact on reversing the effects of cognitive decline if implemented early in the disease.
Bredesen’s dietary protocol is broken into 5 “pyramid” levels:
- Fasting (Clean House)
- The right foods (Indulge Freely)
- Gut health (Upgrade Your Gut)
- Protein sources (Choose Wisely)
- Foods to avoid (Risky Business)
Pyramid Level 1: Fasting [Clean House]
“Fasting promotes the restoration of insulin sensitivity, which leads to an improvement in cognition” (Bredesen, 2020, p. 93). Restoring insulin sensitivity encourages our body’s systems to burn fat for fuel, rather than glucose.
Metabolic flexibility to utilize either glucose or ketones for fuel allows our bodies to engage in healing more effectively.
The Bredesen Protocol encourages participants to fast for at least 12 hours between supper and breakfast and start the fast at least 3 hours before bedtime (12/3).
Sleep allows the body to enter a fat-burning state for maximum detoxification. ApoE4 carriers may even want to extend their fast to 16+ hours for optimal effectiveness.
Maintaining a minimum BMI of 18.5 percent for women and 19.0 percent for men under age 65 is recommended. For those over age 65, it should be a bit higher.
You should not allow your weight to drop below these BMI levels because it increases your risk for loss of lean muscle mass, loss of bone, and cognitive decline.
Pyramid Level 2: The Right Foods [Indulge Freely]
“Go crazy in the produce aisle or preferably in your garden or local farmer’s market” (Bredesen, 2020, p. 102). Choose mainly non-starchy vegetables. Cruciferous vegetables are some of the most powerful and nutrient-rich vegetables to add to your meals.
Include fruits (disguised as vegetables) such as avocados, olives, and tomatoes, which are rich in beneficial fats and carotenoids.
“Older adults, with a diet rich in carotenoids combined with omega-3s, displayed improved cognitive performance and greater network efficiency in the brain” (Bredesen, 2020, p. 107).
Consume 6-9 cups of “deeply pigmented, organic, seasonal, local, non-starchy vegetables per day, gradually increasing the amount” (Bredesen, 2020, p. 109). Leafy greens and cruciferous vegetables should be included.
Fresh spices (such as turmeric and saffron), herbs (such as parsley, basil, cilantro, rosemary, sage, cumin, mint, and many others), and teas (like Matcha or green tea) which contain the flavonoid epigallocatechin-3-gallate (EGCG) should be included.
Pyramid Level 3: Gut Health [Upgrade Your Gut]
“Gut health is the foundation of any health program, and it represents an important opportunity for therapeutic intervention in cognitive decline” (Bredesen, 2020, p. 129). The gut microbiome is the basis for a healthy functioning body and all of its systems.
Bone broth has been found to help heal leaky gut. However, it should be limited to several servings per week.
The root causes of any chronic Gi issues should be addressed. Gradually introduce more prebiotic fiber into each meal. Also, experiment with adding various probiotic foods into your new diet.
Pyramid Level 4: Protein Sources [Choose Wisely]
“Methionine restriction is associated with a more favorable metabolic picture and longevity” (Bredesen, 2020, p. 152). This essential amino acid is found in muscle meat. Another essential amino acid, glycine, is located in collagen, bone, skin, and organ meat. These amino acids should be balanced with other amino acids to optimize health.
Wild-caught seafood and pastured eggs should be prioritized. 0.8-1 gram/kilogram of lean body mass is a healthy limit for non-plant proteins. Heirloom seasonal fruits, small portions of wild berries, and small amounts of unripened tropical fruit provide natural digestive enzymes.
Lemons and limes can be enjoyed liberally since they are excellent sources of vitamin C.
Pyramid Level 5: Foods to Avoid [Risky Business]
Small amounts of chocolate high in cacao and low in sugar allow you to derive the health benefits of flavonoids. However, you should avoid cocoa and cacao powder.
Avoid all conventional animal dairy and sugar. Alcohol is a neurotoxin and should be avoided if you are suffering cognitive decline or at risk of cognitive decline. Xylitol (a sugar alcohol), honey, pure monk fruit sweetener, and stevia should be used in limited amounts.
Strategy #2: Exercise
“Your body was designed to move — a lot” (Bredesen, 2020, p. 200). Strength training and aerobic exercise are important for brain health.
Aerobic exercise appears slightly better for maintaining and improving the cardiovascular system’s efficiency and has been found to delay cognitive function decline.
Strategy #3: Sleep Hygiene
Optimizing sleep is possible. Applying sleep hygiene strategies may look like:
- Setting a regular sleep schedule
- Following your unique circadian rhythm
- Setting and hitting sleep goals appropriate for your age range
- Limiting caffeine
- Exercising earlier in the day
- Winding down before bed
- Removing the TV from the bedroom
- Blocking blue light, particularly in the evenings
These methods can help improve your sleep and optimize its therapeutic power. One more tip: ensure your bed is free of potential toxins.
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Strategy #4: Stress Reduction
“Preventing or managing stress… has an antiaging effect, and clearly this is an important part of any optimal strategy to prevent or reverse cognitive decline” (Bredesen, 2020, p. 227).
Stress reduction can also lead to more positive mental health and better quality of life. Practice being fully present in the current moment. Don’t overschedule. Know your limits. Forget multitasking: Feel free to unplug and focus on the task at hand.
And don’t forget to breathe.
Strategy #5: Brain Stimulation
“Our brains continue to grow new neurons throughout our lives in response to social and mental stimuli as well as during healing from trauma or injury” (Bredesen, 2020, p. 238). The brain has the ability to grow and adapt, a quality called neuroplasticity.
Challenging our brains throughout our lives provides the opportunity for continuous growth.
Feeling a sense of purpose is a determining factor in overall health and mortality. Choose to never stop learning, from sudoku puzzles to new hobbies, and continue enriching your mind even after retirement.
Challenge yourself to learn something new (i.e., a new language, a musical instrument, dancing, etc.). Do not look at aging as a time to mentally retire and downsize. Focus on new areas of interest, meet new people, and follow your passions.
Strategy #6: Oral Hygiene
“When you are taking care of your dentition, you are helping to prevent cognitive decline” (Bredesen, 2020, p. 252). Moving toward and maintaining a healthy oral microbiome is key to minimizing the access of oral pathogens to your brain and preventing chronic systemic diseases as well.
Other Features of the Bredesen Protocol
Reducing stress is vital for overall health. The Bredesen Protocol encourages regular practices like prayer and meditation.
What do you need to do to get started on the Bredesen Protocol? Finding a supportive community partnering with healthcare professionals can help you successfully make the diet and lifestyle changes recommended in the Bredesen Protocol.
Identifying, Reducing Exposure, and Detoxifying “Dementogens”
Dementogens, or chemicals that contribute to cognitive decline, can be identified by lab tests. If present, it’s vital to detoxify these dementogens. Making yourself aware of your exposure to toxins and finding ways to minimize it is crucial for cognitive success.
Optimizing Gut Health and Reducing Infections
Infectious agents such as Borrelia, Babesia, Bartonella, Ehrlichia, or Anaplasma may live within our systems for many years without being detected. Viruses, too, may live inside us for decades. Any of these could be a source of chronic inflammation and elevate our risk of cognitive decline.
In Bredesen’s book, he dedicates a chapter to supplements that can help with multiple areas. Supplementation may reduce systemic inflammation, achieve insulin sensitivity, improve memory, increase focus and attention, and support our mitochondrial function, among many potential uses.
Talk To a Qualified Bredesen Protocol Provider
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- Bredesen, D., Perlmutter, D. (2020). The End of Alzheimer’s Program: The First Protocol to Enhance Cognition and Reverse Decline at Any Age. United States: Penguin Publishing Group. https://www.google.com/books/edition/The_End_of_Alzheimer_s_Program/0vO_DwAAQBAJ?hl=en&gbpv=0
- Beeri, M. S., & Sonnen, J. (2016). Brain BDNF Expression As A Biomarker for Cognitive Reserve Against Alzheimer Disease Progression. Neurology, February 23, 2016; 86 (8) DOI: https://doi.org/10.1212/WNL.0000000000002389
- Bredesen, D. E., Amos, E. C., Canick, J., Ackerley, M., Raji, C., Fiala, M., & Ahdidan, J. (2016). Reversal of Cognitive Decline in Alzheimer’s Disease. Aging, 8(6), 1250–1258. https://doi.org/10.18632/aging.100981
- Hellmuth, J. (2020). Can We Trust The End of Alzheimer’s?. The Lancet Neurology, 19(5), 389-390. Citation: https://pubmed.ncbi.nlm.nih.gov/32333896/
- Gustafson C. (2015). Dale E. Bredesen, md: Reversing Cognitive Decline. Integrative medicine (Encinitas, Calif.), 14(5), 26–29. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712873/
- Casey, D. A., Antimisiaris, D., & O’Brien, J. (2010). Drugs for Alzheimer’s Disease: Are They Effective?. P & T : a peer-reviewed journal for formulary management, 35(4), 208–211. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873716/
- Dominy, S. S., Lynch, C., Ermini, F., Benedyk, M., Marczyk, A., Konradi, A., … & Potempa, J. (2019). Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Science advances, 5(1), eaau3333. Full text: https://advances.sciencemag.org/content/5/1/eaau3333?intcmp=trendmd-adv
- Rice, D. P., Fillit, H. M., Max, W., Knopman, D. S., Lloyd, J. R., & Duttagupta, S. (2001). Prevalence, Costs, and Treatment of Alzheimer’s Disease and Related Dementia: A Managed Care Perspective. American Journal of Managed Care, 7(8), 809-820. Abstract: https://pubmed.ncbi.nlm.nih.gov/11519239/