Cognitive Decline

Cognitive decline: The Bredesen RECODE protocol

Using Functional Medicine to treat Alzheimer’s Disease

The search for a magic bullet has failed to reveal any monotherapy capable of yielding sustained improvements in Alzheimer’s disease (AD). This failure leaves the diagnosis as one of the most feared conditions of the modern age and dementia is now the leading cause of death in the UK.

A breakthrough for Alzheimer’s patients

However, with his truly ground-breaking research, Dr Dale Bredesen has demonstrated that the use of precision-medicine, with a Functional Medicine approach to the symptoms of cognitive impairment, can result not only in a halt in the cognitive decline in Alzheimer’s Patients but can even reverse the symptoms. This is a demonstration of the real power of understanding the pathophysiology, the WHY, behind the symptoms we call Alzheimer’s Disease or Dementia.

In his book ‘The End of Alzheimer’s’, Dr Bredesen discusses his research and its eventual transfer from the lab to the clinical coalface – helping to heal patients with dementia. In 2018, he published details of the reversal of cognitive decline in 100 patients using his RECODE protocol. We recommend both the book and the paper as foundation reading for families wishing to embark on the programme.

With these powerful insights and case studies, his research and approach offer hope to patients and families facing this condition and to those for whom the genetic dice are loaded in favour of developing the condition.

Dr Sarah is a keen advocate of this approach and is happy to see patients and families wanting support with the RECODE protocol and a precision-targeted Functional Medicine approach.

What is the ‘Bredesen Protocol’?

Dr Bredesen’s research has demonstrated that there are multiple metabolic factors (including disturbances in micronutrients, hormone levels, and sleep), which can trigger the changes seen in the brain in Alzheimer’s. Each patient is carefully screened for:

  • Insulin resistance
  • Inflammation / infections
  • Nutrient deficiencies
  • Hormone imbalances
  • Toxins (chemical, biological, and physical)

Through careful screening, the probable mediators of brain injury can be identified and tackled using well-established Functional Medicine therapies involving:

  • Dietary optimisation for maximal micronutrient benefits, blood sugar stabilisation and the induction of ketosis (in which state the brain is able to heal and repair due to increases in Brain Derived Neurotropic Factor /BDNF).
  • Reduction in inflammation and infections identified with antimicrobial therapies and immune system support.
  • Support for safe and effective detoxification of environmental toxins and heavy metals.
  • Hormonal optimisation with replacement therapy where indicated
  • Brain training
  • Targeted nutritional support for any methylation deficit or other metabolic imbalance detected.
  • Lifestyle changes to support brain healing through sleep, mindfulness / meditation and exercise.

This is by no means a simple undertaking and patients will usually require ongoing support from family members and perhaps extra input from our Health Coaching and Nutritional Therapy team.

If you would like to discuss our approach to dementia and cognitive decline further, please contact the clinic and book an appointment with our Doctors

Patient Testimonials for the Functional Medicine Approach to Cognitive Decline

How do you feel Functional Nexus has been able to help you?

Functional Nexus has been central to Mary’s effective implementation of the Bredesen Protocol. I felt very isolated initially when I tried to follow Dr. Bredesen’s guidelines. 

Within four weeks of me implementing Dr. Bredesen’s low-carb, mildly ketogenic diet, Mary told me she felt she had “woken up.” 

She responded very quickly to me changing her diet, and her brain had started to use ketones for energy, just as Dr. Bredesen said patients would. 

This gave us enormous confidence to go to Functional Nexus for help.

It was wonderful for both of us when Dr Sarah became Mary’s functional medicine doctor. 

The fear of isolation and facing the unknown without effective medical input eased considerably. Dr Sarah was able to study Mary’s metabolism and biochemistry and use her expertise to drill down to what were the main drivers of her Alzheimer’s.

It would not have been possible to deal with Mary’s complex needs, in particular, dealing with her high levels of toxicity in her system, which were probably one of the primary “causes” of her condition without Functional Nexus’s input. 

According to Dr Bredesen, Alzheimer’s caused by toxins is one of the most difficult to treat. It gave me the confidence to continue implementing what can feel like a complicated protocol, knowing I had the medical backup from Functional Nexus.

The advice in detailed reports from Functional Nexus was very insightful and full of incredibly helpful recommendations, suggestions, and tools. The advice regarding supplements that would be helpful to clear Mary’s toxins and improve metabolic health would have been impossible without Dr Sarah.

The help with treatment planning and nutritional guidance from Functional Nexus’s nutritionists was so useful because there is so much misleading and unscientific information in the public sphere.

I know how variable an illness Alzheimer’s is, and to have Dr Sarah giving guidance and support was invaluable. 

The Bredesen Protocol is difficult to implement, and the patient and the carer need support to manage it. Having medical support from Functional Nexus is a huge benefit that cannot be understated. This protocol is not a quick fix! 

Please, can you tell us what a day in the life of someone following the Bredesen Protocol is like? What’s made the biggest difference to Mary? 

Mary has maintained many of her ADLs whilst using the Bredesen protocol. She says she feels physically well and has lost a bit of fat from her tummy area; her BP is now normal after having previously been on medication for 20 years to reduce it. She has developed a lot of muscle tissue on her body using the regime outlined below. Her most recent MMSE cognitive score was 27/30, and she scored 80/100 on an Addenbrookes cognitive test, indicating mild cognitive deficits. 

This shows that Mary’s cognitive scores have improved by around 25%-30% since being on protocol.

I think one must be organised to plan and optimise the best interventions to overcome this dreadful degenerative disease. So, we have a regime that we follow as best we can. We don’t always succeed in achieving everything, but we don’t give ourselves a hard time when we don’t.

Mary’s Day:

Our day starts in the morning when we get up for our organic Nespresso coffee from Cru Cafe.

We then start with her Infrared helmet (6 mins) pioneered by Dr Dougal and Dr Chazot from Durham.

Then we do Kaatsu for about 15 minutes, 3/4 times a week.

We also use Joove infra-red panel 3/4 times a week.

We have just got a 1000 Roads Exercise Oxygen Therapy system, which we will use three times a week while Mary does her Jane Fonda exercises, which she enjoys.

It’s then around 8.30 to 9 AM so we have a large breakfast, keeping Mary’s carb intake to around 40-45 gm per day. 

Mary will have last eaten around 4-5 pm the previous day, so she will have fasted for 14 hours regularly. 

Everything we eat is organic, with no sugar, loads of vegetables via homemade soup primarily, eggs, different small fish, a variety of mushrooms, linseed bread or organic mince or chicken. A seed – berry-based smoothie every day. No processed foods at all. In the kitchen, we eat whatever we like, from low-carb foods to vegetables. Our kitchen has been cleared of any processed or high-carb foods. But we eat as we want. We never feel hungry because of our low-carb diet.

We drink filtered water from a Berkey filter.

Dietary supplements recommended by Dr Sarah are organised for the day.

We go out as much as possible and walk if the weather allows.

Mary tries to do her Brain HQ exercises, but that can be variable.

Mary eats a large meal again around 4 p.m. So, our daily eating period is roughly between 8 AM and 4 PM.

We watch TV, trying to focus on comedies.

Mary will go to bed around 7-7.30 pm because she’s usually exhausted by then. She sometimes uses the infra-red helmet for 6 minutes before going to bed. She uses the Sensate Vagus nerve device in bed, which she loves.

What have been the most challenging aspects?

In the beginning, understanding nutrition and Dr. Bredesen’s diet guidelines was the most challenging aspect for me. 

This was a steep learning curve, and it took some time and good input from nutritionists at Functional Nexus to help. 

I have drawn up my chart of foods we commonly eat, which gives a close estimate of the amount of carbohydrates, fats, and proteins in them to keep me from going off track. The ZOE App I used was super helpful in this regard. 

Learning about the different ways to encourage neurogenesis, primarily through exercise regimes, took time. Subscribing to YouTube was incredibly important in allowing me to find genuine experts online to guide me, including Dr Bredesen. Dr Sarah was very helpful in suggesting the Sensate device, which has been very effective as a sleep aid or when Mary occasionally has a panic attack.

A lot of determination and commitment to change is needed to carry out this protocol, and even with Dr Sarah’s help, it would not be possible to improve Mary’s situation if Mary hadn’t supported the process. A patient would need to have a mentor to manage the Bredesen Protocol. Mary would NOT be able to do this without my help. Dr Sarah’s input has been an essential tool for me to continue helping Mary. 

Mary’s recurrent and serious anxiety has been a principal obstacle in her treatment, and Dr Sarah has been very helpful in this regard.

Has it been worth the challenges? Would you recommend it to someone else?

Absolutely yes!

Mary’s cognition and daily activity skills have been maintained, and her quality of life has been protected. 

Mary’s individual needs are being met as best we can, and this would have been impossible without Dr Sarah’s medical input. 

We know that every Alzheimer’s patient is different because of the complexity of the disease. In Mary’s case, she happens to have the most difficult Alzheimer’s to treat, and it takes a long time to do so.

We cannot contemplate not implementing the Bredesen Protocol. The current NHS input is simply doomed to failure, and all the medical evidence confirms that. We are sure that the future of Alzheimer’s treatment will be consistent with the pioneering Bredesen Protocol. 

Without Dr Sarah and my Wife Karen, I would no doubt be in a darker place. They have given me limitless patience, the framework, and the motivation to not succumb to this unforgiving disease.

Dr Sarah has a vast, almost photographic memory of my case, which involves Alzheimer’s, prostate surgery radiotherapy, Hashimotos, and countless test results changing my regime as it unfolds—providing links to recommended reading on different aspects of my case.

How do you feel Functional Nexus has been able to help?

It has given me confidence that there is empirical evidence that the protocol helps and that it is the right path to tread if you want to maintain your marbles. 

I was doing really well until after about a year, I had an op for prostate cancer, and the androgen hormone treatment hit my memory and recall improvements; these are not fully recovered but are now fairly stable. 

However, with the APO4 gene and lead poisoning, I am grateful for treading water till I have eliminated the lead sufficiently in the hope that this will improve my mental agility. I still have 12 months to go before I get below the recognised safe level, and I am motivated to get there in the hope that it kick-starts my stalled brain training improvements, which is the only tangible self-administered measure I have. My brain training has improved my score from around 40 to mid-70, or even my early 80s, for my peer group.

Please, can you tell us what a day in the life of someone following the Bredesen Protocol is like? What’s made the biggest difference?

Bear in mind that I am on a Ketogenic diet, which Bredesen requires in his protocol. So, achieving ketosis is hard, but once done, it opens the door to easily achieving the fasting aspects. I think it requires 12 hours between dinner and breakfast, but I, being AP0E4, need a 16-hour gap. 

For the first two years, I managed 14 hours and three meals in eight to ten hours. I found time to cook and prepare three meals a day. All substantial and loaded with greens and fats, it did not give either the optimum 16-hour fast or the time to do things I enjoyed, or that were essential to daily living. I achieved 2x 36+ hour fasts and then a 72-hour one. This gave me the resolve to drop to 2 meals a day and helped reset my metabolism. Being ketogenic takes away hunger pangs since you are no longer hungry. This made a 16-hour fast daily a reality. 

Depending on the time pressures of a typical day, I would try to incorporate as many of the following into my day –

  • Four lots of pills and supplements a day, two with food and two without
  • A 4k run or half-hour resistance training
  • 20-minute lightbox session 
  • 30 minutes of brain training
  • Lunch at 2 pm and supper at 7.00 pm. 
  • I go to bed at 11 p.m. and rise again at 7, with an 8-hour sleep. I do not achieve this every day, but I achieve differing elements up to 5 days out of 7.

What have been the most challenging aspects?

Managing breaks, holidays, supplements, social events, especially diet, and perhaps relying too much on red wine and pork scratchings.

Has it been worth the challenges? 

There is no choice if you want to continue to enjoy life and family especially. 

Having had an experience with a relative with full-on Alzheimer’s, this is a safer and hopefully cheaper way of dying of something else first. 

Yes, this has been worth the challenges. I know that some people may think it’s too much of a commitment without certainty of not succumbing to this disease. For me, it has given me hope and a future.

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