Maintain Your Brain – Part 3: Addressing the Threats

Why Anti-Alzheimer’s Drugs Don’t Work All By Themselves

Dr. Bredesen and his research team have identified thirty-six individual factors that contribute to the risk for Alzheimer’s. If enough (or a critical combination) of these factors exist, Alzheimer’s sets in. A prescription drug such as memantine may address one factor but leave other factors unaddressed so the progression into Alzheimer’s is not halted. However, in combination with other components (e.g., nutritional, exercise, sleep patterns), certain drugs may help the individual stay healthy or regain his or her health.

Dr. B uses the metaphor of a house with a roof that has 36 holes:

“ . . . drug companies have been like roofers called to a home that had been pummeled with baseball-sized hail. The storm left dozens of holes in the roof, which the homeowners would like fixed. Yet the roofers fixated on a single hole. They may have done a bang-up job of slathering that hole with roofing tar, keeping rain from pouring in. Unfortunately, they did nothing about the other thirty-five holes, and the home is filling up with so much rainwater the owners are looking up specs for an ark. I give the example of thirty-six holes because research in my lab has identified thirty-six different contributors to whether APP goes down the Alzheimer’s-causing or Alzheimer’s-preventing pathway.”1

“There is a threshold that needs to be reached in order to tip the balance toward APP’s anti-Alzheimer’s pathway. What this means is that you don’t have to address all thirty-six holes. When you have patched enough of them, the rest aren’t serious enough to let much water into your house. If we leave our roofing analogy to get back to Alzheimer’s, the presence of a few of the factors nudging APP down the Alzheimer’s-causing pathway isn’t enough to exert that nudge in enough of your brain neurons enough of the time to cause Alzheimer’s. Unfortunately, we don’t yet have a simple way to measure how many of the thirty-six each person can safely live with, and each hole is a different size for each person, depending on his/ her genetics and biochemistry, so it’s best to address as many as you can until you see improvement.”2

In a nutshell, as Dr. Bredesen puts it, “It makes no more sense to try to treat Alzheimer’s disease with a single agent than it does to treat a roof with thirty-six holes with a single patch of roofing compound.”A list of factors that may be contributing to Alzheimers – or the possibility that Alzheimers may develop – can be found here in Appendix A.

“. . . although no single compound can raise brain levels of synapse-supporting trophic factors, reduce inflammation, increase insulin sensitivity, and patch the other thirty-plus holes in the roof that contribute to Alzheimer’s, we can patch them all with the right combination. It requires determining which of the thirty-six contributors a patient had and then tailoring a treatment regimen— a regimen based in large part on diet, exercise, sleep, stress reduction, and other lifestyle factors”4. “Why more than 99 percent of the pivotal trials of experimental Alzheimer’s drugs have failed: They targeted only one of the thirty-six contributors to the disease.”

Now it’s time to turn to the first step in the ReCODE protocol: determining which of the three types of Alzheimer’s disease you have or are at risk for. This will allow you to fashion the optimal personalized program to minimize your risk and, if you are already experiencing cognitive decline, get back to optimal function. The first step toward doing that is determining which of the three major subtypes of Alzheimer’s or its precursors you’re dealing with: hot (inflammatory); cold (atrophic); vile (toxic).5  The three subtypes are described at length in pages 98 – 107 of Dr. Bredesen’s book.

How to stop the process leading to Alzheimer’s if it has already begun or to reverse Alzheimer’s if it has already taken hold:

Evaluate your genetic and biochemical status to determine where you stand, then address each identified contributor. Your very best option is to get The ReCODE Report and find a health care practitioner who has been trained in the ReCODE protocol. Here are the options provided by MPI Cognition founded and operated by Dr. Bredesen as they are presented on his website:

The ReCODE Report™

The ReCODE Report™ is generated from a very specific set of lab and genome tests curated by Dr. Bredesen. After the results are submitted, a personalized ReCODE Report™ is generated, providing a snapshot of the participant’s current state of cognitive decline. The goal is not simply to normalize metabolic parameters, but rather to optimize them. This personalized list highlights the participant’s primary areas of concern and suggests how to specifically address each issue.

The Prevention Program

The Prevention Program is designed for anyone with dementia in the family, or anyone at risk for Alzheimer’s disease. Utilizing Dr. Bredesen’s proprietary protocol, a personalized preventative program is generated to normalize all metabolic parameters to prevent the onset of cognitive decline. Please do not wait—get your numbers checked and stay sharp for decades.

The Reversal Program

We have designed an optimal program to stop the progression of cognitive decline and begin improvement—the only effective program to date. This is a comprehensive personalized program that utilizes the Bredesen Protocol to optimize many different metabolic parameters to enhance cognition and reverse cognitive decline.”6

You can learn how to participate in these programs by requesting it on Dr. Bredesen’s website:

To view a video of what is involved click here

Training in the ReCODE protocol is provided by the Institute for Functional Medicine (IFM) in cooperation with MPI Cognition. If you would like to find out if there is a health care provider near you who has been trained in the ReCODE protocol, inquire by email to [email protected].

How to reduce the risk of Cognitive Impairment (MCI leading to SCI and, potentially, Alzheimer’s):

If you’re not ready to enter the ReCODE program, but you have consulted a neurologist or are planning to consult one you may want to check to see if he or she is familiar with the results of the studies leading to the conclusions and recommendations of ReCODE. It is to be hoped that he or she is more thorough and helpful than this:

I’ll quote the notes from a work-up by a well-known neurologist who specializes in Alzheimer’s disease and practices at one of the country’s most outstanding academic centers for Alzheimer’s research and treatment: “MRI of the brain and blood for CBC (complete blood count), metabolic panel, thyroids, B12. I asked the patient and his wife to keep an eye on his disabilities to manage money, medications, and transportation. I prescribed donepezil 5mg once per day.”

This “gold standard” evaluation failed to include the following information: Genetics, Inflammation, Infections, Homocysteine, Fasting insulin level, Hormonal status, Toxic exposure, Microbiome, Blood-brain barrier, and Body mass index.

For the evaluation and treatment of cognitive decline, the current state of affairs is truly a sad one:

  • Patients often do not seek medical care because they have been told there is nothing that can be done. They fear the loss of their driver’s license, the stigma of a diagnosis, and the inability to obtain long-term care insurance.
  • Primary care providers often do not refer patients to memory clinics, since they have been taught that there is no truly effective therapy. Therefore, they typically simply start donepezil (Aricept), often without a firm diagnosis.
  • Specialists often put the patients through hours of stressful neuropsychological testing, expensive imaging, and repeated spinal taps, and then have little or nothing to offer therapeutically.7

If you’ve been with us this far, you may want to proceed to the next article in this series by clicking here: Maintain Your Brain – Part 4: The importance of Testing.


Bredesen, Dale. The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline). Penguin Publishing Group. Kindle Edition, p. 81

ibid, pp. 82-83

ibid, p. 89

ibid, pp. 91-92

ibid, pp. 97-98

ibid, pp. 116-118

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