Monday, April 16, 2018

Dementia and Alzheimer's: The Bredesen Protocol

I have to emphasize that what is written here is purely MY OPINION and should not be used as an alternative to advice from a medical professional.  

A few days ago I received an email from a friend asking if I knew anything about Dr. Bredesen.  She had recently attended a presentation of The Broken Brain which recommended something called The Bredesen Protocol.  Pronounced Bread'-eh-sin, it's being hailed as both a preventative AND A CURE.   Really?  A cure?  I was skeptical.

I spent several days researching and I was pleased with what I found.  I was on the brink of signing myself up!  But when I tried to do that I found many reasons why I shouldn't go through with it, and I didn't.  I will describe in detail what I learned further down the page but here's my bottom line:

The Bredesen Protocol APPEARS to be both a preventative and a cure
that corroborates the conclusions I had reached on my own and 
presents a supposedly personalized plan for you to follow; 
BUT, his business model is horrendous!  
I refuse to support it:
It is EXTREMELY DIFFICULT to get information on the program and the practitioners
You have to PREPAY $900 just to be considered for the program
If you don't qualify, you do NOT get your $900 back.
Most of the program is NOT covered by insurance (of course) and it is VERY expensive.
They are training 'practitioners' at breakneck speed
The 'practitioners' appear to have wildly different qualifications
You cannot talk to the practitioners, to vet them, until after you PREPAY
The secrecy and insistence on prepayment make me suspicious and reluctant to trust them

If you're interested in how I came to this conclusion, keep reading.

His book, however, IS PHENOMENAL!  




I have to thank my friend for alerting me to this protocol!  Dr. Bredesen has consolidated most of the research I've done and suggests the lab tests you need to devise a treatment plan and to monitor your progress.  Keep reading for the few things he missed.

Listening to this video, I was VERY IMPRESSED with Dr. Bredesen's knowledge.  Apparently, there is now  SCIENCE supporting the nutritional and lifestyle advice that functional/restorative medicine doctors have been advocating FOR YEARS!   

If you aren't familiar with the terms, functional and restorative doctors don't treat symptoms, they look for the cause and work to eliminate it.  They make their money by curing you.  Here's a cartoon from one of my favorite restorative doctors, Dr. Peter D'Adamo:

Back to the Bredesen Protocol.

Based on the video mentioned above,  I wanted to know more.  It SOUNDED LIKE this man had connected all the dots I'd been reading about for the last 10 years.

There was no information online regarding where the doctor is located or how to make an appointment so I ordered his book.  While I was waiting for it to arrive I found this WONDERFUL website which summarized the book!

Based on this summary I believe the protocol has merit.

Bredesen explains that the amyloid plaque characteristic of Alzheimer's is your body's way of protecting you from the three main causes of the disease. You can 'get' Alzheimer's from one or more of the following conditions:
1. inflammation/glycotoxicity (glucose/insulin imbalance),
2. endocrine problems, and
3. toxins/infections.  

In order to design a treatment plan, multiple lab tests are done to determine your current levels of the markers for these conditions.  They also test for leaky gut, leaky brain, and food sensitivities.  AND, they test for the APOE gene which is one of the markers for Alzheimer's.  They claim that insurance will pay for these tests...

Using the results of the tests, they design a program to first normalize and then OPTIMIZE your health.  THAT IS REVOLUTIONARY, in my opinion.  Most doctors ignore everything in the 'normal' range and address only the abnormal readings.  

Even if I was not concerned about cognitive decline, 
I would do these tests!

Using the test results, the Bredesen Protocol claims to accomplish 4 things:

1. treat the underlying cause
2. change lifestyle factors to prevent it from reoccurring
3. restore all biomes
4. optimize hormones and other biomarkers.

I have started reading the book and I am VERY IMPRESSED WITH IT!
I will update this review as I uncover additional nuggets of wisdom.


Bredesen's research identified 36 contributors to cognitive decline.  I am still looking for that list and might need to compile it as I read the book.  There are two chapters on how to manage these contributors, there is a synopsis on page 233, and there are workarounds on page 249.

One of the biggest risk factors for cognitive decline is a gene called APOE4.  There are many pages devoted to describing how this snp changes your internal processes and how to overcome them.  What I didn't find is how to determine whether you have APOE4.

If you have had your genome decoded, here is an excerpt from Self Decode to help you do that:
The Major "C" allele is associated with Alzheimer's Disease
  • rs429358 (C;C) + rs7412 (C;C) = APOE4/APOE4 (Bad) = 12x for late-onset Alzheimer's and 61x for early-onset disease [R].
  • rs429358 (C;T) + rs7412 (C;C) = APOE4/APOE3 (Bad) = >3x increased risk for Alzheimer's; 1.4x increased risk for heart disease  [R].
  • rs429358 (T;T) + rs7412 (C;C) = APOE3/APOE3 (Good)
  • If the allele of this SNP is "C" and the same chromosome also harbors the rs429358 "C" allele, the combination is known as an APOE-ε4 allele. The APOE-ε4 allele has a strong influence on the risk of Alzheimer's disease.
The Minor "T" allele is associated with Decreased Alzheimer's risk:
  • When rs7412 and rs429358 are both T (for the two SNPs located on the same chromosome) this is known as the APOE2 allele. APOE2 indicates a reduced risk of Alzheimer's disease.

HOWEVER, even if you don't have the APOE risk factors, you are not risk-free.  He identifies three types of non-APOE related dementia/Alzheimer's.  And, he explains how to overcome them.

Listed below are the areas he discusses - the things that contribute to cognitive decline - all those things restorative practitioners have been warning  us about for years:

Vitamins B, D and E
Insulin resistance
Heavy metals
Cholesterol and other lipids
Leaky gut
Blood brain barrier permeability
Gluten sensitivity
Autoimmune antibodies
Mitochondrial function
BMI (body mass index)
Genetics (he doesn't mention MTHFR)
Quantitative Neurophysical Testing
Cerebrospinal fluid and Electrophysiology
Historical and lifestyle:
head trauma
general anesthesia
dental amalgams
high-mercury fish
medications like valium, antidepressants, HBP meds, statins, PPIs (reflux), antihistamines
street drugs
oral hygeine
surgical implants
liver, kidney, lung or heart disease
snoring/sleep apnea
hot-pressed or refined oils
foods high in trans fats or simple carbohydrates
chronic sinus problems
GI problems like bloating, constipation and diarrhea
mold exposure
processed foods and foods that are grown/raised conventially
tick bites and related diseases like Lyme
use make-up, hair spray, or antiperspirant
don't sweat much
don't drink enough purified water.

On page 167 is a summary of the key tests with target values.  This is one of the most valuable parts of the book!  (NOTE: the only gene he tests for is APOE (using 23-and-me), and he does recommend the Mercury-Tri-Test from Quicksilver.)  The other valuable part is the methods used to achieve the targeted values.  (The book's index isn't the best.  The test summary isn't listed and neither are the individual tests.  You have to read the whole book and mark them yourself.)

Although the suggested lab tests are expensive, they help you fine tune your protocol.  You take only the supplement's needed to address imbalances, and make only those lifestyle changes needed to achieve balance.  The recommended supplements can cost from $150-$450 per month .

I suspect that the lab tests are also extremely motivating because they give you precise goals against which you can measure your progress.   You KNOW what numbers you need to change and it must be thrilling to monitor your progress. 

Once you start the program, the labs and report are rerun periodically to monitor your progress.

Here are the things that concern me about the protocol:

The recommended diet is ketogenic - high in protein and fat, low in carbs, high in sulfur and goitrogens (cruciferous veggies).  This advice is corroborated by my other research but could be disastrous for some people

On page 257, organic food is recommended but not required unless you are sub-type 3 - toxic.

His explanation of this sub-type is that they are dangerously low in zinc.  Hmmm.... mercury and glyphosate (Round-up) both prevent zinc from being absorbed.  He mentions that removing amalgam fillings often results in improvement but he never makes the jump from there to detoxing heavy metals, and from there to detoxing chemicals even though he admits that chemicals are causing the problem.  WHY?????  (And why, given the research connecting glyphosate to inflammation and endocrine problems, does he only require organic for sub-type 3?)

On pages 136 and 211 he addresses metal toxicity.  He does recommend removing dental amalgams but he glosses over detoxing in general.  He mentions chelation but recommends, "A gentler but equally effective method ... is Detox Qube from Quicksilver."  Detox Qube is definitely an option for people who don't have an MTHFR snp.

The book lists some of the other supplements they use but detoxing is not as easy as taking supplementsIf toxin removal isn't done correctly the toxins released from the places your body hides them can be REABSORBED in places where they can do a LOT OF HARM!  Like your brain!  You MUST work with a qualified toxin removal specialist! 

Another thing they do not address (in the book) are genetic SNPs that impact all of the markers they test for.   For instance:

MTHFR genes control your methylation pathways - the routes your body uses to remove toxins.  If you have any MTHFR snps you may have trouble processing both B vitamins and sulfur.  A diet high in cruciferous veggies, like the one they recommend, will not be beneficial until you correct those snps.  In addition, IF you are toxic and you attempt to remove those toxins without FIRST correcting any MTHFR snps you will make yourself very sick. It would be like pouring sewage into a toilet that's plugged up downstream. 

It is possible that the lab tests reveal the deficiencies these snps create, and his protocol suggests supplements to overcome them, but if you have a genetic snp supplements frequently don't work and can make the condition worse.  You must address the underlying cause.  

Excerpt from this EXCELLENT article by Suzy Cohen:
Do not take a lot of folic acid thinking you will just push the pathway into making glutathione! It won’t work, and besides, it can cause more problems. You need to address this problem slowly, after all, it took you years (decades) to get to this point!

It astonishes me that he doesn't address either MTHFR, since 50% of the population may be affected, or glyphosate (Round-up), since 100% of the population is affected.   Whether you're  sub-type3 or not, please look into MTHFR, heavy-metal detox, and chemical detox.  Start here.

Except for those two things, THE BOOK IS AMAZING! He mentions things like A2 dairy, grass-fed beef, pastured eggs, and processed foods!  Buy the book!!!

Personally, I would use parts of the book, not one of their practitioners.  Here's why: 

They are 'training' hundreds of practitioners at breakneck speed.  These practitioners do 3 things: order the lab tests, enter the lab results into the ReCODE program, and recommend supplements based on the resulting report.  How difficult can that be?  It must be EXTREMELY difficult based on what they charge....  Here are the hoops you have to jump through to get to talk to one of their practitioners:

When I contacted them and asked for a list of practitioners in this area I received a loooooong email recommending that I sign up for a Patient ReCode account using this 5 minute video as a guide.

Once you have created an account, you will be asked to submit the first of 12 MONTHLY $75 payments!   Eeep!  That's $900 just to check things out!   I'm curious, but not THAT curious. 

I (again) requested a list of practitioners in my area so I could inquire about their rates and received a list of about 20 within a 1000 mile radius (yes, they think 1000 miles is local).  But, *I* can't ask about their rates or philosophies, only the Bredesen office can do that.  And, if I find a practitioner whose rates are reasonable, I can't make an appointment until I pony up the $900 for the ReCODE account.

When I asked whether they could use the genetic data I had received from 23-and-me or  they refused to answer.  When I asked whether they take any genes into account other than the APOE genes they refused to answer.  When I asked whether everyone follows the same diet with different supplements they refused to answer.   You're buying a pig in a poke.  They will not share one shred of information without that $900.  Why?  (I think I know why.  Scroll to the bottom.)

I suspect it's because the 'practitioners' are merely data entry personnel.  They don't interpret the lab results, the ReCODE software does that and then they parrot it back to you.


Let's say you pony up the $900, there is a practitioner close by, and their rates are manageable.  What do you get for your money?  You would have access to the following:

UNLIMITED ReCODE reports (this is a good thing)
Complimentary Brain HQ Account (sounds like another good thing but what is it?)
Nutritional Guidelines for the protocol (crucial but isn't this in the book?)
Highest quality supplements delivered to you (might be useful)
Live Town Hall meeting with the doctor
Exclusive videos
Neural Agility Meditation
Patient Community Support Site
Exercise Tips
Sleep Hygiene
Several up to date health topics

ASSUMING you qualify for the program.  If you don't, you CANNOT GET A REFUND!  They will continue to charge $75/month for a full year. 

Honestly, this sounds like a shady racket to me.  If the protocol works as well as they claim it does,  why do they control access to the practitioners and require a non-refundable payment for reports they may never run?   Their business model makes me VERY SUSPICIOUS.

Here are some quotes from Bredesen's Facebook page:

The cost of participation is huge. $25,000 to $30,000. We went to a Dr in Tampa who was just trained in the protocol and the blood tests alone are $5,000.00. The Dr did not tell us anything about how the protocol works or even what's involved in it. We would gladly pay the money if it would help but I do not want to be taken advantage of when you will try anything to help or control the disease. But was advised by a number of people that it was not legitimate. My husband refused to go back to the Dr. If you can give me some insight that would be helpful.

Mary - for people with mild to moderate dementia, we definitely have success in halting and even improving the cognitive issues when we can uncover all of the factors that are contributing to the dementia and resolve these. It does require a lot of motivation from the patient and their family/caregiver to comply with the program. It requires changes in diet, daily exercise, daily brain training, daily meditation, and adequate sleep.

But the rewards can be huge! For the patients that I work with, I get a large majority of their laboratory testing done through their medical insurance. There are some specialty tests that may not be covered by insurance, but those might be on the order of $400-$500.

I hope you will find a practitioner to work with that you have confidence in. No one could promise that this program works for everyone, but we have definitely seen lots of success.

Wow, that's expensive. I looked at the training programs and even that is 1,550.00-1,800.00. I can't do that. My mom passed away from alzheimer's too.  

The book has been instrumental in being able to get potential patients to understand the multifactorial nature of cognitive decline. It provides a roadmap for them to follow and a tick box for me as a Bredesen trained practitioner. A great but no just for cognitive decline but healthy ageing. 

I am EXTREMELY disappointed in The Bredesen Protocol ReCODE program. We were extremely excited and hopeful to find a program that could help my dad with Alzheimer’s. However, to find a certified provider to get a consultation to learn more about the program and to see if my dad is even a good candidate, Dr. Bredesen’s ReCODE report makes you pay $75 just to get a name of a certified provider. But we did pay the $75 because want to learn anything that could possibly help my dad that is battling Alzheimer’s. We visited the certified provider. Unfortunately, we will not be able to participate in this program due to a number of reasons. And they will not give us a refund/cancellation of the ReCODE subscription which we will not be using at all, making us pay $75/ of $900 for nothing! When we aren’t able to use the site or Dr. Bredesen’s program. It is extremely disappointing to want to profit from families that are already suffering so much with a family member battling Alzheimer’s. Simply sad and heartless. I just feel it is really important for other people interested in the bredesen Protocol program before signing up. 


I do believe Dr. Bredesen's protocol is everything he says it is and that it is worth trying.  I really, REALLY wanted to use one of his practitioners; but his business model SUCKS and I refuse to support it.  If you do use one of his practitioners and you have a good experience, please let me know!

In the meantime


The more I think about it, the more I'm convinced that the reason for this business model is to prevent the practitioners from 'stealing' his patients.  Using the book, which has been out since August 2017 and can't be recalled, it's possible for any practitioner to follow the protocol without using the proprietary software. The software makes it easy but it isn't necessary, IMO.  In this light, the weird business model makes total sense.

The only benefit to using the software that I can think of is that it prevents human error - the software isn't going to miss something that manual analysis might miss.   There IS a benefit to using a restorative practitioner, though, as they will be able to help you fine tune your protocol.  It's too bad his business model precludes this.  I recommend you find a restorative practitioner you trust and see if they're willing to work with you (the benefit to them would be experience in the Bredesen Protocol without having to go through his training). 

Buy the book, 
have your doctor order the lab tests, 
and then use the book to interpret them and design a program for  yourself. 
Or, even better, find a restorative practitioner willing to work with you. 

If you're toxic, make sure you work with a qualified practitioner to remove toxins safely!

NOTE:  The book is not an easy read.  It's full of background and explanations WHY, which are crucial IMO.  If you are already suffering from brain fog or other cognitive decline, it might be challenging to read, understand, and then follow through on his suggestions.  In that case, you WILL need someone to guide you.  Whether that's a family member, a restorative practitioner, or a Bredesen practitioner is, of course, up to you. 

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