Hormones and Alzheimer’s: Prevention & Treatment
Hormones and Alzheimer’s: Prevention & Treatment
In keeping with my intent to provide a literature update/review that goes beyond that which is taught in the Hormone Optimization series, I wish to address another organ and system that is of utmost importance, but that is not well addressed by mainstream medicine at the 7th Annual Summit: Breakthroughs in Brain Health, CVD, and Autoimmunity. Rather, what disease entity should we review that, similar to hormone replacement for menopause and andropause, mainstream medicine remains oblivious to despite a plethora of data and scientific literature supporting benefit of multiple therapies? Although I touch on the topic throughout the Hormone Optimization Series, I would like to provide all the latest and greatest literature in a review of the topic that is of such great importance from a functional and morbidity perspective, but for which mainstream medicine ignores, and that is Alzheimer’s disease and other dementias – the multiple pathways and causative factors, prevention, and treatment. The pharmaceutical world still provides no significant prevention or treatment for Alzheimer’s disease and dementia. And much to my dismay and disappointment, I read daily in the medical newsletters that there is no treatment or preventive therapy for AD. Nonsense.
Current Literature and Knowledge in Dementia Prevention
Each day that I spend hours reading and researching various medical journals, I am amazed at the literature and data that address various modalities and treatments that are successful in treating and protecting against all types of dementia but are seemingly ignored without explanation. I am disappointed that the specific medical specialty that should address and focus on these issues, and the one specialty that you would expect to be on the front line of defense, is neurology. But it’s not.
In my experience, the specialist that knows the least about dementia prevention but should, is a neurologist (Ken Sharlin excluded as well as other Worldlink Medical/APIM neurologists). Sadly, most neurologists know little about prevention, treatment, and reversal of dementia and AD. In my residency the neurologists were referred to as gardeners because all they did was walk around and water their vegetables as there was nothing else that they could do or offer. Similar to CVD and the cardiovascular world and DM and the endocrine world, neurologists are great at diagnosing the disease, but no one focuses on prevention, or reversal of the disease despite the plethora of studies proving benefit of multiple therapies and interventions. One of our esteemed Worldlink/APIM trained professionals, Dr. Ken Sharlin, is the foremost expert in understanding, diagnosing, treating, and reversing AD and he will share his pearls with us in his lecture at the 7th Annual Summit: Breakthroughs in Brain Health, CVD, and Autoimmunity in September. Ken will inform us of everything that we will need to know on Monday morning, from a diagnostic work-up, to a function medicine perspective, pharmacologic perspective, nutritional and life-style change perspective, and when to refer your patient for specialist evaluation.
After Dementia Diagnosis
Finally, what does one do after a diagnosis of dementia? Since hormones are verboten in neurology because they increase the risk of dementia and AD as seen in the WHI study, just what is one to do other than letting patients suffer? Again, we must resort to medical science and literature to support what we do and why, but most doctors are not prepared to analyze and interpret medical studies. In fact, most will interpret studies and data incorrectly. Therefore, I will also present why the rest of the world does not understand hormones, particularly when it comes to AD and dementia. And, sadly, I’ll present all the data demonstrating that high levels of estradiol are associated with increased AD and dementia in both men and women. (They just don’t get it).
Conversely, I will extensively review all the recent data on prevention and treatment of the common forms of dementia that are not understood or embraced by the rest of the world. Oh, and I almost forgot. What specialist is the best at preventing dementia 30 years before it becomes clinically evident? Look in the mirror – it’s you.
Once you see the literature I will review for you, one can appreciate that it requires a firm grasp and understanding of how to interpret the medical literature that most clinicians, subspecialists, and patients don’t possess, particularly with respect to hormones and AD. Ken is an expert in hormone replacement thereby making him an expert in AD and dementia. Dale Bredesen appreciates the importance of hormones, however, upon reading his book it is evident that he has no grasp of, with all due respect, which hormones are both beneficial and recommended, which ones are neutral, and which hormones should be avoided. We’ll review all those outcome studies published in Neurology and Alzheimer’s Journals that are missed and ignored by the ROW. Jorge Peleaz, another Worldlink Medical neurologist, is also publishing a book on the treatment of dementia.
Listening to Dale Bredesen’s lecture was very entertaining and insightful, particularly when he provides case examples and success stories. However, when all was said and done, I did not come away with anything helpful that I could apply on Monday morning to better help my patients. Nor did I find anything spectacular to better help me work up my patients that may be later prone to develop AD. My goal is to not let that happen at the 7th Annual Summit: Breakthroughs in Brain Health, CVD, and Autoimmunity.
So, Dale emphasizes that AD is evident at least 30 years before symptoms become clinically manifest. Should we do FDG-PET scans on everyone or are there other factors, avenues, thought processes, and tests that we should entertain first to protect against the disease process without breaking the bank on tests that may be futile? Then, what other surrogate tests and work-ups should we be doing?
Although the name of my clinic is “Preventive Medicine Clinic,” most patients and clinicians have no clue as to what type of medicine I practice or treatments that I offer. I personally view metabolic aberrations, mitochondrial dysfunction, inflammation, autophagy, DM, CVD, NAFLD, and cancer as being part of the same, complex disease process. And Alzheimer’s disease and other common dementias are no different. Sure, there will be the rare genetic causes of dementia that defy any treatment that we can offer (those get referred to Ken), nevertheless, I want to focus on any prevention strategy for the average patient that we see on a daily basis.
What can we do as for the work-up and treatment of all our patients 30 years before the disease becomes manifest? Of course, if we utilize preventive medicine to protect against the aforementioned entities, we might never have to refer any patients to Ken if we can prevent dementia in the first place. At 7th Annual Summit: Breakthroughs in Brain Health, CVD, and Autoimmunity, we will look at the various disease pathways to dementia and dissect them, discover that which is good and bad for prevention, and how to optimize it with drugs, hormones, supplements, life-style change, and avoid environmental toxins. If we can affect the intracellular gene promoters and suppressors and understand the body’s various defense mechanisms and optimize the removal of cellular debris by microglia before it damages neurons, then perhaps we can attain Bredesen’s goal of not seeing AD by the year 2050.