Alzheimer's disease early detection - complete list of tests

I realised that all the tests where mentioned across few posts, sa maybe it will be easier if there is a list of them, with the normal values:

Genetics - ApoE -Ideally negative for ApoE4

Blood tests:

Inflammation AD (Alzheimer's disease)

-homocysteine - under 7

-vitamin B (B6 60-100, B12 500-1500, Folate 10-25)

-vitamin C 1.3-2.5

-vitamin D 50-80

-vitamin E 12-20

-Omega3:Omega 6 ratio 0.5-3.0

-A/G ratio (albumin/globulin) -more than 1.8/ albumin more than 4.5 

-fasting insulin - less than 4.5 (fasting glucose 70-90)

-A1c - less than 5.6

-BMI (body mass index) - 18-25

-LDL-p 700-1000

-cholesterol - more than 150

-HDL more than 50

-triglycerides - under 150

-glutathione 5-5.5

-RBC thiamine - 100-150

-Leaky gut, leaky blood-brain barrier, gluten sensitivity - negative

Trophic support AD

-vitamin D -50-80

-estradiol (E2) - 50-250

-progesterone -1-20

-pregnenolone -50-100

-cortison 10-18

-DHEA sulphate 350-430 women, 400-500 men

-testosterone 500-1000, free testosterone 6.5-15 free

-free T3 3.2-4.2, free T4 1.3-1.8, reverse T3 less than 20, TSH less than 2

Toxin related AD

-mercury less than 5, lead less than 2, arsenic less than 7, cadmium less than 2.5

-copper/zinc ratio 0.8-1.2

-C4a less than 2830, MSH 35-81

-RBC magnesium 5.2-6.5

-copper 90-110, zinc 90-110

-selenium 110-150

-potassium 4.5-5.5

-calcium 8.5-10.5

Microbiome - gut/oral/nasal - no pathogens

I hope this helps. You just read my previous posts to see if you are at risk and which way you need to improve. 

G.

Alzheimer's disease and two very important vitamins related to it

There are two important allies in the fight preventing Alzheimer's disease (AD). I am talking about the vitamin E and the vitamin B1. 

Vitamin B1, also known as thiamine, it is closely linked with the memory formation, which as you guessed, is one of the main problems in Alzheimer. When is defficient, due to alcohol abuse or malnutrition-associated memory loss, has the fancy name of Wernicke-Korsakoff syndrome. What you need to know is that there are foods containing thiamine-degrading enzimes (drinks like alcohol, tea and coffee, and some types of raw fish). Normal levels of thiamine are good for healthy cognition, so even if you are not suffering from ageing, cognitive decline and AD, it is ideal to keep healthy levels. The best way to measure it is by checking the thiamine pyrophosphate (TPP) in the red blood cells. The optimal value for TPP is between 100 and 150 ng/ml or, if you are doing serum thiamine, then the optimal values are between 20 and 30 nmol/l.

The second star of our story is the vitamin E, also known as tocopherol. To be more accurate, what we call in layman terms vitamin E is in fact a group of multiple molecules of tocotrienols and tocopherols. This set of compounds are protecting the fatty cell membranes from the damage done by the free radicals (and yes, i mean ageing), due to the powerful antioxidant action of the vitamin E. Even when is used alone, without any other treatmenSt, the vitamin E was shown to slow AD cognitive decline by some degree. The result were not spectacular, but they were proven to work. Anyway, you cannot expect to slow AD cognitive decline completely using only this vitamin. The optimal values for vitamin E (measured as alpha-tocopherol) are between 12 and 20 mcg/ml. 

In the next post i will try to tackle the link between the AD and the gastrointestinal permeability (leaky gut). 

Hope everyone is enjoying this beautiful day! Take care!

G.

Alzheimer's disease and the danger of lipids (i mean bad cholesterol, you know that)

Motto: “The idea is to die young as late as possible.” ― Ashley Montagu

This is a new ideology in the longevity research, and they are reffering at this as healthspan, as opposed to the idea of lifespan, that was used before. You need to aim to be healthier for as long as possible, not to live longer. As per the motto used for today post. Avoiding Alzheimer's disease and other forms of demetia should be one of our main priority. Let's continue our journey then. 

Testing for cholesterol is not a surefire diagnosis, as there can be people with high cholesterol and no vascular problems, aswell as people with normal cholesterol and significant vascular disease. The cardiovascular disease is a known contributor to the cognitive decline, which in turn can be a sign of Alzheimer's disease (AD) or vascular dementia. But do you know what is more dangerous than high cholesterol? Low cholesterol, as in brain decreasing in volume because of the lack of essential fatty acids. 

Quite a contradiction, isn't it? Measuring just the cholesterol can be quite ineffective in the AD risk assesment. But (there is always a but), there are some specific tests related to the cholesterol that can help you to undestand better the relation between lipids and AD. The tests and their normal values are:

1. LDL-p (LDL particle number) with normal values between 700-1000

2. OR sdLDL (small dense LDL) with normal values lower than 20 mg/dl (or 20% of the total LDL)

3. OR oxidised LDL with normal values lower than 60 U/L

4. total cholesterol with suggested values bigger than 150 (yes, bigger, not lower). 

I need to remind you that these are the recommended values for people at risk of AD, not for super-healthy young people. 

I am a bit tired now and i will go to sleep soon, but i will come back soon with another post about 2 essential vitamins (E - tocopherol and B1 - thiamine). 

Have a nice day!

G.

Alzheimer's disease and the secret weapon against it (the sleeeeeeeep)

Sleep apnoea is quite common, most of the cases are not identified (we are talking of 75% of the cases that are never diagnosed), and it is one of the factors contributing to the cognitive decline. The sleep apnoea is happening when your breathing will halt completelly for a short period of time, almost waking you up, and stopping you for reaching the deep sleep, the maximum regenerative time of our sleep. If you are snoring, you are old, overweight or have a short neck, then probably you have sleep apnoea. If you are chronically tired during your waking time, this may be also a cause. There are wearable devices that can detect sleep apnoea at home, or very expensive tests that require to stay overnight in a special sleep center. The conclusion is named AHI (apnoea-hypopnea index) and normal is less than 5, ideally zero, and a value of around 100 means that you have this condition. Basically AHI is measuring how many times per hour you stopped breathing. 

Let's explain a bit more what happen during the high quality sleep:

-the anatomy of the brain cells is altered, allowing cleansing, flushing out the amyloid-beta and other debris. During sleep, less amyloid-beta is generated.

- as we are fasting during sleep, the insulin sensitivity is reseted and improved. 

-during sleep the autophagy process is initiated, destroying damaged mitochondria and defective proteins.

-hormonally speaking, the growth hormone secretion is increased, repairing and producing new supportive brain cells.

-different reparative processes are initiated during deep sleep. 

Sleep deprivation can lead to impaired cognition, increased risk of obesity, diabetes and cardiovascular disease, all three of them increasing in turn the risk of Alzheimer's disease. 

Next post will be about the cholesterol influence on AD.

Alzheimer's disease, metals, heavy metals and other kinds of rock

Today i will talk about oligoelements, or as you know them minerals, or even metals present in our body and their link with mental health and AD (Alzheimer's disease). But what are these oligoelements? I will tell you, they are small amounts of chemical elements present in our body. If we do not have enough of them, defficiences will appear, as a result of specific pathologies, unbalanced diet, poor assimilation, excessive physical effort, soreness, fatigue and pregnancy, just to name few of the causes. Just to make a list, we are talking mainly about Silver, Gold, Bismuth, Calcium, Cobalt, Chrome, Copper, Fluorine, Iron, Iodine, Potassium, Lithium, Magnesium, Manganese, Molybdenum, Nickel, Phosphorus, Sulphur, Selenium, Silicon, Vanadium and Zinc. But for today we will only insist on those linked to AD risk factors. 

First, one of the tests associated with dementia and AD is the copper/zinc ratio. Most of us (and the risk is increased if you are libing in a developed country) have too much copper and not enough zinc. You may have too much copper because of the copper piping and extra copper from the multivitamins. You may have less zinc because of a zinc poor diet and poor zinc absorbtion (less acid production in our stomach as we age or medication - proton pump inhibitors for gastric reflux). Not only ageing is associated with the zinc levels decrease, but also AD. The type 3 of Alzheimer's disease (the toxic one - we talked about it in here) can have only 50% of the optimal zinc level that a healthy person will have. When the zinc is low you are more sensitive to toxins (heavy metals like mercury or mycotoxins from the mould), the levels of autoantibodies is increased (source of inflammation), the insulin signaling is reduced (zinc needs to be present for insulin synthesis, storage and release), you age faster and you may have more oxidative damage, the hormonal and neurotransmitter signaling is reduced. Most of these consequences lead to cognitive loss, and in many cases to AD. At the moment, more than 25% of the global population are zinc deficient. 

I was mentioning the copper/zinc ratio because the copper and the zinc are competitive in a number of cases, and each inhibits the intake of the other (for example intestinal absorbtion). Too much copper will lead to even less zinc. The zinc is stable, and does not produce free radicals, while the copper does. One more reason to treat this carefully. 

In terms of testing, the copper/zinc ratio should be 0.8/1.2, and the zinc optimal values are 90-110 mcg/dl (12-14mg/l for red blood cell zinc).

Next on the list is magnesium. This one is needed for optimal brain cell function, improving cognition and in case of AD, the hippocampus and the cortical areas close to it are affected, impairing the memory consolidation, due to low levels of magnesium. Measuring magnesium in the red blood cells is much more efficient than in serum (the test is called RBC magnesium where RBC means red blood cells) and the optimal values are 5.2-6.5 mg/dl. 

Selenium is another important oligoelement. This one has the task of cleaning the free radicals damaging our DNA, cellular membrane and cellular function with the help of the glutathione peptide. With this in mind, and the fact that glutathione's levels decrease with age, we need to realise that normal levels of selenium paired with low levels of glutathione can lead to inflammation, lack of synaptic support and toxicity (too many free radicals), and i just counted here each of the main cause of every subtype of Alzheimer's disease. The optimal values for serum selenium is 110-150 ng/ml, and for glutathione (GSH) is 800-1220 micromolar.

Heavy metals like mercury, arsenic, lead and cadmium are neurotoxic, affecting the brain function. If we eat fish often, we need to know that the larger and long living is the fish, the more mercury it has (tuna, showrdfish and shark are the main culprits - and the irony is that these ones are also used to create health supplements like Omega3 rich fish oil and shark cartilage products). The mercury can induce amyloid-beta plaques and neurofibrillary tangles - which are main symptoms of AD. On top of that, the mercury also destroys the glutathione, its role in preventing AD being mentioned in the previous paragraph. 

Arsenic can be present in the groundwater and in the chicken meat (it is lower in the organic grown chicken), and it can impair the executive function of the brain and decrease our verbal skills. Lead can lower IQ of the exposed children (impeding their neuro-psychological development), impairing the cognitive function and increasing the amyloid-beta plaques formation as we age. Can be found in food, water and dust coming from old paint. Cadmium is a carcinogen and a dementogen, and together with lead and arsenic can greatly increase the risk of AD. Cadmium is present in cigarette smoke, chemical factories grounds, yellow and red paintings. 

There is a very sensitive test called Mercury Tri-test, measuring mercury from hair, urine and blood, done by this company. If you evaluate using the blood levels, then the optimal values are listed bellow:

Mercury - less than 5 mcg/l

Arsenic - less than 7 mcg/l

Lead - less than 2 mcg/l

Cadmium - less than 2.5 mcg/l

My next post will be about the link between sleep apnoea and Alzheimer's disease.

If you want to know more about witamins and oligoelements, you can find everything about the normal values and much more in one of my older books - link here. I even made a huge promotion for you for the next 3 days (29-31.05.2020). 

Alzheimer's disease and the hormonal (im)balance

So, do you know what the hormones are? Probably you have some idea, but i will tell you anyway. The hormones are specific molecules produced by our endocrine system (glands) with the main mission to send messages and directions to different parts and organs of our body. The are present in the whole body, but can offect only specific target cells (hormone and hormone receptor - key and lock, so they are hormone receptors answering only to specific hormones. There are many hormones with the mission to optimize your cognitive function. They can support, maintain and create synapses. 

First on our list, the thyroid gland, as a decrease in thyroid activity is quite common in AD (Alzheimer's disease). The thyroid is mainly taking care of the metabolism speed, so when the activity decreases, the slower the cells will work. The reflexes will also slow significantly when the cellular metabolic speed is low. Your heart rate, your mental focus, your sleep quality and many other factors are affected by the thyroid function. As a side note, people suffering from dementia, mild cognitive impairment, subjective cognitive impariment and AD, all of them have low thyroid function level. 

There are four main tests for thyroid function:

1. TSH (thyroid stimulating hormone) - This is usually the only test used by most doctors, and it is not very accurate, as you can have suboptimal levels of thyroid activity with normal levels of TSH. TSH is produced by the pituitary gland, in direct relation with the thiroid hormones. When the activity of the thyroid is low, more TSH is freed in the bloodstream, so high levels of TSH translates in low thyroid activity. The normal accepted value is 0.4-4.2 microIU/ml, but in reality anything higher than 2.0 is concerning. 

2. Free T3 (active T3) - This is an active thyroid hormone which lasts only for one day, and dissapears after that, and the optimal levels for it are 3.2-4.2 pg/ml. 

3. Free T4 (inactive or storage form of the thyroid hormone) - Lasting about 7 days in the bloodstream, with optimal levels between 1.3-1.8 ng/dl. 

4. Reverse T3 - It will inhibit the thyroid activity, and this is the main reason of measuring the ratio of freeT3/reverseT3. The ideal ratio is minimum 20, as the reverseT3 levels will increase when you are stressed, reducing the free T3 presence. 

The sexual hormones are also very important, as for the men with low concentration of testosterone the risk of AD is increased. The testosterone is present in both sexes, but is higher for males, and supports the neuronal survival. There are two tests to measure testosterone, the total testosterone, with optimal values between 500-1000 ng/dl, and the free testosterone, with optimal values between 6.5-15 ng/dl. 

The estrogen and progesteron hormones, more important from a feminine point of view, and not enough researched in connection with the cognitive decline, but the women that removed their ovaries due to genetic cancer risk are more than double at risk to have AD. Also, a high ration of estradiol to progesteron can lead to poor memory skills and 'brain fog'. 

The tests for these hormones are:

1.Estradiol  - optimal value of 50-250 pg/ml

2. Progesterone - optimal value of 1-20ng/ml

3. Estradiol/progesterone ration - optimal value of 10-100

The cortisol is a hormone released by our kidneys, and it is a stress related hormone. High levels of cortisol are linked to neuronal damage (focusing on the hypocampus area) resulting in cognitive and memory skills declining. When we are exposed to chronic stress, the hormones needed to deal with it are not produced optimally, and out ability to deal with stress is affected (you become very sensitive to stress, and experience cognitive decline). The cortisol test (taken in the morning) has optimal values between 10-18 mcg/dl.

The pregnolone is a master steroid hormone, precursor to estradiol, testosterone, cortisol and dehydroepiandrosterone (DHEA). Y ou may realise now that this hormone can be heavily used to create stress hormones when we experience high stress for prolonged periods of time, and not enough is left to create the sex hormones. If you ever wondered why you are not in the mood when you are under heavy stress, now you know. Lower levels of pregnolone are linked with cognitive decline too. A normal value for pregnolone will be between 50-100 ng/dl. 

As i just mentioned DHEA, this hormone is a neurosteroid supporting the stress respones, and it is measured as DHEA sulphate, with normal values between 350-430 mcg/dl for women and 400-500 mcg/dl for men. 

With so many numbers and technicalities thrown at you in this post, i will stop here for now, coming back soon with minerals and heavy metals (you rock!). 

See you soon, take care and stay safe!

G.

Alzheimer's disease and the lack of vitamin D

What is the link between AD (Alzheimer's disease) and vitamin D? We have two ways to get the vitamin D, first, when the sun converts a cholesterol molecule from our body (7 dehydrocholesterol) into vitamin D (inactive form), which in turn is converted in the active form, or second, by taking vitamin D supplements (ideal if we work on nightshift or we stay a lot inside a building, or we wear a lot of clothes covering most of our skin, or too much sunscreen cream, or in the winter when the day is shorter - September to March). Once the active form of Vitamin D is present in our body, a vitamin D receptor (VDR) bind to it, alowing it to pass via the cellular membrane, into the cell nucleus, and by doing this will activate over 800 genes (some responsible for reducing inflammation and for creating and maintaining synapses in the brain, via enzymes from the brain and the cerebrospinal fluid). There are VDR (vitamin D receptors) in the CNS (central nervous system) and hypocampus. Vitamin D it is also regulating the insulin levels, with a role in preventing the IR (insulin resistance), which we already learned that is one of the risk factors in AD. 

Low levels of vitamin D are linked to cognitive impairment, decreasing the information processing speed (cognitive impairment can be one of the symptoms preceding Alzheimer's disease)

The vitamin D is measured in the blood stream as 25-hydroxycholecalciferol, and even if the accepted normal values are 20-80 ng/ml, you may want to reach a level of 50-80 ng/ml. Supplementing with a dose higher than 4000 UI per day (the upper limit) can be toxic for the body, leading to calcification of the bones and blood vessels and organs hardening. 

Fun fact, even if it is called vitamin, the vitamin D is in fact a prohormone (hormone precursor). 

Alzheimer's disease and the inflammation

There is a connection between AD )Alzheimer's disease) and inflammation. There is enough evidence to show that the risk of having AD is greatly increased by the inflammation, as a chronically activated immune system will attack not only the pathogens, but also the own body cells. A mild inflammatory state, if it is chronic, may increase the risk for cardiovasculad disease (CD), cancer, AD and it will accelerate the ageing process. Not very helpful, isn't it? 

The main damaging agents are infections produced by viruses, bacteria or fungi, AGE products (advanced glycaetion end products - we talked about them in this previous post), free radicals, damaged lipides or/and proteins (oxidized low-density lipoproteins - LDL), trauma (broken bones, strains, bruises, cuts) and few more others. 

How do we measure inflammation?

- C-reactive protein - produced in the liver in response to any kind of inflammation, can bring additional trouble if it is high sensitive (the test that you want is hs-CRP - high sensivity C-reactive proteine, as the standard CRP test is not able to distinguish between optimal and mild high). If the hs-CRP is higher than 0.9mg/l, you need to find the inflammation source. You may have your choice (trans fats, overdosing of sugar and other simple carbohydrates, gluten sensitivity, leaky gut, poor oral hygiene, mycotoxins such as mold and few more others). Once you deal with the problem, you check hs-CRP to see if it is under 0.9 mg/l. 

- the Omega-6/Omega-3 ratio in the blood stream should ideally be in between 0.5 and 3. More than 3 is bad, as Omega-6 is inflammatory, under 0.5 increases the risk of hemorrage. 

- A/G ratio (the albumin to globulin ratio) is another inflammation measurement, and ideally should be higher than 1.8.

- TNF-alpha (tumor necrosis factor) and IL-6 (interleukin) are two members of the cytokines family, which may reach higher levels in the type 1 AD (inflammatory type). Normal values are under 3 pg/ml for IL-6 and under 6 pg/ml for TNF-alpha. 

Alzheimer's disease and the insulin resistance

    For years it was hypotethised that there is a link between diabetes and Alzheimer's disease. But, as the latest researches point out, both illnesses got something in common: poor blood sugar management and insulin resistance. Despite the sugar being present in almost everything we eat or drink (yes, even bread, yogurts, cereals, you name it, it is there), our body tolerance for sugar is somewhere around 15-20 grams of single carbohydrates per day. Per day, i said, and keep in mind that just one energy drink with reduced sugar has 24 grams of it. There is also the not so well explained issue about high and low glycaemic index foods. Let's start with this first. 

    The higher the glycaemic index is (do not think only about sugar, the starch also has something to do with this - white bread, white rice, potatoes, baking goods) the larger amounts of insulin our pancreas will secrete into the bloodstream, to lower the blood sugar. If this happen too often, our cells will start to resist to the insulin signalling too much blood sugar, in the same way you got used in a very noisy environment (eventually). The noise is there (blood sugar in our case), but   you stop reacting too it. And a high level of blood sugar is damaging our body in so many ways. (Find more about this in this article).

    Well known effects of the insulin resistance are type 2 diabetes, fatty liver, metabolic syndrome, but also AD (Alzheimer's disease). There are many pathways that are affected by the insulin resistance. To start with the insulin binding to the insulin receptors, triggering the survival of the neurons, you can only imagine what will happen if this trigger is drastically decreased by the high insulin levels, present most of the time in our bloodstream. Another way to mess up with our nervous system is via the insulin-degrading enzyme (IDE) used to get rid on the insulin, but, surprise, also used to get rid of the amyloid beta (one of the main issues in AD). Because, as we know already, higher levels of amyloid-beta equals full blown AD. 

    As the insulin resistance is just a result, the cause being chronically high blood sugar levels, let's see how this is wreaking havoc in our body. The glucose can attack easily to many proteins, interfering with their usual functions. The common blood test to check diabetes called HbA1c is measuring one of these overused proteins - hemoglobins changed to produce advanced glycation end products (AGE). As these proteins trigger our immune system, raising inflammation (one of the risk factors in AD), they are also binding to their own receptor (AGE receptors of RAGE), triggering inflammation even further. Shall we add to the list? Yes, there is more, AGE molecules form free radicals, which in turn can damage almost anything they touch, even DNA and any cell membranes. The additionally damage the blood vessels (less nutrients to go to the brain) and negatively alter the blood-brain barrier. 

    The main blood tests to monitor these risk factors are fasting insulin level (ideally 4.5 microIU/ml or less), the HbA1c test (ideally under 5.6%) and the fasting glucose ( ideally between 70-90 mg/dl, but not more than that). 

    How you manage this? Learning about diabetes management is a good idea, as everything that is recommended for a type 2 diabetes, it will also work for healthy individuals or pre-diabetes condition. 

Next issue to tackle will be inflammation, as i started to explain a bit of its mechanisms today. 

Alzheimer's disease and vitamin B group optimal levels

To continue our Alzheimer's disease knowledge journey, we need to remember that in the last post we mentioned the homocysteine role in the disease and how keeping it in the normal values will need adequate levels of vitamin B (B6, B9 and B12), in their active form for humans. Let's find out about those active forms. For B6 this is P5P ( pyridoxal-5-phosphate), for B9 is methyl-folate and for B12 is methylcobalamin. 

The optimal values for these B vitamins are:

B6 = 60-100 mcg/L

B9 (folate) = 10-25 ng/ml

B12 = 500-1500 pg/ml

Now, if you look online for example for normal values, they will be: 

B6 = 30-110 mcg/L

B9 (folate) = 2-20 ng/ml

B12 = 200-900 pg/ml

Now there is an issue here, as some physicians accept these values as normal, even if they are in the lower range. Some may tell you that lower values may be linked to diseases such as anaemia, dementia and Alzheimer's disease, which is already known. But you want to be in the upper half of the scale, so low walues may be within normal limits, but they are not optimal. For B6, the lower end is bad (30-50 mcg/L), but any value over 110 mcg/L is dangerous also, as it can be toxic and affect the nerves responsable for touch and pressure. The right supplementation for B6 deficiency is P5P ( pyridoxal-5-phosphate). For B6 you are within normal limits at 2-20 ng/ml, but again, you do not want to be in the lower range. Methylfolate is your choice of supplement if you need nore vitamin B6. You want to reach optimal values of 10-25 ng/ml. As for vitamin B12, values of 200-500 are within the normal range, but they are not optimal. 500-1500 pg/ml is where you want to be, and the supplement of choice is methylcobalamin. Related to B12, as the level of vitamin B12 decrease, the methylmalonic acid (MMA) increase. So the MMA blood test is more accurate than the B12 levels, and can be used as complementary test. 

Blood tests recommended to check these vitamins are: B6, B9 (FOLATE), B12 and MMA blood tests.

My next factor to talk about will be insulin resistance. I must admit that i need to learn a bit more about this, as i still have some questions about few of the connections that are not enough researched at the moment. 

The homocysteine blood test, hippocampus atrophy and cognitive decline

Ok, today we talk a bit more about Alzheimer's prevention. 

One of the blood tests that needs to be done is the Homocysteine level, as high levels of this specific aminoacid can be used as a marker of the inflammation and of the loss of trophic factors (two out of the three causes of synapse loss, the third being the accumulation of toxyns and heavy metals). The methionine is the precursor of homocysteine and we got that from food (nuts, beans, dairy, eggs, shellfish, fish, meat from turkey, lamb, beef and pork). The conversion from methionine to homocysteine needs vitamins like B6, B12, folate and betaine (this is another aminoacid). If these supplements are in their normal values, there is not problem in the homocysteine cycling, but if any of them are lacking, the homocysteine will start to build up, and this can lead to brain and blood vessels damage. This is one of the contributors to cognitive decline, and if your value is above 6 mmol, then you got a problem. Because higher levels of homocysteine can lead to hippocampus atrophy, and this is translated straight to cognitive decline. 

Conclusion: you may want your homocysteine level to be less than 7 mmol. Higher levels can be decreased using specific vitamins (B12, B6 and B9-folate). Some versions of these vitamins are better than others ( the most active forms are usually methyltetrahydrofolate for folate (B9), methylcobalamyn for B12, pyridoxal-5-phosphate for B6). 

 

Tests and pathways leading to the early detection of Alzheimer's disease

There are 7 stages in Alzheimer's disease (AD) development, and we cannot realise it until stage 3-4 that there is a posibility of something wrong. In stage two there are only few incidents and usually they are identified as ''senior moments'. In stage two there is a very mild cognitive decline, but it is still not observable by the subjects or family or friends. Stage 3 has a mild cognitive decline, and the person may start  to have difficulties remembering names or finding/using words (especially 'fancy' words, as the vocabulary tends to get much simpler). In this stage you realise that something is wrong, but you brush it off, and try to minimasing, blaming age. Stage 4 is a full blown Alzheimer's disease (AD), and according to doctors, you may have on average 12 years left to live once you reach this stage. Which may or may be not true. Up to stage 4, you may still have a chance to delay it significantly or even recover. Just for your curiosity, in stage 5 you start to be confused, have problem with dressing and remembering informations about yourself and short term memory will not work optimally. In stage 6 you may be unaware of your surroundings, do not know where you are, do not remember much about yourself, start to wander around and have toileting accidents. Stage 7 is the terminal one, when you forget how to eat, speak and most of the other basic functions.

But, there is a way to deal with this from stage 2, and this is by using the knowledge already accumulated and test yourself in many way, keeping an eye on your cognitive abilities. Genetical informations are very important, as i already mentioned the ApoE allele involvement in AD in my previous post. By cheching which version of Apolipoprotein you got (E2, E3 or E4), you may have an idea at what age the degenerative process is most probably to start. Checking a service like 23ANDME can provide this information, but i find the price being quite prohibitive (in the £100-150 range). So my advice is to make an account and wait for them to offer some Christmas or Easter promotion, and you may get it done for half the price. Unless is urgent. Inflammation is another very important symptom, and it is closely linked with AD (and many other problems). Some infections are definetely linked with the AD (yes, tick bites, that's what i am talking about - viruses like Herpes Simplex, Borrelia - responsable for Lyme disease, some oral bacteria like Porphyromonas gingivalis, and a number of fungi and moulds). There is one aminoacid called homocysteine, which is causally associated with AD and linked to brain atrophy. Fasting insulin level or blood sugar level is of utmost importance, and some hormonal imbalance has definitely linked to AD. Mycotoxins (moulds) and heavy metals exposure can also be a cause for Alzheimer's disease. There are some other factors observed and almost never mentioned, for example the AD patient may have a distinct gut microbiome, even if we do not knnow yet if it is the microbiome leading to AD or the AD leading to the specific changes in microbiome. The blood-brain barrier is often abnormal in AD patients. And everybody is blaming obesity for many ilnesses, yes, it is to blame for AD also, as a higher BMI will increase the changes to suffer from it. Prediabetes state is also mentioned in some researches (it is related to the insulin resistance and the high levels of blood glucose). 

All this should be checked in an ideal situation, but what really happen in reality? You reach stage 4, you or your relatives or your friends start to worry about the cognitive decline, you check with a doctor, asked to do a MRI to check the brain, have some blood tests like complete blood count, vitamin B12, Thyroid hormone levels ( TFT, TSH T3 maybe) and metabolic panel, and then you are prescribe some generic meds and your partner or children are asked to help with finances and medication. And this is it. A surefire approach to failure. 

What i will talk about in some following posts is how to detect it early, as early as in stage 1-2, and what you need to do to delay it as much as possible. Stay with me and read my future posts (i still need to read a ton of research to realise all the intricaties involved. But i hope it will help you to stay cognitively healthy for longer. 

 

 

How to (not) lose your mind - a (not so) original approach on Alzheimer's disease (1)

Did you know that Alzheimer's disease is in fact not one but a group of three diseases. Type one (inflammation type) is characterized by loss of ability to store new information, but the long term memory and the ability to speak, calculate, spell and write is retained. Type 2 is characterized by loss of trophic support, and by loss of ability to store new information, but the long term memory and the ability to speak, calculate, spell and write is retained. Inflammatory markers are not high in  this case, they can even be lower than normal. You can have both type 1 and type 2 in the same time later in life. This may run in the family. Type 3 is toxic (vile) and appears usually in people carrying the common ApoE3 allele rather than ApoE4. Does not run in the family. Usually strikes at age 40-50, following grat stress, with cognitive difficulties involving numbers , speech and organizing skills. Short term, long term and procedural memory (how to do simple or complex things) is affected. Exposure to toxic compounds (heavy metals, mycotoxins from mold) seems to be also one of the factors increasing the risk. 

Type 1 starts at age 40-50 if you have one copy of ApoE4 allele, or at age 50-60 if you have two copies of ApoE4. No copies of ApoE4 - starts around 60-70. Type 2 initiates a decade later than type one, given the same variation of ApoE4. 

(Extra information here - Apolipoprotein E (APOE) is a protein involved in the metabolism of fats in the body. It is implicated in Alzheimer's disease and cardiovascular disease. ApoE3 is considered the "neutral" APOE genotype. ApoE4 has been implicated in atherosclerosis, Alzheimer's disease, impaired cognitive function,reduced hippocampal volume, HIV, faster disease progression in multiple sclerosis, unfavorable outcome after traumatic brain injury, ischemic cerebrovascular disease, sleep apnea, accelerated telomere shortening and reduced neurite outgrowth.A notable advantage of the E4 allele (relative to E2 and E3) is a positive association with higher levels of vitamin D, which may help explain its prevalence despite its seeming complicity in various diseases or disorders. APOE transports lipids, fat-soluble vitamins, and cholesterol into the lymph system and then into the blood. It is synthesized principally in the liver, but has also been found in other tissues such as the brain, kidneys, and spleen. In the nervous system, non-neuronal cell types, most notably astroglia and microglia, are the primary producers of APOE, while neurons preferentially express the receptors for APOE. There are seven currently identified mammalian receptors for APOE which belong to the evolutionarily conserved LDLR family. Hence the relation with the amyloid-beta plaque issue in Alzheimer's disease). 

I will write a bit more about this soon. 

Take care and be safe!

G.

Ely Lilly, Biogen and Alzheimer wonder drug

Today BBC showed us for the entire day about the pharmaceutical company Ely Lilly and his wonder drug that will slow Alzheimer progression 3 times more.
Lets go step by step through this gigantic misunderstanding, or may just not enough research. Hmm, is BBC we are talking about. Really?

First, the results showed a 34% reduction, not a 300%, that just basic math. Two, what the hell are we talking about ? As a professional working directly with Alzheimer patients, i am directly interested in every new research. We got two companies that are leading this kind of research, called Biogen Inc and Ely Lilly & Co. They developed some drugs aiming to clear the amyloid plaque build-ups from the brain, in an effort to slow Alzheimer's cognitive declines. The drug makers said last Wednesday that both drugs showed signs they may do that. Lilly's drug displayed consistently better results the longer patients took its drug, while Biogen's showed it yielded stronger efficacy the higher the dose. But this wonder drug of Ely Lilly is not yet on market, as advertised, Phase 3 of the project will be finished only in 2016. So we are still waiting, and BBC is still doing some extra rating claiming without enough data ( i wonder if they've seen this in The guardian article from yesterday, instead of checking at the source).