A note from Dr Fitzgerald: “I couldn’t be more delighted and proud to see the results that our own Dr. Litwin and our Nutrition Team are achieving in addressing cognitive decline and Alzheimer’s Disease. The scale of the cognitive decline problem that medicine faces today is unprecedented: it is one of the top 10 causes of death and has no effective treatment within conventional medicine. Functional Medicine, however, DOES have answers here, which Dr. Litwin outlines in this article. It’s important to note that this Fx approach isn’t limited to just later stage cognitive decline. This approach is ideal for anyone interested in optimal brain and total body health, for life!” – DrKF
As a 25-year-old 4th year medical student, I truly enjoyed my Neurology rotation. I applied knowledge learned as a Neuroscience major at Oberlin College to actual patient care, learned the art of neurological examination from experienced Attending Physicians, and improved my ability to diagnose brain and nervous system-related conditions. In other words, I practiced “identifying the lesion,” a skill that neurologists refine over many years of seeing patients.
Looking back, I now see that the standard workup for cognitive decline learned during med school only serves as a starting point. It provides important data but does not change the course of the disease or influence treatment.
Only years later, after I began using Functional Medicine, did I see cognitive function actually improve using advanced lab assessments and personalized protocols addressing underlying mechanisms from a holistic perspective.
These are powerful tools. When used in conjunction with the Bredesen Protocol®, they are incredibly effective for preventing and even reversing cognitive decline.
Gaps in the Standard Medical Workup for Cognitive Decline
Let’s look at the standard conventional approach used for evaluating neurological symptoms, so we can highlight where gaps exist. A neurologist examines a patient with specific neurologic problems and carefully notes what is found on physical exam. This helps determine exactly where the problem area, or “lesion” is located within the nervous system, even without doing expensive testing such as CT scans or MRIs. This is “old school” neurology, like it should be done.
In the case of cognitive decline or dementia, this process of “identifying the lesion” helps determine the area of the brain most responsible for the symptoms and disease. In the next step towards making a diagnosis, the physician matches physical findings with the patient’s history. Getting details about symptoms and creating a “timeline” of when they developed is essential for making an accurate diagnosis.
Some important symptoms to ask about when evaluating problems with memory and cognitive decline include:
- Problems recalling names of people or misplacing objects
- Tremor of the hands
- Personality or mood changes
- Trouble doing simple math, such as keeping track of finances
- Getting lost while driving
- Problems with walking or balance
Cognitive testing, including basic testing like the MoCA or more extensive testing such as CNS Vital Signs or a full neuropsychological exam are also useful in determining the diagnosis and the severity of the cognitive problem. Blood tests, CT scans, MRIs, and even evaluation for markers in the CSF (cerebrospinal fluid) with a spinal tap may also be used to rule out other potential conditions which can look like Alzheimer’s but aren’t.
It wasn’t apparent to me back in medical school that all this investigation, while necessary for diagnosing someone correctly with Alzheimer’s, never led to any differences in treatment or outcome.
Sadly, even in the 25 years since medical school, this is still true. The drugs available are basically the same as they were back then, with a few minor variations. None have ever been shown to slow the progression of the disease. At best, the medications can help slightly with some Alzheimer’s symptoms. At worst, the medications are a waste of money and represent false hope for patients looking for something to slow their decline.
What has been lacking all these years in the treatment of cognitive decline and Alzheimer’s has been any attempt to identify and address the underlying causes in a comprehensive, effective manner.
It is clear to me now that using Functional Medicine, which at its core investigates root causes of diseases and symptoms, is the only way to prevent, slow, and reverse cognitive decline.
What Do Functional Medicine Practitioners Do?
Several years ago, I was introduced to Functional Medicine by a colleague. It completely transformed the way I “do” medicine. It soon became obvious to me that educating and motivating clients to make changes in lifestyle, especially with nutrition, made enormous differences for all kinds of conditions. I saw improvement where before I only saw progression in diseases like diabetes and rheumatoid arthritis. My patients were thriving on fewer medications.
Some of the features of Functional Medicine that you won’t find in a conventional care model:
- Advanced testing: We do testing that is rarely done in a conventional medical office. We test for things like digestive function, gut microbiome, organic acids, toxins, food sensitivities, and mitochondrial function. All these areas can have direct impacts on brain function, as well as other organ functions.
- Holistic approach: We address many variables using multiple modalities in our “toolkit.” This includes pharmaceuticals, nutraceuticals, Complementary and Alternative Medicine (CAM), and lifestyle optimization.
- Customized treatment: Every person is unique, so we insist on a personalized approach to treatment.
- Team support: We recommend lifestyle modifications using a team-based approach. This way, making important but difficult personal changes is more manageable. We work with nutritionists, health coaches, personal trainers, and other practitioners to support patients while implementing the personalized protocol.
- DNA-based therapy: We capitalize on the power of epigenetics and lifestyle medicine. Over the past decade, it has become increasingly clear that epigenetic mechanisms play a pivotal role in Alzheimer’s and dementia. Epigenetics is the modern science about the food-gene and environment-gene interactions. Applying what we have learned about epigenetics has had a huge impact on prevention and treatment of all chronic conditions.
The Bredesen RECODE ® Protocol—A Giant Step Forward for Alzheimer’s and Cognitive Decline
In 2016, Dr. Fitzgerald told me about the amazing work of Dr. Dale Bredesen. He is a neurologist and researcher in the field of Alzheimer’s. In 2017 his New York Times best-selling book “The End of Alzheimer’s” came out. Reading Dr. Bredesen’s publications and completing his training course rekindled my interest in neurology. I became motivated to focus my practice on the prevention and treatment of Alzheimer’s.
I was inspired to see within Dr. Bredesen’s work that the symptoms of Alzheimer’s disease could often be partially reversed even in more advanced cases. His RECODE Protocol® returned many people to pre-diagnosis levels of cognition. They were able to work, regain their independence, and even resume driving if they maintained their lifestyle changes and the protocol! In many patients, he saw the volume of the hippocampus, the primary brain area which shrinks in Alzheimer’s, return to normal on MRI, something that the radiologists reading the MRI scans had never seen before.
Dr. Bredesen’s RECODE Protocol ® works because it brings an organized, multifactorial approach to diagnosis and intervention.
His research demonstrates that successful reversal of cognitive decline is possible by:
- Addressing multiple root causes simultaneously
- Optimizing key lifestyle factors – including sleep, exercise, diet
- Designing individualized treatment based on subtypes for each patient
In short, it is completely aligned with the concepts of Functional Medicine. Practitioners trained through the Institute for Functional Medicine (IFM) are seeing results NOW in reversing Alzheimer’s. That’s because IFM practitioners specialized in the use of lifestyle and systems medicine to identify and address root cause of chronic disease – we’re the best suited to apply, and even expand, the Bredesen protocol for treating Alzheimer’s.
Dr. Bredesen’s Protocol + Functional Medicine = Incredible Outcomes
In our clinic, we see incredible outcomes combining Dr Bredesen’s protocol with our full Functional Medicine approach.
The entire process leads to comprehensive diagnostic and treatment programs for our patients. Our advanced lab assessments go far beyond what is available in a conventional medical or neurology clinic, enabling us to identify underlying brain-impacting imbalances that standard medicine evaluations usually ignore such as:
- Hormone imbalances
- Blood sugar control
- Environmental toxins and infectious triggers
- Nutrient deficiencies
- Food-related allergies and sensitivities
- Gastrointestinal inflammation
- Digestive function
- Microbiome imbalances in the gut
Why is our combined approach so effective?
- We use specific tests to measure underlying factors driving the formation and removal of amyloid plaque, which is felt to be the main final disease mechanism in Alzheimer’s
- We lean on Dr Bredesen’s system to accurately classify the disease by 6 subtypes based on specific testing, informing individual treatment based on root cause
- Comprehensive plan addresses accompanying lifestyle factors, especially diet, sleep, stress management, and exercise.
- Personalized protocol that addresses the root causes of the disease for each individual patient, including gut health, hormonal balance, environmental exposures, and infectious triggers.
- Establishes a systematic and full systems approach to the prevention and treatment of Alzheimer’s and cognitive decline.
Learn more about this robust, comprehensive approach
There are things you can do TODAY that can lower your risk of Alzheimer’s disease.
Interested in finding out more? Join us for a free webinar on June 28 and take advantage of our expertise! You will learn effective ways to prevent and treat cognitive decline. We will give you tips on simple lifestyle changes and tools so you can get started RIGHT NOW!
Live* Webinar: Detoxification & Cognitive Decline Risk
Wednesday December 19, 2018 at 7PM EST.
*recording will be available for a short time after original broadcast