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Dr. Sandison confesses that when she first heard Dr. Dale Bredesen talk about his work reversing cognitive decline and Alzheimer’s disease she was skeptical. But when she started to apply the Bredesen principles in her clinical work and saw just how meaningful the improvements were to patients’ symptoms and quality of life, as she puts it: “…how do I do anything else with my life, but basically tell as many people who will listen that this is possible?” She then went on to found the first two residential care facilities for individuals with cognitive decline that are based on the Bredesen approach. She’s published research on her clinical outcomes and is continuing to gather more data for publication. The information and inspiration she shares are relevant to anyone dealing with cognitive decline, caring for someone with cognitive decline, or even those of us who want to preserve and optimize cognitive function as we move through life. I found her report that environmental toxins were one of the most common findings among her patient population illuminating. – DrKF
Tackling Alzheimer’s Disease Head On – the Inspiring Work of Dr. Heather Sandison
Dr. Heather Sandison is challenging the status quo of dementia care and offering genuine hope and actionable insights to tackling cognitive decline. As she explains (and has backed up through peer-reviewed research publication), the potential causes of dementia (including Alzheimer’s disease) are many, and patients often present with multifactorial contributors. These can range from environmental toxins, to infections (including periodontitis), to metabolic dysregulation and more. When appropriately investigated and addressed through strategic shifts in diet and lifestyle (even if it is only to the extent that each patient can manage to implement), symptoms and quality of life can often be improved. This is a far cry from the limitations of current pharmaceutical approaches.
In this episode of New Frontiers, learn about:
- Dr. Sandison’s groundbreaking work in dementia care, including founding Marama, a residential care facility.
- Case study demonstrating transformation in patients with severe dementia through holistic and multimodal interventions.
- Effects of environmental toxins and oral health on dementia risk.
- Emphasis on early intervention and brain-healthy lifestyles to prevent dementia.
- Use p-Tau 217 and amyloid markers for diagnosing and monitoring dementia.
- Positive outcomes from a six-month intervention study, improving cognition and quality of life.
- Comparison with Dr. Dale Bredesen’s study, showing high improvement rates.
- Understanding dementia causes: toxins, nutrients, stress, and infections.
- Challenges in implementing functional medicine treatment plans for patients with cognitive decline.
- Importance of tailored treatments addressing toxicity and sleep apnea for cognitive improvement.
- Future directions: ongoing trials, funding challenges, and the complexity of dementia research.
Dr. Kara Fitzgerald – Welcome to New Frontiers in Functional Medicine, where we are interviewing the best minds in functional medicine. And of course, today is no exception. If you’re with me on YouTube, you can see I am sitting next to the brilliant Dr. Heather Sandison. I want to tell you about her. She’s become a great friend of mine, and you’ll quickly see why as we launch into this conversation. But let me give you her background, and then we’ll just tuck right into some of the amazing work she’s doing. Dr. Sandison is a distinguished naturopathic physician. She’s devoted her career to providing compassionate care and innovative solutions to those affected by dementia. Renowned for her pioneering work, Dr. Sandison has integrated groundbreaking, holistic, and multimodal interventions, seamlessly creating clinical, residential, research, and educational platforms. Her relentless dedication has not only transformed the lives of patients and caregivers, but she’s also set new standards in the field of dementia care. Dr. Sandison, welcome to New Frontiers.
Dr. Heather Sandison – Thank you for having me. It’s a privilege.
Dr. Kara Fitzgerald – Yeah. It’s great to have you here. So, it’s extraordinary. Folks, she is the founder of the first residential care facility for older individuals, people primarily suffering from dementia. She’s just already carved out and done extraordinary work in this field, but Heather is also published some amazing research, and she’s releasing a book. So, I want to understand how you got into focusing your work on dementia, and then, incredibly enough, actually opening, I think you have two treatment facilities now. So, give me your background and bring us current and then we’ll talk about your extraordinary study and book.
Dr. Heather Sandison – Thanks. Yeah. So I went to naturopathic school, and on the end of that, I thought, okay, autism and Alzheimer’s, there’s these two things that you really can’t treat. I don’t see them getting significantly better. I’d been told in training that to suggest that someone with Alzheimer’s could improve would be to give them false hope. So don’t do that, That would cause more harm than good.
Dr. Heather Sandison – And I heard that over and over again, that refrain around these brain diseases, neurodegenerative diseases, especially at the end of life, but also at the beginning of life, where it was just this black box of mystery and suffering. And then I was at a conference and I heard my mentor, Dr. Dale Bredesen, speak, and he basically said the opposite. He was like, no, with dementia, with Alzheimer’s, you can get reversal of the disease process and you can see symptomatic improvement, which is where the rubber meets the road. Right? This is what patients care about. This is the difference between independence and dignity and just being siloed into a senior living facility, a memory care unit, and not knowing the names of your grandchildren. And so, this was shocking to me. I didn’t believe it. But the way that Dr. Bredesen described it, this systematic approach to essentially applying functional medicine, naturopathic medicine, to neurodegenerative processes, it made conceptual sense to me, even though I was a skeptic. I didn’t believe it.
Dr. Heather Sandison – But I went to his training anyways because it made sense and I was like, okay, well, if I can treat someone with dementia, then I can kind of do everything else. Everything else is a cakewalk. Great. So then I was on his list in 2017 when his book, The End of Alzheimer’s came out, and there were people who read his book, found his book, and then came into my office, and what I saw next totally surprised me. I remember my first patient who had severe Alzheimer’s who got better. I share her story in the book. I just was in tears. I couldn’t stop crying because seeing someone with such severe dementia improve their quality of life, go from single word answers, yes or no, to having complete conversations and full sentences. Going from basically having to stay at home completely dependent on her husband for every single activity of daily living, to ballroom dancing with him three times a week. Both of them had this radical shift in their quality of life over six weeks.
Dr. Heather Sandison – And when I saw that this was possible for this couple and she had she had a MoCa of two. So MoCa is the Montreal Cognitive Assessment and a perfect score is 30, a normal score is 26 and above. She had a MoCa of two. And just six weeks later, after applying Dr. Bredesen’s approach, she had a MoCa of seven. And so that shift, this was a measurable shift, and it was a meaningful shift in their quality of life. And when I saw that, it was like kind of first disbelief, and then how do I do anything else with my life, but basically tell as many people who will listen that this is possible. And then the best thing about her story was that she wasn’t alone. I kept seeing this over and over and over. And then Marama, the residential care facility, was really born out of people asking, you know, I want this Bredesen approach for my loved one and I’m working and I’ve got kids and I have so much else going on, I can’t do it. I can’t drop everything and do this for my mom or my dad. Where can I send them?
Dr. Heather Sandison – And I realized there wasn’t a place with this vision of returning memory-impaired patients to independent living. And so I thought, well, this is possible. How hard can it be? And we had a facility nine months later, and now we have a sister facility in Kansas. And in Kansas, we haven’t published this, we will probably try, but we have to get retrospective IRB (Institutional Review Board) approval, but the first five residents have been there for more than six months now, and four of them improved their MoCa scores, which is consistent with what we measured in the research and also from Dr. Bredesen’s group. Most people get better. More than half have an improvement in their measurable cognitive function.
Dr. Kara Fitzgerald – That’s extraordinary. It’s just absolutely phenomenal. I can see how the turn of events in your career as it unfolded would absolutely put this in… How could you say no to this? And I’m so glad that you had the courage to follow it and to be lit up by this extraordinary, extraordinary work of Bredesen and take it on yourself. So this first patient who brought you to tears, I mean, what were her… I’m sort of cutting to the chase, but I know everybody’s thinking about it. We’re talking mostly to clinicians now, what were her fundamental imbalances?
Dr. Heather Sandison – Yeah. So she had a mouth full of mercury and gingivitis. She had a ton of dental work that needed to be done. She did that in those first six weeks. She was post-menopausal, as most people who suffer with dementia are, and they were excited to get started on bioidentical hormone replacement. She was nutrient-depleted, and they were living in a moldy bedroom. They moved out of that moldy bedroom, they actually moved into the living room. She had not been exercising, they had been going for walks, but she wasn’t really getting that cognitive engagement at the same time that she was getting physical engagement.
Dr. Heather Sandison – We refer to that as dual-task exercise. And so they started ballroom dancing, which they really enjoyed. She got on a ketogenic diet. She was a little hyperglycemic, so she was going in the direction of diabetes. She didn’t have diagnosed diabetes, but she had higher levels of glucose, and so we got her on the ketogenic diet. We see that’s often very helpful for cognition. We systematically went through the list and that first time I saw her, because this was between our first and second visit, so I didn’t even have labs on her yet. Maybe I had some previous ones because I knew the glucose piece, we knew to get her into ketosis and give her a little bit of support there, so she probably had minimal labs from her primary care provider, but we hadn’t done her heavy metal testing. We hadn’t even done mycotoxins testing. This was all based on what they were telling me, and she was able to get started. Her husband had way more confidence than I did, but they dove in fully and she got the benefits of it.
Dr. Kara Fitzgerald – That’s extraordinary. Was her decline pretty swift and sudden? I mean, what was her movement into this?
Dr. Heather Sandison – She had been suffering for years. Yeah. She had a decline for years. Yeah.
Dr. Kara Fitzgerald – And what were you… It’s amazing that he felt really empowered and confident in it. And where did you ultimately see her MoCa peak? Did it continue to increase over your work together?
Dr. Heather Sandison – Slightly. Not significantly. That’s typically what we see. So, in the first three months we often will see, not every time, but we’ll often see improvement even in those first three months with just mostly getting the lifestyle pieces going. And then six months, it’s often improved more, sometimes 12 months even more. There’s definitely a connection between how much people are engaging in the whole protocol, in the lifestyle, in the supplements, in the medications, in all of it. And then sometimes we see drops. I mean, with these patients, there’s so many variables.
Dr. Heather Sandison – And certainly for her there were financial constraints. And so they backed off of supplements at one point and she slid backwards, and I didn’t see them as often anymore and she kind of slid backwards. But everyone’s different and I haven’t seen anyone go from a MoCa of two to a MoCa of 30. My confidence is highest in that MoCa of 17, 18 and higher, those we will see them go back up to 30. And so, I really encourage people, I think so many people are afraid to see their neurologist, afraid to talk to their doctor about cognitive decline, and so they try to hide it, they cope. And really that’s when we want them engaging with a Bredesen-trained provider where they can do all the testing, they can change their lifestyle, they have the agency to do that. And we’re not trying to repair really big structural changes in the brain. I think when we’re in that biochemical where we’re changing the energetics by getting into ketosis, we’re getting more oxygen to the brain, treating sleep apnea…
Dr. Heather Sandison – When we’re in that kind of energetic intervention stage, we have so much more confidence. We see bigger deltas in terms of MoCa scores, better improvements, and more sustained improvement.
Dr. Kara Fitzgerald – Right. So, this should just be a part… I mean, I think you’re focused on dementia now exclusively, but obviously we should be bringing this investigation into our practice much earlier. When do we start? When do we actually start?
Dr. Heather Sandison – Dr. Bredesen refers to it as a cognoscopy. So, 45? We know that dementia, by the time you have symptoms- So dementia is the umbrella term which includes. frontotemporal dementia, of course, Alzheimer’s, which is the most common, it includes vascular dementia, posterior cortical atrophy, there’s lots of different variants of dementias, and Alzheimer’s is one of those. But we really are talking about all of them because the neurodegenerative process, regardless of the ICD ten code you put on it, there’s a systematic way to understand what the causes of the neurodegeneration at the cellular level are.
Dr. Heather Sandison – And really, Kara, what’s fun is that I’ve got your book right here behind me, and our protocols are not that different. Right? Really, it’s about healthy aging and that includes the brain. There are some specific things about brain health, of course, and there’s some specific genetics that we would want to look into. And if you have that genetic risk, the APOE4 status, either 1 or 2 copies, and you want to be, as a consumer, much more proactive. And as a provider as well, encouraging people to be screened for genetic risk, for dementia and Alzheimer’s. And then also encouraging more of the brain healthy lifestyle and more of these interventions sooner. With dementia and Alzheimer’s, the physiological changes in the brain are happening decades before you start to notice a symptom, and so we have many, many years to intervene from a prevention standpoint. And now we have much better testing in terms of the p-Tau 217, amyloid markers in the blood, these weren’t even around when I developed the clinical trial.
Dr. Heather Sandison – And so we weren’t able to study, these in our trial. They were still in the research phase in terms of the lab assays, but now these are available and so we can look very specifically and diagnose Alzheimer’s and see what direction we’re going, not just based on the cognitive performance but also on some biomarkers.
Dr. Kara Fitzgerald – And just give me these biomarkers again.
Dr. Heather Sandison – Yeah. So the p-Tau 217 is one. This is essentially in the neurons, they have a structure, and when the structure starts to break down you can measure p-Tau in the blood. And then the amyloid markers are also something that you can now measure in blood. There are a couple different ones of those available and this is available through LabCorp or Quest. And then imaging studies can also be very helpful. You can look at perfusion studies and you can look at amyloid testing on imaging as well.
Dr. Kara Fitzgerald – Were you able to incorporate this information in your book?
Dr. Heather Sandison – Some of it yeah. You know it keeps changing.
Dr. Kara Fitzgerald – I know, I know.
Dr. Heather Sandison – Yeah, it’s exciting. In fact, in the book we talk about some of the pharmaceuticals and the last day that I could get the book back with any sort of edits, I think that day there was a news article that Aduhelm, aducanumab, had been pulled from the market by Biogen. So, there are these monoclonal antibody therapies that are out there and available, and one of them got pulled because it really doesn’t work that well. It has high risk. Yeah.
Dr. Kara Fitzgerald – And were you able to pull that chunk from the book or at least-
Dr. Heather Sandison – Put little asterisks, no longer available.
Dr. Kara Fitzgerald – I remember going through the same thing, you know, really trying to stay current. Nothing quite as extraordinary as that but thank God you got that in before it went to publication and you couldn’t do anything. And the name of your book is…
Dr. Heather Sandison – Reversing Alzheimer’s is the name of the book. It’s the new toolkit to prevent and reverse cognitive decline, really at any stage.
Dr. Heather Sandison – So I talked to entrepreneurs, attorneys, CPAs, and professionals all the time, and part of the idea with this book is that anyone can pick it up and use it as a toolkit, as a guide to optimize cognitive function, whether you’re looking for a cognitive edge or if you’re looking to support someone with severe cognitive impairment. And also, of course, if you’re in that area where it’s kind of scary, you’re starting to notice yourself that you can’t remember where you put your keys more often and or you’re not finding those words or those names that you used to. It’s harder to calculate. Or often an early sign is feeling overwhelmed. If you’re somebody who used to have a dinner party every Thanksgiving for 25 people, and now the thought of doing that is just too overwhelming, that’s one of those signs. Things that you used to do travel, booking tickets, and making mistakes doing that, or feeling overwhelmed by that, can be one of those early signs. My brain isn’t as sharp as it was.
Dr. Kara Fitzgerald – Yeah. Wow. That’s interesting. I can relate to some of those at the moment, but it’s hard to say when there’s so much going on. But yeah, indeed. I mean, it’s the time for me to be doing some of these investigations. So folks, we’re going to link on the show notes to her paper, to Heather’s research, and to the book, of course. Any other studies she mentions or the testing, we can pop some links to the testing she’s referencing from Quest and LabCorp there as well, so you can go right to them. Let’s talk about this pretty extraordinary study that you guys did, and you did it over at my alma mater NUNM (National University of Natural Medicine) at the Helfgott Research Institute, where we conducted our study as well. And I think, you know, Ryan Bradley and his team are really doing a great job. So yeah, talk to us about your paper, what you guys looked at, what you found.
Dr. Heather Sandison – Yeah. So I agree they have been phenomenal collaborators. Ryan is a good friend, and I had this wonderful opportunity where a philanthropist had a good experience and offered to help us and our study. Of course, we had patients coming in asking if I do this, if I spend the time, the money, if I invest in this approach, how likely is it that my loved one will get better? And I didn’t know the answer. And so, when this philanthropist offered to help, I was like, this is the question I want to know the answer to. If these patients are investing in this, are they going to get better? Is it 50%, is it 25%, is it 80%? And so, I was totally overwhelmed and went to Ryan and I was like, what do you think? He’s like, oh yeah, easy. We got this. And so, we collaborated with them and went through the IRB approval process that took 18 months.
Dr. Heather Sandison – I was like, “Ryan is still really easy?” but he was like, “yeah, this is normal.” And then, recruitment – I thought that was going to be a cakewalk. But we started recruiting in February of 2020, and then the world shut down in March, and so there were all kinds of wrenches, but we did it. For the study design, we had 23 participants who completed a six-month intervention and our primary endpoints were MoCa scores and then we also used the Cambridge Brain Sciences battery of cognitive testing. (Now known as Creyos cognitive tasks.) We looked at quality of life and sleep scores as well. Over those six months of intervention, we recruited people who had measurable cognitive impairment, MoCa scores of 12 to 23. And all these patients were seen here in San Diego at my office. We basically were looking at, what is the clinical course? What happens when we see patients the way we would normally see patients, applying this Bredesen protocol? What happens after six months for people with measurable cognitive impairment? And what we saw was that 17 of the 23 improved after six months.
Dr. Heather Sandison – So that’s about 74%. And we had statistically significant improvements in overall composite cognition, in memory specifically, and in MoCa scores. We had improvements in all of the other domains of cognition that we studied, but they were not statistically significant across the means of all participants. Essentially, what we showed was that most of the time we’re getting significant improvements in cognition. We also saw improvements in quality of life and in sleep.
Dr. Kara Fitzgerald – And to your earlier point, obviously, the earlier you catch it, the more likely you are to be able to achieve normality, which is greater than 26, I think, on the MoCa.
Dr. Heather Sandison – Yeah, exactly. And so, this trial we published in the Journal of Alzheimer’s Disease in August of 2023. Now a year previously, Dr. Bredesen and his team, the first author is Kat Toups, in July of 2022, they also published in the Journal of Alzheimer’s Disease, and they had 25 participants who had a nine-month intervention and they took participants who were less severely declined. They were down to a 19 on the MoCa score, so not as severe and a longer intervention, and 84% of those participants improved.
Dr. Kara Fitzgerald – Yeah, that’s incredible. And they were using a similar, the same kind of structure that you employ?
Dr. Heather Sandison – I mean, it’s functional medicine, right? Everybody has their flavor of it and their style. And they had three sites in that trial, so, there were three different doctors who recruited about ten patients each, and so they each had a different style, but the majority of them got better. And all had been trained by Dr. Bredesen. They were using this functional medicine approach, a very systematic approach to measuring the different components. I think of toxicity- When I think of Alzheimer’s and the way I frame it, the way I organize it in my brain, I’m looking for causal level issues. Right? What’s going to cause imbalance at a cellular level? Too much, too little in the wrong place at the wrong time.
Dr. Heather Sandison – And then from there it’s going to be toxicity, it’s nutrient imbalances, it’s structural imbalances. And that might mean molecular structure like APOE status. It might mean obstructive sleep apnea. It might mean vascular dementia, clogged arteries, or maybe it’s pain. Chronic pain can also cause stress and contribute to dementia. So the way an orthopedist or a chiropractor might think about it, but also the way a molecular geneticist might think about it. So toxins, nutrients, structure, stressors, and that might mean, again, too much or too little. Are you getting enough exercise? Are you sleep deprived? Are you too stressed out and bathed in cortisol all day that’s becoming toxic to your brain? Or do you have enough purpose and meaning? Are you pushing against something? Or are you just watching TV all day and being passive so that you’re not engaging your brain? So, with stress, really it is about balance. And then infections. We know that Covid, the Lyme spirochete, herpes and, P. gingivalis, that’s associated.
Dr. Heather Sandison – I mentioned that my first patient, she had gingivitis. So P. gingivalis can directly trigger inflammation in the brain. H. pylori… There’s a lot of infections that have direct connections to inflammation in the brain. And the gut microbiome, of course, plays a role there as well in nutrient absorption, so our nutrient repletion but also then an infectious burden. And the last is signaling. So as we age, making sure that our vitamin D, our thyroid and our hormones, sex hormones, stress hormones are all balanced so that we’re getting the signals to the brain that promote the creation of new neurons and new connections between them. And when we systematically go through this process, which both Dr. Bredesen’s team did and my team did, those are the outcomes we get, generally improvement.
Dr. Kara Fitzgerald – Yes. Functional medicine, in general, can be challenging for our patients because it is complex. Everything is multifactorial. Treatment plans can be challenging and, in some cases, impossible, and we need to meet people where they’re at and kind of negotiate and make that realistic.
Dr. Kara Fitzgerald – I’m assuming that some of this difficulty prompted you to open your inpatient setting, right, so that you could control those variables so you could really get in there and be able to move the needle, perhaps more efficiently.
Dr. Heather Sandison – Yeah, you’re absolutely right. So what I was seeing clinically was that most people got better, but the people who couldn’t implement, for whatever reason, financial constraints, they lost their driver’s license, they couldn’t get anywhere, they couldn’t get the right food, they had a son who wanted to have a happy hour every night. Right? Like there’s all kinds of crazy constraints that come up.
Dr. Kara Fitzgerald – You have to have a broad enrollment. The individual may not even be obviously that aware of what’s happening. I mean, you really have to have this deep buy-in to engaging in this protocol. Yeah.
Dr. Heather Sandison – The trial was set up as a feasibility trial, right? I mean, we didn’t know what kind of outcomes we would get, but it was really like, can we do this with a cognitively declined population? Can we implement a multimodal functional medicine intervention? And the answer was yes. Now to be clear, nobody did everything. No one was perfect.
Dr. Kara Fitzgerald – Are you able to tell? I mean, that’s something that we looked at in our study. Like, how much adherence actually needs to take place. Do you have some ideas around that?
Dr. Heather Sandison – Yeah. So we sent everyone home with pill boxes, and then we counted what pills were left. And, you know, of course, then somebody would say, “Oh, well, I couldn’t take them. I threw them away.” And then they’d come back with their pill boxes empty. And I was like, “Oh, I don’t know how—I think I shared that with you when I saw you at a conference. I was like, I don’t know about this whole pill counting thing.” But what we did check was ketone levels. So a mildly ketogenic diet was part of the protocol and there were people who improved who never got into ketosis measurably. So, you know, they weren’t on a CGM (continuous glucose monitor) or we weren’t measuring continuous ketones.
Dr. Heather Sandison – Maybe they did at a time that we didn’t check. But, you know, we certainly got feedback from their partners, we had these the pill box counting, and we did have them do kind of a journal checkbox thing where they told us what they were engaging in and what they weren’t. And it’s such a good point that you have, like, is this possible to do? Right? And I think that’s part of the beauty of these multimodal interventions. It’s kind of a choose your own adventure. Do the part that works for you. And we might not get 100% reversal, but just doing what you’re capable of should get us some improvement. And then maybe we can use that to build and stack these interventions.
Dr. Kara Fitzgerald – Yeah. I mean, especially if they and their loved ones are able to witness that, you know, to actually see the change. That’s highly, highly motivating.
Dr. Heather Sandison – I mean, it’s so fun. Just this January I had a family and she’s just so adored by her- She has two daughters and her husband and they came in January and she started with a MoCa score of 8, so a single-digit MoCa score about a year and a bit ago, and she now has a MoCa score of 15. And after Christmas a year ago, she had been kind of despondent in the corner and this is the woman who hosted holidays every year forever, and well, December 2023 versus 2022, the cousins were like, oh my gosh, your mom’s back. Auntie’s back. And she was buying Christmas presents for the grandkids and engaged and I get chills just even talking about them. They’re such a sweet family. The daughters are so supportive, and the husband… I tell people it’s like watching a game of volleyball because they’re like, okay, you take her to the sleep study. All right, I’ll make sure that I call and schedule it. And you can do Mondays. Right?
Dr. Heather Sandison – And it’s just like this incredible collaboration to care for this absolutely adored woman. And, you know, there’s been ups and downs. She ended up hospitalized with a GI bleed at one point on our journey together. And it hasn’t all been unicorns and rainbows, but she is significantly better and people notice. And she is back.
Dr. Kara Fitzgerald – And they did this outpatient? They weren’t in your inpatient setting.
Dr. Heather Sandison – Yeah. And no one in the clinical trial to be clear to you, they were all patients in my clinic. So, it’s confusing because there’s the community, the residential facility, we haven’t done any clinical trials there. We haven’t done any research there. We’ve done it all in an outpatient setting in a functional medicine practice.
Dr. Kara Fitzgerald – Okay. But you’re going to try to do the retrospective analysis looking at the Kansas group? It would be interesting to fold in the California group as well.
Dr. Heather Sandison – Yeah.
Dr. Kara Fitzgerald – So out of the buckets that you outline in the protocol you use, what are the areas that pretty consistently light up?
Dr. Heather Sandison – In terms of imbalances?
Dr. Kara Fitzgerald – Yeah. So, not everybody has mold. Probably not everyone has a smoldering occult infection. Or maybe they do in your experience. I’m actually really curious about that. But we know that most individuals, you know, really in the world, I won’t even cite USA in this, are somewhere on the metabolic continuum. They’re marching towards diabetes. And so that’s got to be a bucket that you’re seeing broadly. But anyway, what in your experience, what are the areas that would really light up.
Dr. Heather Sandison – That’s funny, because it’s actually the opposite. I think by the time people end up in a naturopathy clinic, in a functional medicine clinic, I haven’t seen a ton of metabolic syndrome. I don’t see a ton of diabetes. Now, in the clinical trial, there were, I’m not remembering exactly the number, it is in the paper we refer to, the different buckets and how many people were in each of them. 23 out of 23 had toxicity. If you look for it in this population, they’re older, and so there is some degree of toxicity, whether it’s metals or mold or environmental pollutants. We found it in every single one. Significant-
Dr. Kara Fitzgerald – And did a particular type of toxin or toxins light up more than others?
Dr. Heather Sandison – Not really. Yeah, kind of a mix. And there were certainly some people who had all of them, and some of them, I remember there was a gentleman who had very high levels of both mold and glyphosate, and they were the highest numbers I had ever tested. So there were some people that had very, very high levels, but not all of them. All of them had some degree of toxicity. Obstructive sleep apnea is one where, this is very conventional and I also think it gets missed. It’s been hard. There’s a lot of resistance to doing an overnight sleep study in a clinical setting.
Dr. Heather Sandison – And with Covid, there’s been a lot of technology towards the at-home sleep studies that can rule in apnea. They can’t rule it out, and they’re not looking for other sleep disorders, but for sleep apnea, obstructive sleep apnea, you can catch this on these at-home devices. And I think that will help us to prevent people from declining cognitively because it’s such a big part of- Hypoxia to the brain is going to trigger neurodegeneration. It’s going to prevent you from doing the rinsing of the brain. The lymphatic system is active in deep sleep. And so, if we miss that, we have an accumulation of not just amyloid plaques, but everything that’s triggering them.
Dr. Kara Fitzgerald – Just going back to amyloid plaque, do you anticipate seeing some of these newly available labs improving? And are you using them in your clinic setting?
Dr. Heather Sandison – So they’re cash pay right now, and it costs about $700 to do them, so there’s a part of our population that can afford that and wants to see them.
Dr. Heather Sandison – They don’t change my treatment plan and so, we’re doing it really for research purposes to say, what’s the directionality here? My treatment plan is going to be changed based on the why. What’s triggering neuroinflammation or neurodegeneration. And so, I don’t require that everyone gets them, but I put them on all treatment plans and if somebody can afford them, then we’re happy to run them. It’s pretty new and so how it plays out, I’ll be very curious to see. I hope that it helps to inform us. And certainly, if I were talking to the Pacific Neuroscience Institute, where Dr. Bredesen works, Dr. David Merrill is there and runs that institute and we’re talking about doing a randomized controlled trial. Dr. Bredesen’s group has a five-site randomized controlled trial that they are recruiting for right now, I think, at the very end of recruiting and so, we’ll do a basically a follow-up to that. So, we’re putting that together right now and we will absolutely be using the imaging and all of those markers in a trial.
Dr. Kara Fitzgerald – Okay. That will be interesting to see long term. And that actually brings me to another question. I think that between you and Bredesen’s team, you’ve demonstrated that larger trials are needed. So what are the numbers for these follow-up trials?
Dr. Heather Sandison – He’s recruiting, I think, 70 participants, and it’s randomized-controlled and then they’ll cross over, so that the control group will cross over. At the Pacific Neuroscience Institute, they’re doing a prevention trial as well. They’re looking at people with mild cognitive impairment to see if they can prevent progression. They have a trial going on right now. So those two are happening, and we are working on a follow-up trial, another one and we always are going to need more research. One thing that is challenging is, well, why don’t you have these great big randomized controlled trials? This isn’t going to be funded by a pharmaceutical company. This is not something you can get a patent on. This isn’t a quick, simple, single molecule intervention. I really think it’s time to reject the idea that that will work. This is a complex disease process with multiple triggers, multiple whys, multiple reasons that neurodegeneration starts and that’s where we need to be focused. And that’s not a one-size-fits-all, Medicare covered… Hopefully, it’ll be Medicare-covered when they see the data and when we continue this work. I do hope that it becomes Medicare-covered. But it’s not a simple intervention. It’s hard. It’s also not the type that a pharmaceutical company is going to put a bunch of money behind to take through phase 3 clinical trials. It’s a precision-based, individualized approach, and it meets the complexity of the disease process. It’s a complex intervention, but it’s a complex disease.
Dr. Kara Fitzgerald – That’s very well stated. So, you guys will just continue to gather data, doing the best that you can, and hopefully, an investor, you’ll have another philanthropist, somebody with deep pockets who can sort of see how to bring this forward into the world in a meaningful way, will really usher us into larger trials. But in the meantime, the work that you all are doing is really extraordinary. I’m so excited for you. I’m so excited for you, for the book, for the publication. By the way, it’s open source. It’s in the Journal of Alzheimer’s Disease again. It came out in 2023, Sandison is the lead author. “Observed improvement in cognition during a personalized lifestyle intervention in people with cognitive decline.” And Heather’s book, Reversing Alzheimer’s, is here. You can get it; you can grab it. It’s great for the clinician, but I think it’s also accessible. You designed it for everybody.
Dr. Heather Sandison – Yeah, absolutely. Hopefully, it’s a companion and adding each of these things, there is certainly a coaching component to it. Where do I start? It can feel overwhelming. And really what I’m most excited for is for the patients, right? That hopefully, we can reduce the suffering and the burden of this disease.
Dr. Kara Fitzgerald – I am just so excited for you. God, thanks for taking this on. You know, thanks for really making this your mission and bringing it forward in such a clear, elegant way and for taking the time to do the science. I mean, it’s intense running a clinical trial. I mean, it’s a big deal and writing a book, and here you are doing it. And starting an inpatient clinic, I just can’t even imagine that one. The rest of the stuff I have some familiarity with, and it’s a lot. Continue to rock the world, and we will certainly support you.
Dr. Heather Sandison – Thank you Kara. Such a privilege to be here.
Dr. Heather Sandison, a distinguished naturopathic doctor, has devoted her career to providing compassionate care and innovative solutions to those affected by dementia. Renowned for her pioneering work, Dr. Sandison has integrated groundbreaking, holistic, and multimodal interventions, seamlessly creating clinical, residential, research, and educational platforms. Her relentless dedication has not only transformed the lives of patients and caregivers she has also set new standards in the field of dementia care.
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REVERSING ALZHEIMERS: The New Tool Kit to Improve Cognition and Protect Brain Health by Dr. Heather Sandison
The End of Alzheimer’s by Dale Bredesen
Montreal Cognitive Assessment (MoCa)
Marama Residential Care Facility
Creyos Cognitive Tasks (Formerly known as Cambridge Brain Sciences)
Study: Precision Medicine Approach to Alzheimer’s Disease: Successful Pilot Project
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- Podcast: Addressing Root Causes of Neurodegenerative Diseases with Dr. Dale Bredesen
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- DrKF Clinic: Patient consults with DrKF physicians including Younger You Concierge
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