CAN ALZHEIMER’S BE PREVENTED?
When I take time away from my practice and speak at various conferences, one question that I’m often asked is, “What disease or illness are people most afraid of?”
Most people may automatically think the answer is the dreaded cancer. But when you peel back the layers, and get to people’s inner fears, it usually involves their loss of memory. And more often than not, Alzheimer’s disease is most associated with this tragic symptom.
The thought of losing one’s independence is scary enough, but imaging a point in time when you may not even recognize your closest loved ones is one thought that few of us even want to ponder. Often this is because Alzheimer’s or other forms of senile dementia have touched so many of our lives. After all, over 4 million Americans have Alzheimer’s, and as our population ages these numbers will surely grow. As we age, our chances of getting Alzheimer’s go up dramatically. At age 85, we have one in two chance of seeing the onset of the disease.
WHAT CAUSES ALZHEIMER’S?
Alzheimer’s Disease is a brain disorder that usually occurs in the later years of life, although the first case of Alzheimer’s Disease was described by Dr. Alois Alzheimer in the early 1900’s in a woman in her early fifties. Over the last century, there has been extensive research into the cause of this dreaded condition; unfortunately, the medical establishment still has few answers. There have been some studies over the years indicating that aluminum toxicity may play a role in the development in this disorder although it is considered controversial1. Nevertheless, it is still probably prudent to minimize exposure to this metal. There does seem to be some genetic predisposition in some families. The most recent theory is that there is excessive oxidative stress (similar to the rusting process of metal) that takes place in certain portions of the brain2. With the destruction of these nerve cells, there is loss of certain neurotransmitters such as acetylcholine and others that are critical in mental functioning.
CURRENT MEDICAL TREATMENT
The primary pharmaceutical agent presently being utilized in this country for Alzheimer’s disease is Aricept. The drug, Cognex, was previously approved by the FDA but has been largely abandoned by physicians because of the significant side effect profile, including liver toxicity. Both of these drugs are cholinesterase inhibitors, which raise the level of acetylcholine in the brain. Although Aricept is easy to take and has only mild side effects, it is not a very effective medication. The current treatment for these dementing patients is frustrating not only for the families but also for the doctors themselves.
THE CRITICAL ROLE OF NUTRITION
For over last few years, I have totally devoted myself to learning all that I can about nutritional supplementation and its value in the treatment and prevention of disease. I have reviewed thousands of studies during this time and I have seen some very promising studies focused on Alzheimer’s.
Recent studies have shown that vitamin E has far reaching effects throughout the body including benefits regarding dementing illness. With respect to Alzheimer’s, it’s been demonstrated that large amounts of vitamin E may slow the progression of the disease, according to the researchers from the Alzheimer’s Disease Cooperative Study published in the prestigious New England Journal of Medicine3. In this two-year study of 341 individuals with Alzheimer’s of moderate severity it was found that 2,000 IU per day of vitamin E extended the time patients were able to care for themselves, such as bathing, dressing, and other necessary daily functions, compared to those taking a placebo.
Recent studies indicate that Alzheimer’s patients can have a relative deficiency of thiamine (vitamin B1) within the brain. There is a particular form of dementing illness known as Wernicke Korsakoff Disease. This disorder most frequently occurs in chronic alcoholic patients or in individuals on long-term hemodialysis. Treatment with thiamine can immediately reverse some of the effects of this disease. Thiamine, which is involved in glucose metabolism, can mimic the neurotransmitter, acetylcholine4. Thiamine is also critically important in cardiovascular function.
The herb, ginkgo biloba, has been used for decades in Europe as a leading treatment for early stage Alzheimer’s. While not a cure, ginkgo biloba extract (standardized to 24%) may improve memory and quality of life in the early stages. In a double-blinded, randomized study published in JAMA in 1997, those patients treated with 120 mg of standardized gingko showed stabilization of their condition over the one-year study period with 37% showing some actual improvement5. I prescribe this nutrient on a regular basis to my patients with early dementia. Gingko is thought to work by increasing cerebral blood flow, stabilizing cell membranes, potentially reducing inflammatory response within the brain, and acting as a potent free radical inhibitor. Although it is considered a safe nutrient, it does have mild anti-coagulant effect and should not be used in patients taking Coumadin.
Phosphatidylserine is the major phospholipid found within the cell membranes within the nerve cells in the brain. Twenty five human studies (about half of them double blinded) have been conducted in the U.S. and Europe using phosphatidylserine with the results showing conclusively that this nutrient can help maintain concentration and memory6.
There is a nutrient known as acetyl-L-carnitine that contributes to the production of the neurotransmitter acetylcholine. Several clinical trials have suggested that this nutrient can delay the progression of Alzheimer’s, improve memory and overall performance in some individuals with the disease7.
Huperzine A, which is a novel alkaloid isolated from a Chinese herb, appears to have promise in the treatment of Alzheimer’s. It works in a similar fashion to the cholinesterase inhibitors drugs presently on the market (such as Aricept), but seems to have an overall better therapeutic index with minimal side effects. In a double blinded randomized study in China looking at over 150 patients with Alzheimer’s and multi-infarct dementia, those individuals treated with Huperzine A between 0.3 mg. to 0.5 mg. twice a day for two to four weeks, showed a significant improvement in memory compared to the placebo group8. Although this nutrient is relatively new on the scene, it appears to have great therapeutic potential.
Several population studies have shown that all age groups including the elderly do not consume adequate levels of the essential vitamins, minerals and other nutrients.
The senile dementia patients usually fare less well than most when it comes to nutrient intake. I recommend all individuals with memory disorders to consume a well balanced Multivitamin, multimineral formulation containing at least 500 to 1,000 mg. of Vitamin C (preferably Ester C), along with 400 to up to 2,000 units of Vitamin E daily. Studies have shown that natural vitamin E is much better absorbed and utilized than synthetic vitamin E. It is extremely important to get good doses of all of the B vitamins especially thiamine (vitamin B1). I typically recommend that these patients get 35 to 75 mg. daily of vitamins B2, B3, B5 and B6 with 200 to 400 mg. daily of thiamine. One particular B vitamin, known as cobalamin (Vitamin B12) seems to be most effective in the methyl form (methylcobalamin) rather than the usual cyanocobalamin. The typical daily B12 intake should be in the range of 100 to 1,000 micrograms. Folic Acid in the amount of 400 to 1,000 micrograms daily is essential to reduce risk of cardiovascular and cerebrovascular disease.
It is also important to consume adequate minerals principally magnesium and calcium. The calcium form should be calcium citrate around 500 to 1,000 mg daily. Other forms of calcium especially calcium carbonate depend on a certain pH in the stomach and with less acid production in the elderly, absorption of calcium carbonate could be quite negligible. Calcium citrate, however, is absorbed independently of pH9. Supplemental magnesium intake should be in the range of 300 to 400 mg. daily. Use the chelated, not the oxide form. A small amount of zinc (15 to 30 mg. daily) is important. The form of zinc I prefer is zinc monomethionine, brand name L-Opti zinc.
Aside from the standard vitamins and minerals listed above, I favor the use of ginkgo biloba (60 to 120 mg. twice a day), phosphytidylserine (100mg. three times a day) and Huperzine A (0.3 mg. twice a day). There is certainly the potential for some side effects if these three nutrients are utilized simultaneously. I would probably introduce one nutrient supplement at a time and monitor the effectiveness. Be sure to check with your doctor about any possible drug interactions
Although Alzheimer’s disease is usually a progressive degenerative disorder with no real possible cure, I believe that with early and effective nutritional intervention, the condition can be slowed and quality of life can be prolonged. I further believe that with proper long-term vitamin and mineral supplementation that the onset of this devastating disease could be potentially delayed for many years or possibly even avoided altogether.