Nov
02
2019

A New Drug For Alzheimer’s

It is not the first time that there has been an announcement of a new drug for Alzheimer’s. In the first place, in 2013 Pfizer had to admit that their new drug did not exceed the effects of placebo. Second, in 2016 Eli Lilly’s drug solanezumab failed to show effects in Phase 3 trials. Third, Merck developed a drug that was supposed to fight beta-amyloid plaques of the brain in Alzheimer patients. But the drug was not effective and the trials were discontinued in 2017. Fourth, Johnson & Johnson’s attempted to develop a drug that would slow cognitive decline in early Alzheimer’s patients. But study participants developed elevated liver enzymes indicating liver toxicity. The trial stopped in May 2018. This meant that a new drug for Alzheimer’s had not been developed.

New drug against Alzheimer’s may be expensive

In like manner the pharmaceutical giant, Biogen and its Japanese partner Eisai have now announced that they were successful in Phase 3 clinical trials with the new drug aducanumab. In other words, patients with Alzheimer’s disease experienced better brain function, memory, cognition, orientation and language. One of the doctors involved in clinical trials of this drug notably mentioned that even, if the FDA hurdles are overcome, the drug might be extremely expensive. This could be devastating to patients and families of Alzheimer’s patients, who are most likely unable to afford a costly medication.

Alternative approach to treating and preventing Alzheimer’s

At the 22nd Annual A4M Las Vegas Conference in mid December 2014 Pamela Smith gave a presentation entitled ”How To Maintain Memory At Any Age”. She gave a comprehensive overview of what you can do to prevent Alzheimer’s disease. Surely, the better we understand the causes of Alzheimer’s the more we can interfere with the biochemical processes that lead to Alzheimer’s or dementia.

Specifically, there are many lifestyles that cause memory loss: too much stress (from high cortisol levels that damage the hippocampus); smoking that damages acetylcholine receptors; chronic alcohol abuse leads to memory problems from the toxic effect of alcohol on brain cells. This in turn causes a disbalance of serotonin, endorphins and acetylcholine in the hippocampus. This area of the brain is where our memory is located.

Lack of exercise

The first thing to remember is that a lack of exercise is an independent risk factor for the development of Alzheimer’s disease. Exercise increases the blood supply to the brain, strengthens neural connections and leads to growth of neurons, the basic building blocks of the brain. In addition, mood-regulating neurotransmitters are also receiving a boost (serotonin and endorphins).

Inflammatory conditions, foods and drugs that can affect memory

Conversely, any inflammatory condition can trigger destruction of neurons, so do the beta-amyloid proteins associated with Alzheimer’s. By the same token, contributory factors can be food allergies, disbalance of gut bacteria, recreational drugs (particularly ecstasy) and certain medications. Equally important, Dr. Smith stated that the most common foods causing allergies that affect the brain are: sugar, wheat, dairy, eggs, shellfish, potatoes, beef, tomatoes, corn, coffee, peanuts, roasted soy beans and yeast. Moreover, Dr. Smith mentioned that the following medications can affect memory: statins, sedatives, steroids, levodopa, muscle relaxants, antihypertensive drugs, antidepressants, antibiotics, anticonvulsants, anti-arrhythmic drugs, pain relieving drugs (analgesics) and antihistamines. Regarding antihistamines it is only the older type like Nytol, Benadryl, Ditropan and Piriton, which have strong “anticholinergic” effects and make you tired.  If you are on any of these, you may want to discuss alternatives with your doctor. Similarly, Dr. Perlmutter mentioned in Ref. 1 that statins interfere with brain function and can lead to Alzheimer’s.

Promoting brain health

Medication helps only to stall further memory loss for up to 6 months, so Dr. Smith said about medications only: “much research is still necessary in this area”.

On the other hand she stated that many foods, vitamins and supplements in combination could improve memory and prevent the development of Alzheimer’s disease.

She spent considerable time in the remainder of her talk on details regarding foods, vitamins and supplements.

Dr. Smith said that we need to eat foods that are rich in antioxidants like blueberries, apples, raspberries, blackberries and strawberries; cherries, cranberries, cooked kale, garlic, grapes, prunes, raisins and raw spinach. But at the same time she stressed that we cannot trust the food industry anymore, and we need to buy organic foods. She gave an example of the “dirty dozen” as defined by the environmental working group (contaminated fruits and vegetables).

Portion control and healthy fats

Food intake also applies to portions: eat 5 to 6 smaller meals per day. Consume red meat no more than three times per week.

The brain needs fats like nuts and seeds: walnuts, almonds, pine nuts etc.

Fish also contains healthy omega-3 fatty acids and DHA. The problem with predator fish like tuna or swordfish is that they have high contamination levels of mercury. But wild salmon and mackerel are still OK. A good alternative is to supplement with pharmaceutical grade EPA/DHA omega-3 capsules.

They are molecularly distilled, which means they are not contaminated with mercury or PBC’s, and they are more concentrated; they typically contain 1000 to 1400 mg of EPA/DHA per capsule. One to two capsules twice per day (a total of 2 to 4 per day) would be a good anti-inflammatory dose.

Specific food recommendations

Use olive oil and coconut oil for cooking; avoid the omega-6 oils (safflower oil, grape seed oil, sunflower oil, corn oil to just mention a few). These latter oils, which are heavily advertised by the food industry, create too much arachidonic acid leading to body inflammation. Your brain is very sensitive to inflammation, which causes Alzheimer’s. For the same reason avoid deep fried foods and processed foods.

There is more you need to watch for: no food additives, no artificial food colorings, no preservatives, flavors and MSG. Be alert about the food industry’s alternative “language” or terminology for MSG. The label often says “natural flavor”, “yeast extract” etc.

Brain nutrients

Dr. Smith reviewed a long list of brain nutrients that support the brain in its metabolism and prevent the development of dementia and Alzheimer’s disease.

I will only highlight the most effective and established nutrients here. 

DHA

It has been known since 1999 that Alzheimer’s patients are missing DHA in their system.

Molecularly distilled fish oil with high omega-3 fatty acids (both EPA and DHA) is one of the mainstays of prevention of inflammation in the body and the brain. 2 capsules twice per day of the concentrated 1000mg to 1400 mg capsules is a desirable dose to prevent Alzheimer’s disease.

Phosphatylserine (PS)

This phospholipid is part of the membrane of brain cells and controls what nutrients enter into them. It also increases the neurotransmitters acetylcholine, serotonin, norepinephrine, epinephrine and dopamine.

Dr. Smith mentioned that PS is naturally present in foods like brown rice, fish, soy and green vegetables (particularly the leafy ones). The daily dosage recommended by Dr. Smith is 300 mg (note: some people develop a bothersome, but harmless bitter taste in the mouth at this dose; in this case you can take a lower dose like 100 or 200 mg per day).

Ginkgo biloba

Ginkgo Biloba improves blood flow to the brain and counteracts shrinkage of the hippocampus with age. Dr. Smith recommends 60 mg to 240 mg daily.

Alpha Lipoic Acid: Alpha lipoic acid is an antioxidant which helps stimulating the sprouting of new nerve cells and nerve fibers. Take 100 mg of alpha lipoic acid daily for memory.

Other supplements

Dr. Smith recommended many other supplements, which I will not explain in detail here: B vitamins, vitamin E and C, carnosine, acetyl-L-carnitine, boron, ginger, coenzyme Q10 (or CoQ10), curcumin, vinpocetine, zinc, grape seed extract, blueberry extract, Ashwaganda, glyceryl-phosphoryl-choline, SAMe, huperzine A and DMAE.

When the benefits of taking CoQ10 were discussed, Dr. Smith reminded the audience that “whatever is good for the heart, is good for the brain”. She recommended to read Dr. Perlmutter’s book from which this phrase was borrowed (Ref. 1). Her recommended dose of CoQ10 for people above the age of 50 was 400 mg per day. That’s double of what a 35-year old person would need.

Genetic factors

Dr. Smith pointed out that there are about 5 genes that have been detected to have an association with Alzheimer’s disease and in addition the apolipoprotein E4 (APOE4). About 30% of people carry this gene, yet only about 10% get Alzheimer’s disease, which shows how important lifestyle factors are (in medical circles this is called “epigenetic factors”) to suppress the effect of the APOE4 gene. She also stated that our genes contribute only about 20% to the overall risk of developing Alzheimer’s disease. This leaves us with 80% of Alzheimer’s cases where we can use the brain nutrients discussed above and exercise to improve brain function. Since then new Alzheimer’s genes have been detected, namely a total of 25 genes. However, this does not change what Dr. Smith has stated, namely that a healthy lifestyle can mostly overrule the effects of genes and only 20% the genes will result in the overall risk to develop Alzheimer’s.

A New Drug For Alzheimer’s

A New Drug For Alzheimer’s

Conclusion

Don’t wait for a magic pill by Big Pharma that they may come up with. The latest such pill may be aducanumab from Biogen and its Japanese partner Eisai. But as mentioned earlier the drug might be extremely expensive and unaffordable for the regular consumer.

Follow the simple steps in combination that Dr. Pamela Smith talked about in her presentation: Exercise, have organic food to keep toxins out of your body and brain, replace missing hormones with bioidentical ones and take supplements that are effective. In other words provide the right environment for your genes to work properly without getting Alzheimer’s disease.

Reference

  1. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

 

Jun
11
2016

Drugs Can Cause Dementia

An April 2016 study from Indiana University found that drugs can cause dementia. There were 451 people enrolled in the study with an average age of 73. 60 of them were taking at least one or more anticholinergic drugs. Anticholinergic drugs are drugs that inhibit the neurotransmitter acetylcholine in nerves or in the brain. As a result spasms in the stomach, bowel or bladder are relieved. Also the many over-the-counter sleep medications that may contain anticholinergic drugs help you to fall asleep easier. In the above-mentioned study researchers measured the effects that the drugs have, using different tests. They used memory and cognitive tests to check for memory loss, reasoning and judgment. PET scans are a useful diagnostic tool to measure brain metabolism. MRI scans were used to look for structural brain changes.

Results on how anticholinergic drugs can cause dementia

Memory tests and cognitive function tests showed that those taking anticholinergic drugs did worse on memory tests, verbal reasoning, problem solving and planning. The PET scan showed that glucose utilization by the brain was down in those who were taking anticholinergic drugs. It was apparent that the hippocampus had particularly lower glucose utilization. This is the center where short-term memory takes place. The hippocampus is also the area where Alzheimer’s patients have problems with early memory loss.

MRI scans showed that there were structural brain changes in the patients that were using anticholinergic drugs. There was a reduction of their brain volume (brain atrophy) and there was an enlargement of their brain cavities (ventricles). Overall this meant that their brains had much less brain cells when compared to controls that did not take anticholinergic drugs.

Indian University study about anticholinergic drugs

In a 2013 study from the Indiana University researchers had established that it took only 60 days of taking anticholinergic drugs to cause cognitive problems. Using drugs with only weak anticholinergic side effects, it took up to 90 days before the same cognitive deterioration could be measured.

The researchers concluded that it would be wise for physicians to consider switching a patient to medication that does not include anticholinergic side effects to prevent development of dementia or Alzheimer’s disease.

Anticholinergic drugs can cause dementia

In the study above it was stated that it was the group of anticholinergic drugs that was particularly problematic. These are over-the-counter-drugs like sleep aids, antihistamines, and incontinence drugs etc. that had anticholinergic side effects. The more of these types of drugs people take, the more interactions are possible, leading to full-blown anticholinergic symptoms. As people age, they collect more and more symptoms and diseases. Physicians tend to treat the symptoms with various medications, so it is not unusual for an elderly person to be on 5 or 6 different drugs. If one or more of these drugs have anticholinergic side effects, this can add up and cause the kind of observations the above mentioned clinical study showed: dementia symptoms and proof that the brain metabolism has been slowed down. The brain also experiences the structural changes of dementia that I mentioned.

Possibility that herbs and drugs can cause dementia

The problem does not stop here. It is possible that over-the-counter herbs that you may innocently get in the health food store can participate in the overall metabolic interaction of anticholinergic substances. Many herbs have pharmacological substances in them that have specific helpful effects. But whenever a drug or herb has a positive effect, quite often there is an undesirable effect or side effect.

Historically Belladonna is a poisonous plant that has medicinal values. Unfortunately many Belladonna preparations are available in health food stores that are not regulated by the FDA. Belladonna has strong anticholinergic side effects that interfere with other anticholinergic side effects.

There are many other herbs that are available without prescription.

Kava-kava, passionflower and hops

Kava-kava is an herb and a hallucinogenic that has anticholinergic properties. If you use Kava-Kava, keep in mind that the more you consume it, the more your brain shuts down. Why? The anticholinergic effect of Kava-Kava shuts down acetylcholine, the main stimulus in your brain cells to help you think.

Passionflower is an herb that sedates and is often used as a tincture to help you to fall asleep. What people perceive as a “natural effect” is merely the anticholinergic effect on the central nervous system.

Hops is the calming compound found in beer. It is also often in use together with other sedating herbal sleeping remedies in sleep inducing teas.

St. John’s wort and skullcap

St. John’s wort is also on the list. In smaller doses this herbal antidepressant may be useful and may have less side effects than commercial antidepressants. But there are possible side effects of dry mouth and constipation, which are the result of the anticholinergic side effect.

Skullcap is often used in tea to help a person to fall asleep. But keep in mind that the effect of helping you fall asleep comes from the anticholinergic effect of skullcap on brain cells.

All of these herbs are not any different from the medications in the discussion above, except that they are a bit weaker with regard to the anticholinergic effect.

Street drugs can cause dementia

Many street drugs are sedating and they have anticholinergic effects. It is therefore no surprise that with chronic use of street drugs drug users can come down with dementia, even at a relatively young age. Long-term use of anticholinergic drugs is associated with delirium and dementia.

Particularly benzodiazepines, meperidine (an opioid), antidepressants and many other drugs when taken together cause dementia, in part because of additive anticholinergic activity.

Pathology findings in street drug users

In an Edinburgh study from England 34 deceased patients, who were heavily using street drugs were autopsied. The researchers compared their brains to healthy 16-year-old non-drug users. There was nerve cell damage in the brain area, which is the control center for learning, memory and wellbeing. The pathologist found the same dementia findings that would be present in much older Alzheimer patients. We have to conclude from this that the anticholinergic effect of the drugs they received as a mix in the years prior to their deaths caused the damage to their brain. Toxicity to nerve cells from interacting drugs and their side effects can add up.

Drugs Can Cause Dementia

Drugs Can Cause Dementia

Conclusion

Whenever you have a substance that helps to get you drowsy so you can sleep better, be careful and check that it is not because of the anticholinergic effect of an herb or an over-the-counter drug. Melatonin is an exception, because this is your body’s own sleeping hormone that your body knows. Whenever anticholinergic drugs or herbs act on your brain they can over time cause an irreversible brain atrophy. As mentioned in the study above, an MRI scan can shown brain atrophy quite well. This leads to cognitive problems including memory problems.

PET scan shows slowdown of glucose metabolism in hippocampus

PET scans have also shown a permanent slowdown of glucose metabolism of the brain cells of the hippocampus, where short-term memory is located. Without that function you get permanent dementia. Ask your physician to treat the cause of your symptoms instead of treating you symptomatically. You may not always get the answer you need from conventional medicine. As the next step you may want a second opinion from a naturopath to see whether there would be an alternative treatment available that does not involve anticholinergic medications. Go to the root of the problem, avoid drugs that cause damage, and keep your brain healthy and your mental capacities without cognitive deficits!

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