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.

 

Feb
01
2014

Early Alcohol Use Will Result In Memory Loss Later In Life

Researchers found that heavy alcohol use in males during midlife paves the way to memory loss from dementia later in life.

I thought that this would be a good topic to review the effect of alcohol in general. Alcohol is a known cell poison, yet cardiologists keep on referring to the beneficial effects of that 1 glass of wine per day that will prolong your life. I will attempt to explain these diverse effects, where small amounts are supposed to be good for you while high amounts can be very damaging.

Review of the effects of alcohol

50% of the world population drinks alcohol, 10% to 20% have chronic alcoholism (Ref.1).  Just recently a Guardian news study was released showing that an astounding 25% of Russian men die before reaching the age of 55, compared to only 7% of men in the United kingdom and less than 1% of men in the US. The study looked at the effects of consuming large amounts of vodka.  There are about 10 million chronic alcoholics in the US. Chronic alcohol consumption leads to 100,000 deaths every year in the US. More than 50% of these deaths are from traffic accidents, the rest from medical problems caused by alcohol (Ref.1). Most of the alcohol gets detoxified through the liver cells and is metabolized into acetaldehyde. This involves the cytochrome P-450 system. That means that when a person also takes narcotics, sedatives or psychoactive drugs that are also metabolized through this liver enzyme system drugs and alcohol are taking much longer to be metabolized. This can lead to lethal overdoses that we hear about on TV all the time, hence the warning that you must not mix alcohol with drugs.

Early Alcohol Use Will Result In Memory Loss Later In Life

Early Alcohol Use Will Result In Memory Loss Later In Life

Alcohol is a cell and nerve poison. The most vulnerable organs in the body are the liver, brain, heart, pancreas, bone marrow and stomach. So, here are a number of conditions caused by drinking alcohol:

a)    Anemia: When a person drinks heavily and regularly anemia shows up in a blood test. Alcohol has a toxic effect on the bone marrow, which interferes with the production of red blood cells. But certain vitamins required by the bone marrow to manufacture red blood cells are often also missing in the diet of an alcoholic, which contributes to anemia as well.

b)    Cirrhosis of the liver develops in 10% to 20% of heavy drinkers. With cirrhosis part of the liver cells get replaced by fibrotic tissue and in advanced cases this can lead to a hepatic coma and death. Others are developing alcoholic hepatitis. This is an inflammation of the liver with fever and jaundice where the skin and eyeballs turn yellow. It is associated with severe abdominal pain.

c)    Gastritis: Alcoholic gastritis is common, but often undetected. The affected individual may just have stomach pains for a few days, or vomit food and/or blood in addition. With continued use of alcohol it may turn chronic. Alcoholic gastritis can turn into gastric ulcers with massive bleeding that often lead to death.

d)    Pancreatitis: The pancreas is a particularly vulnerable glandular tissue, which gets damaged by regular alcohol intake and with chronic alcohol intake gets partially replaced by fibrotic tissue causing the feared and painful chronic pancreatitis. This is a condition with vomiting and severe abdominal pains that can be unrelenting.

e)    High blood pressure, seizures, dementia, depression, heart irregularities and nerve damage:

You may ask yourself how all of these conditions would be reasonably under one heading. The heading for this is “nerve damage”. Let me explain: The sympathetic nerve is very sensitive to alcohol toxicity and when the sympathetic nerve fibers are damaged, you will develop high blood pressure. You see your physician, get blood pressure medication, but the pressure is difficult to control, if you continue to drink alcoholic beverages. It does not make sense to just add blood pressure pills and hope that this will cure your problem. Seizures are due to direct nerve damage in the more sensitive parts of the brain, which will cause these areas to produce extra electrical activities, which we call seizures. Again, just treating with anti-seizure medications is not the solution. Avoidance of alcohol is the other part of the treatment schedule. Dementia from heavy alcohol use is due to direct nerve atrophy in the brain. Our brain shrinks normally 1.9% to 2.8% per decade, depending on which research papers you read. But in the presence of heavy drinking the frontal lobe of the brain is particularly vulnerable to brain shrinkage.

As this publication shows, mild and moderate drinkers did not suffer more frontal lobe shrinkage than abstainers, but heavy drinkers had a 1.8-fold higher risk of frontal lobe shrinkage on average when compared to abstainers. It was calculated that alcohol had contributed 11.3% to that frontal lobe shrinkage.

The rest of the toxic effect on the nerve tissue explains why depression would develop. The frontal brain contains most of the serotonin producing nerve cells. When serotonin-producing nerve fibers get damaged, the body does not produce enough serotonin to prevent depression from setting in; GABA producing cells often also get damaged, which causes anxiety. It’s not good enough to just prescribe anxiolytic drugs to which the patient will get addicted. The whole person needs to be treated, and abstinence from alcohol has to be part of the program.

Heart irregularities (atrial fibrillation, ventricular fibrillation) can be life-threatening complications due to the toxic effect of alcohol on the nerve fibers within the heart muscle. Emergency physicians are aware of the connection of these conditions to alcohol consumption. Some people’s hearts are more sensitive to the effects of alcohol than others. The most common cause of temporary atrial fibrillation is excessive alcohol intake (holiday heart) according to Ref. 2.

Finally there is the effect of alcohol on nerves in the body. This explains that heavy alcohol consumers can come down with painful pins-and-needles sensations in their hands and feet or with numbness or loss of muscle strength. When the parasympathetic nervous system is affected embarrassing incontinence or constipation can result. Erectile dysfunction in men is also very common. Viagra and continuing to drink is not the solution.

f)      Gout: This painful formation of uric acid crystals in joints can be precipitated in sensitive individuals by consuming alcohol in combination with eating large helpings of beef. There may be a history of gout in the family. Treatment for this is to refrain from alcohol and avoid foods that are leading to uric acid production when ingested.

g)    Cancer: When the body detoxifies alcohol in the liver, the breakdown product is acetaldehyde, which is a known cancer producing substance. A whole array of cancers are known, which come from heavy, chronic alcohol consumption: cancers in the mouth, larynx, esophagus, stomach, pancreas, liver and colorectal cancer have all been linked to excessive alcohol intake.

h)    Cardiovascular disease: heart attacks and strokes can be caused particularly by binging; it is thought that binging makes platelets from the blood more sticky so they clump together and cause blood clots, which in turn leads to heart attacks and strokes.

i)      Infections: Alcohol weakens the immune system, which is another effect on the bone marrow similar to causing anemia, except that this is the toxic effect on the white blood cells and lymphocytes. Heavy alcohol consumers are more prone to pneumonia, to HIV, sexually transmitted diseases, and tuberculosis.

Cardiology view of preventative alcohol

Despite all of these hair raising toxic effects cardiologists have painted the rosy picture that 1 glass of wine for women and 2 glasses of wine for men per day will prevent heart disease. What is the true story here?

Ref.2 points out that there are about 100 prospective studies that confirm that there is an inverse relationship between mild to moderate alcohol consumption and “heart attack, ischemic stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes”. It describes further that the reduction of risk in these various studies was persistent and consisted of a 20% to 45% risk reduction. Using blood tests investigators have found that this is because of an increase of HDL cholesterol, reducing blood clotting, making platelets less sticky and reducing inflammation as evidenced by a reduction of the C-reactive protein. Further research has pinpointed that it is the phenols and resveratrol that are contained in alcoholic beverages that are responsible for the beneficial effects. The bad news is that three glasses of wine or more do the opposite, so does binge drinking. Unless you are extremely disciplined and never increase your allowed limit (1 drink for women, 2 drinks for men) you will CAUSE heart disease rather than PREVENT it (Ref.2). Some people have a family history of breast cancer or colon cancer and they should avoid alcohol altogether; also people coming from alcoholic families should avoid alcohol.

Conclusion

Where does this leave us with regard to prevention of heart attacks, strokes and hardening of the arteries in the legs (peripheral vascular disease)? If you are disciplined and stick to the limits, you could prevent 20% to 45% of cardiovascular risk. The brain study mentioned in the beginning of the blog would also confirm that there was no difference between dementia or brain shrinkage when mild to moderate drinkers were compared to abstainers over 10 years. What is not told by the wine industry is that the same effects that prevent cardiovascular disease in mild to moderate drinkers can also be achieved by natural means: exercising regularly will raise your protective HDL cholesterol; taking ginkgo biloba, flax seed and omega-3 fatty acids thins your blood and the platelets are getting less sticky; omega-3 reduces inflammation and resveratrol elongates telomeres making you live longer. At the A4M conference in Las Vegas in December 2011 there were three speakers who pointed out that even small amounts of alcohol will poison mitochondria of your cells and interfere with normal hormone action. This was enough to make me join those who abstain alcohol completely. One thing has not yet been investigated in long-term studies, namely how small effects of alcohol may affect the body over several decades and over an entire lifetime. Despite all the promises of interest groups that red wine is a trendy drink for those interested in heart health, the fundamental long-term studies are missing. What does a guy do with a healthy heart and a brain that is not functioning too well? I just do not want to be the guinea pig in that worldwide study.

More information on alcoholism: http://nethealthbook.com/drug-addiction/alcoholism/

References:

  1. Kumar: Robbins and Cotran: Pathologic Basis of Disease, Professional Edition, 8th ed. © 2009 Saunders
  2. Bonow: Braunwald’s Heart Disease – A Textbook of Cardiovascular Medicine, 9th ed. © 2011 Saunders

Last edited Nov. 7, 2014