The End of Alzheimer’s

Bredesen. The name kept coming up over and over again.

“He has the best model.”

“He has the most comprehensive approach out there to neurocognitive decline and chronic disease.”

“He was the most impressive speaker at IFM.”

Daniel Schmatchenberger, Dr. Hyla Cass and several other people I have oodles of respect for encouraged me to look into the Bredesen Protocol Training. I reached out to see if I could make it happen. It was expensive and it was happening in Dallas. It was July and I had started my own practice weeks earlier. The timing couldn’t be worse.

North County Natural Medicine had been blessed to find a temporary location, but we didn’t have the real home yet that we enjoy today. Lab kits and supplements were piling up, staff were sitting on the floor and every time anyone said anything I had the urge to scream, “We can’t! We don’t have space for it!”

While launching my dream practice, it didn’t make sense to leave town and go get more training.

But I did it! I signed up for the Bredesen Training in Dallas, TX. I signed a lease at North County Natural Medicine’s new home in Encinitas on Thursday and flew to Dallas on Friday. With this new sense of place, I was able to sleep and pay close attention to everything Dr. Dale Bredesen, Dr. Jill Carnahan, and Dr. Mark Menolascino had to offer.

This is what I learned and what we now offer at NCNM:

The Bredesen Protocol for Neurocognitive Degeneration and Alzheimer’s Disease

The Bredesen Protocol is used to reverse neurocognitive degeneration and Alzheimer’s Disease. It is not simple, it is not guaranteed but it is the best thing out there. This is 21st Century Medicine. Doctors offering the Bredesen Protocol aim to understand and address all of the contributors to disease, whether there are 5 or 75. We have left behind the paradigm of one drug for one symptom.

There is still work to be done. If you have spent any time in my office or discussing medicine with me then you will know I have a reverence for what we don’t know. I don’t claim to have all the answers but I will work hard to fit together the pieces of what we do know. I have so much respect for Dr. Bredesen and his colleagues who presented the ReCODE protocol. They share my humility when it comes to the complexity of the human body. We don’t know everything. There is a lot to learn and every patient we have the honor of supporting teaches us so that we are better equipped to help the next person.

A Difficult but Groundbreaking Health Protocol

This is not an easy protocol to follow. Patients need to LIVE this protocol for a full six months and they need a care team to implement the changes. The amazing thing is that irreversible disease reverses. Patients who follow the steps get back to really living.

The diagnosis of Alzheimer’s often feels like another step on an endless downward spiral for the patient, their families and caregivers. They go to their primary care provider and get a prescription for Aricept and are then sent to a specialist who takes away their driver’s license and ability to get long-term care insurance. It feels disastrous.

Bredesen Protocol for Alzheimer’s

Alzheimer’s disease, like all chronic illnesses, is a signaling imbalance. In Alzheimer’s disease the imbalance is between synaptoblastic (remembering) and synaptoclastic (forgetting) signaling. This imbalance is not caused by one thing. Multiple things cause this imbalance over time as is true with all chronic disease. My goal as a practitioner is to identify the signals that are out of balance, how they were thrown off balance and recreate balance between them.

Get your Neurons Functioning Again

Dr. Bredesen describes the brain as a super computer. Neurons in the brain depend on complex communication he likens to romantic relationships. There are phases and degrees of balance in neuronal communication including courtship, commitment, functional, dysfunctional and divorce. Molecular switches, determined primarily by lifestyle choices, give rise to neuronal communication that either makes and keeps memories or leads to neurofibrillary tangles, mitochondrial dysfunction, and memory loss. My job as a doctor is to flip that molecular switch and get your neurons functionally communicating again.

We currently know of 36 mechanisms that lead to the development of Alzheimer’s disease. Dr. Bredesen predicts that we will find more than 50 but less than 100 contributing factors. This list includes complex biochemical signaling like capsase cleavage and simple things like vitamin D levels.

Alzheimer’s Begins as a Protective Response

It is helpful for me to remember that in our body’s divine design Alzheimer’s disease develops as a protective mechanism against inflammation, infections and toxins. Amyloids that are associated with Alzheimer’s are actually antimicrobial. If you have parasites you do better if you develop amyloid plaques in your brain! With the help of Dr. Bredesen’s work we now know that Alzheimer’s disease doesn’t develop for no reason. There are contributing factors that lead to cognitive decline and we have a roadmap to determine what they are and reverse them.

ApoE4 and Alzheimer’s Disease

ApoE4 is the genetic single nucleotide polymorphism (SNP) most associated with Alzheimer’s disease risk. The gene this codes for is important in determining inflammation, longevity and memory. It interacts with receptors AND enters the nucleus, binding to DNA and promoting 1700 different genes! This one little lipoprotein is determining the programming of your neurons and making big decisions about many genes that write the story of how you store memories.

Although ApoE4 is important this is just one piece of the Alzheimer’s disease puzzle. Diet, stress, sleep, exercise, nutrient status, hormone status and toxic load ALL affect signaling balance in the brain. There is not one therapy for all when it comes to Alzheimer’s disease.

Dr. Bredesen’s ReCODE Protocol

Dr. Bredesen uses the ReCODE approach outlined here to determine and treat the cause of each patient’s cognitive decline.



Step 1: Determine Diagnosis

  1. No symptoms but amyloid plaques can be seen on imaging
  2. SCI – Symptoms of cognitive decline begin, cognitive tests are normal
  3. MCI – Cognitive tests begin to show decline
  4. Alzheimer’s, loss of activities of daily living


Step 2: Determine SubType

Type 1: Inflammatory/ HOT

Type 2: Atrophic/COLD

Type 1.5: Glycotoxic/SWEET combo of 1&2

Type 3: Toxic/VILE

Type 4: Vascular/PALE

Type 5: Traumatic/DAZED


Type 1 Alzheimer’s Disease

  • Inflammatory or HOT
  • PITA in Ayurvedic medicine
  • Patient experiences amnesia
  • Labs show increased hs-CRP, ESR, IL-6, IL-8, TNFalpha
  • Labs show a reduction in Albumin/Globulin ratio
  • ApoE4 is an important risk factor
  • Imaging shows reduced hippocampal size


Type 2 Alzheimer’s Disease

  • Atrophic or COLD
  • Vata in Aruveydic Medicine
  • Patients tend to be in 70’s or 80’s
  • Typically amnesia presentation, however, patients often protest that nothing is wrong
  • Labs show reduced estrogens, progesterone, testosterone, vitamin D, pregnenolone and thyroid hormone
  • ApoE4 is a genetic risk factor
  • Other risk factors include early menopause or surgical menopause
  • Imaging shows reduced hippocampal size


Type 1.5 Alzheimer’s Disease

  • Glycotoxic or SWEET
  • Combination of Type 1 and Type 2
  • Inflammatory secondary to metabolic syndrome
  • Atrophic because of insulin resistance
  • Patients often experience amnesia
  • ApoE4 is an important risk factor
  • Paradox of insulin sensitization and trophic requirement


Type 3 Alzheimer’s Disease

  • Toxic or VILE
  • Early onset possible in 30’s, 40’s, 50’s
  • Cognitive decline accompanied by brain fog, fatigue, and other multi-systemic symptoms
  • Decrease in ability to do math, simple calculations and organization
  • Symptoms worse with stress
  • Imaging may show frontal, temporal and hippocampal changes
  • Risk factor is toxin exposure including heavy metals, mycotoxins, and biotoxins
  • Genetic considerations include all detoxification pathway SNPs
  • Has not responded to nutrient, hormone or other therapies


Type 4 Alzheimer’s Disease

  • Vascular or PALE
  • Cognitive decline is sudden or stepwise in progression
  • Associated with transient ischemic events
  • Risk factors include family history of stroke or personal history of aortic, peripheral or carotid artery disease


Type 5 Alzheimer’s Disease

  • Traumatic or DAZED
  • Early onset is possible
  • Cognitive decline associated with violent behavior
  • Follows repeated or significant head trauma
  • Multiple white lesions on imaging can be correlated to traumatic events


Step 3:

Work with your doctor to create an individualized plan for you based on the subtype indicated by your history and work up.

The best results are when these symptoms are caught and addressed early. If you have a family history of Alzheimer’s disease the best thing you can do is prevent cognitive changes before they happen. Do not delay in determining your risk and working to create a plan to protect the health of your brain.

As the weekend went on and I learned more and more about Dr. Bredesen’s approach I thought of patients I have seen recently who complained of memory loss. I am thrilled to be offering this new perspective on Alzheimer’s disease to current patients and my community. As North County Natural Medicine grows, I am committed to keeping up with the advancements in neurocognitive health and sharing them with you!

Yours In Health,

Dr. Heather Sandison, ND


Contact Us if you or a loved one is experiencing signs of confusion, memory loss, mental decline, toxins, parasites or any other concerning symptom.

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