Alzheimer's Disease

by Andrea McBeth, ND

January 16, 2018

Alzheimer’s Disease is incredibly complex. The genetic and environmental factors that lead to an accumulation of amyloid plaques and misfolded tau proteins are unclear, although basic correlations and risk factors have been identified.The general consensus is that inflammation speeds the progression of the disease, but the exact mechanism is still unknown. It appears there are hundreds if not thousands of biochemical pathways leading to the accumulation of enough pathology to cause symptoms.

When faced with such a complex disease, naturopathic medicine has a very simple approach: support the body to keep it working as smoothly as possible. Reduce the risk that our natural systems fail or fall short. Address underlying inflammation, stress, and any other external affronts on the body.

Anti-inflammatory support

The following recommendations are foundational for all chronic disease. The most effective, but sometimes most difficult, aspect of reducing inflammation is through diet. The ketogenic diet has been shown to have profound effects on inflammation in the brain. It uses dietary modification to shift the metabolism of the brain to a less inflammatory process. By limiting carbohydrates and proteins and increasing healthy fats, the brain uses ketones instead of glucose as its energy source. There have been a number of case studies and a few research studies looking at the ketogenic diet in Alzheimer’s Disease and other neurodegenerative diseases. The data has been promising, in some cases demonstrating a reversal of disease processes.[1],[2],[3]

Another important aspect of dietary support, one easily applied in the setting of long-term care facilities, is the introduction of healthy fats. Coconut oil, Medium Chain Trigylceride(MCT) oil, and fish oil are all good sources. In addition to healthy fats, introducing more vegetables and limiting refined sugars can reduce inflammation. This is loosely defined as an anti-inflammatory diet. A physician named Terry Wahls outlines my favorite version of this diet. She has a multi-staged diet that is very approachable depending on the level of resources people have.

Sleep support

One of the most important ways to support brain health is sleep. When we sleep, the body removes toxins from the brain through a system called the glial lymphatic system. This is specifically how some of the beta amyloid plaques that cause Alzheimer's Disease are removed.[4]

Understanding that sleep is paramount to good plaque removal helps patients and people caring for them prioritize sleep health. One aspect often overlooked is whether there is an underlying issue with obstructive sleep apnea.[5] A sleep study and appropriate therapy can go a long way in improving cognition and overall health.

Once major medical issues have been addressed, medicinal herbs and supplements can be used to help with anxiety or stress related insomnia. There are many herbs relaxing and safe enough to help people fall asleep without increasing drowsiness. Adding these herbs to small doses of melatonin and other calming neurotransmitters is a safe and effective alternative to more aggressive pharmaceuticals like Ambien.

Meditation and sleep hygiene routines can also help. Simple recordings can be used to help induce sleep. Meditation or mindfulness can be integrated into daily activity to help reduce anxiety and also support sleep.[6] Sleep hygiene is a basic set of guidelines to help people maintain good routines and avoid blue light (such as from TVs and device screens) before bedtime.[7]

Nutrient support

Mitochondria are the vesicles in every human cell responsible for energy production. When they work correctly, they facilitate each cell’s metabolic process. When they do not work properly, they can instead create reactive oxygen species(ROS) that damage the cell. The mechanism of mitochondrial dysfunction and increased ROS has been directly associated with the pathogenesis of Alzheimer’s Disease.[8] Luckily, there is a large host of vitamins that can be used to support mitochondrial function.[9] These vitamins can be taken in the form of a conveniently administered multivitamin. The most important are listed below and can be taken as singles. Coq10 and B vitamins are the two most commonly depleted and most important to replace in elder patients.

Vitamin D and glutamine have also been connected to Alzheimer’s Disease. Vitamin D deficiency has been linked to many chronic diseases and aging populations are at increased risk for deficiency.[10] It is an important vitamin to supplement in most aging populations and recently concerns about too much vitamin D supplementation have been countered by evidence that dosages of up to 10,000IU daily is safe.[11]

I include glutamine in my recommendations because it supports gut and brain health. It is a GABA precursor, an important neurotransmitter diminished by Alzheimer’s Disease.[12],[13] In addition to its role in the brain, oral glutamine supplementation is one of the best tools to support gut health and nutrient absorption.[12] When people age, their ability to absorb the key nutrients for healthy mitochondria decreases. Whenever oral multivitamin supplementation is being used, I encourage people to first ensure they are absorbing nutrients and that their digestion is working optimally.

Cognitive support

This section emphasizes the importance of daily activities in Alzheimer’s treatment and prevention. The research is overwhelmingly positive when we look at movement and mental stimulation through socializing and puzzle-based brain activities.[15],[16] Exercise can sometimes be daunting considering the limitations of mobility in aging populations. I encourage patients and caregivers to be creative.Never underestimate the power of walking! Yoga and Tai Chi are two other forms of exercise easily accessible through YouTube videos or local guest teachers.

In addition to exercise & puzzles, there are two Alzheimer’s Disease specific supplements. Ginkgo biloba is a Chinese herb that has been used for centuries for brain health. It is one of the most studied herbs for neurodegenerative disease.[17] My other favorite supplement, lion’s mane mushroom, hasn’t been researched as heavily regarding cognition support, but what has been investigated is impressive.[18]

Keep in mind, when looking for a supplement it is very important to be cautious about sourcing. Herbs can be improperly labeled or contain high levels of pollutants.

Naturopathic support summary

Below is a summary of the recommendations discussed above. Included are links to products I have used and trust, plus helpful online resources. I am not affiliated with any of the brands I recommend. Caution should be used when purchasing supplements. Poor federal regulation means quality is not always what a brand claims. Make sure whatever products you use are from a reputable source and have been third party tested. Every company I have included has good quality products.


Footnotes

  1. Paoli A, Bianco A, Damiani E, Bosco G. Ketogenic diet in neuromuscular and neurodegenerative diseases. Biomed Res Int. 2014;2014:474296.
  2. Lane-Donovan C, Herz J. High-Fat Diet Changes Hippocampal Apolipoprotein E (ApoE) in a Genotype- and Carbohydrate-Dependent Manner in Mice. PLoS One. 2016;11(2):e0148099.
  3. Hertz L, Chen Y, Waagepetersen HS. Effects of ketone bodies in Alzheimer’s disease in relation to neural hypometabolism, β-amyloid toxicity, and astrocyte function. J Neurochem. 2015;134(1):7-20.
  4. Tarasoff-Conway JM, Carare RO, Osorio RS, et al. Clearance systems in the brain-implications for Alzheimer disease. Nat Rev Neurol. 2015;11(8):457-470.
  5. Sharma RA, Varga AW, Bubu OM, et al. Obstructive Sleep Apnea Severity Affects Amyloid Burden in Cognitively Normal Elderly: A Longitudinal Study. Am J Respir Crit Care Med. November 2017. doi:10.1164/rccm.201704-0704OC.
  6. Zhou ES, Gardiner P, Bertisch SM. Integrative Medicine for Insomnia. Med Clin North Am. 2017;101(5):865-879.
  7. https://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side
  8. Hirai K, Aliev G, Nunomura A, et al. Mitochondrial abnormalities in Alzheimer’s disease. J Neurosci. 2001;21(9):3017-3023.
  9. Nicolson GL. Mitochondrial Dysfunction and Chronic Disease: Treatment With Natural Supplements. Integr Med. 2014;13(4):35-43.
  10. Gloth FM 3rd, Tobin JD. Vitamin D deficiency in older people. J Am Geriatr Soc. 1995;43(7):822-828.
  11. Zittermann A, Prokop S, Gummert JF, Börgermann J. Safety issues of vitamin D supplementation. Anticancer Agents Med Chem. 2013;13(1):4-10.
  12. Albrecht J, Sidoryk-Węgrzynowicz M, Zielińska M, Aschner M. Roles of glutamine in neurotransmission. Neuron Glia Biol. 2010;6(4):263-276.
  13. Solas M, Puerta E, Ramirez MJ. Treatment Options in Alzheimer´s Disease: The GABA Story. Curr Pharm Des. 2015;21(34):4960-4971.
  14. Wang B, Wu G, Zhou Z, et al. Glutamine and intestinal barrier function. Amino Acids. 2015;47(10):2143-2154
  15. Ebrahimi K, Majdi A, Baghaiee B, Hosseini SH, Sadigh-Eteghad S. Physical activity and beta-amyloid pathology in Alzheimer’s disease: A sound mind in a sound body. EXCLI J. 2017;16:959-972.
  16. Epperly T, Dunay MA, Boice JL. Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and Functional Symptoms. Am Fam Physician. 2017;95(12):771-778.
  17. Yuan Q, Wang C-W, Shi J, Lin Z-X. Effects of Ginkgo biloba on dementia: An overview of systematic reviews. J Ethnopharmacol. 2017;195:1-9.
  18. Sabaratnam V, Kah-Hui W, Naidu M, Rosie David P. Neuronal health - can culinary and medicinal mushrooms help? Afr J Tradit Complement Altern Med. 2013;3(1):62-68.
  19. I, Andrea McBeth ND, am not affiliated with any the brands I recommend. Caution should be used when purchasing supplements. There is poor federal regulation so many brands are poor quality or not what they claim. Make sure whatever products you use are from a reputable source and have been third party tested. Every company I have included has good quality products.
The information provided is the opinion of Dr. Andrea McBeth and not intended as medical advice or to replace a one on one relationship with a healthcare professional. It is intended to be the sharing of knowledge from research and experience of Dr. McBeth and her community.

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