welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Friday, July 15, 2022

alzheimers news-a precision medicine approach to treatment


whats precision medicine
basically you check things in ones history and exam and lab data 
anything abnormal you treat it
diet history if its bad you start the mind diet or mediteranean diet
if you smoke or drink too much you stop smoking or stop drinking too much
if you dont exercise you start exercising
if you dont sleep well you figure out why and correct it eg like sleep apnea
if you have stomach issues like reflux etc you treat and correct them
if you are anxious or depressed you seek treatment with medicine or therapy or relaxation techniques or yoga or meditation and exercise
if you are obese you lose weight and do exercise
usually doing the above things helps with the weight
you check labs like thyroid levels hormone levels vitamin d levels vitamin b12 levels homocysteine levels inflammatory markers like crp and esr 
you check your hgbaic ie for diabetes your lipid cholesterol levels your chemistries for electrolytes and liver functions
you check for infections like hiv or hep c
you do memory testing like the moca test ive had multiple times to follow how your memory is over time
you check your apoe 4 status since being apoe 4 increases your chance of getting alzheimers as you get older
you have an mri to assess any changes like brain shrinkage or white matter hyperintensities that indicate vascular issues

then you look at what shows up and treat these to control them hoping that doing so will cause an improvement in your memory or at least slowing down memory loss

several years ago i read dr bredesens article on the reversal of cognitive decline where he took 10 folks with memory loss and treated them for a year with this precision medicine approach
most showed improvement in that year in their memory 

thats what i did after i was diagnosed
my memory improved from the mci level to the normal level today

now i didnt do all of what he did in that study above and the one below but i did most of them

i will admit that if any of you did this even if you werent having memory loss you would definitely feel an improvement in your energy level your well being feeling and probably your alertness 
you would also reduce your risk for developing alzheimers significantly over your lifetime
your risk for diabetes heart disease stroke cancer in the future would be reduced

for my initial evaluation 
i had a good history and physical that showed a strong family history of alzheimers disease and heart disease and stroke and high cholesterol
my labs showed abnormal lipids high homocysteine level less than normal vitamin b12 less than normal vitamin d3 and my thyroid level was normal
my esr and crp blood chemistry hgbaic testosterone levels were normal
my apoe 4 level showed i was homozygous for apoe 4/apoe 4
my mri was normal except for a few white matter hyperintensities 
my spinal fluid for amyloid and tau was abnormal
my memory test called the moca was in the mci range initially 

so i attacked each of these things
my blood pressure was elevated so i began blood pressure meds later after my weight dropped and i stopped alcohol and changed to decaf coffee i was able to stop my bp meds
my lipids were high so i started a statin called atorvastatin or lipitor
my weight was up slightly as my bmi was close to 25
my vitamin d3 and vitamin b12 was corrected with taking those supplements
my digestive issues were treated with omeprazole and a daily probiotic and my diet
the probiotic may help with gut inflammation which can transfer inflammation to the brain
i had regular dental care to cut down on inflammation from dental disease which also can get transferred to the brain
after starting aricept or donepezil my sleep became an issue since i could only sleep 5 hours a night
i added a 1-2 hour nap that fills in the gap of sleep hours i lose
this works well for me and ive adjusted my lifestyle to fit this schedule
i changed to a mind diet a combo of the mediterranean diet and the dash diet
i added a baby aspirin a day since i have the white matter hyperintensities and i have ocular migraines 
the use of aspirin will be discussed this month with my pcp and my neurologist

so now
i have better sleep habits
i eat a mind diet
i drink no alcohol mainly since i have stomach issues but if i could i one drink one glass of red wine a night
my bmi is 20
my blood pressure is normal
my lipids are normal 
my vitamin b12 is normal
my vitamin d3 is normal
my homocysteine is normal
best of all 
my memory is normal for now

oh also i take monthly infusions of aduhelm or aducanumab at ucla which removes amyloid plaques from my brain

so my suggestion to you is to make sure you look at most of these things which you all should be doing anyway and to correct any abnormalities 
do your own precision medicine approach

do it now while you are younger before all these diseases show up

this month dr bredesen and friends published a new article linked here from the journal of alzheimers disease 
its about using this precision medicine approach on 25 patients with mci and following them over 9 months
they found that the folks all had an improvement in their memory 

now they plan a much larger study using a control group to test how well this precision medicine approach will work

do your own precision medicine approach 
it will help you live a longer happier healthier life

the organicgreen doctor

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