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

Thursday, May 9, 2024

alzheimers news-homozygous apoe4 gene is not good

an article was published in nature medicine linked here about the apoe4/4 homozygous gene for alzheimers disease
i have the homozygous apoe4/4 homozygous gene called the late onset alzheimers gene

this ny times article written by the same person that interviewed me about the aduhelm clinical trial i was in did an excellent job of writing about the nature medicine article

we are only talking about 15-20% of the cases of alzheimers

in 2010 i had my blood drawn for alzheimers genetic studies
it showed i was apoe4/4 or homozygous
i had very mild symptoms that have since resolved such that now 14 years later my memory is normal for my age
at that time my spinal tap showed amyloid and tau levels that were compatible with alzheimers disease
5 years later when i had my amyloid pet scan for amyloid plaques it was positive
6 months ago or 14 years later after receiving 34 months of aduhelm the antiamyloid monoclonal drug my amyloid pet scan is now negative for amyloid plaques

in this article mentioned above they say we should be classifying apoe4/4 patients as having a distinctive genetic disease ie alzheimers disease caused by the apoe4/4 gene

a gene for the early onset alzheimers disease causes alzheimers early on in all of the patients that inherit that gene

this apoe4/4 gene called the late onset gene it appears if you have the double version or the homozygous version 
you will at the age of 55 have positive biomarkers for alzheimers in the brain
by 65 you will have amyloid plaques in the brain at close to 100%
you will get alzheimers probably 10 years before those from other causes get it except for those with the early onset gene
3% of the population have the apoe4/4  gene
it represents about 20% of the cases of alzheimers disease

if you just have the apoe4 single gene your risk is increased close to 2-3 times
this represents 50% of those with alzheimers

it seems 
if you have the apoe4/4 gene you will get alzheimers and get it sooner than those who have other causes
your amyloid scans will be positive in your 50s and early 60s
thats when the new treatments need to be given before too much plaque builds up

now before you get the leqembi or donanemab infusions to remove the amyloid plaques you have to have your apoe4/4 gene tested
if its positive you have to be monitored closer for bleeds and symptoms
some infusions centers will not give you the infusions of these new drugs if you are apoe4/4 positive
others will give it

i got all my infusions even though i was apoe4/4 positive
they eased up to the maximum dose over time and did frequent mris of the brain looking for edema and bleeds

once when i had a real bad ocular migraine and more smaller ones for several months they stopped the meds and did serial mris
i had no bleeds

thank goodness i was in a clinical trial where they had strict protocols to follow

so what does this all mean
the apoe4/4 gene is a distinct genetic gene that causes late onset alzheimers just as the early onset gene like presenilin and others cause early onset alzheimers

if you have the  apoe4/4gene you will close to 100% get alzheimers
if you get the early onset gene you will 100% get alzheimers 

having the apoe4/4 gene is more ominous now that we know this

this is being widely discussed in the alzheimers world
not all agree but my guess it will be fully accepted eventually

but should you get tested
well read my last blog on this linked here
for me i would
for others they wouldnt
my view is it scares you to take care of your health and to be looking for treatments as it comes available
for me
i feel like i was destined to be in the full throws of alzheimers by now
luckily im not yet
healthy living
aricept or donepezil early on in my disease
getting 34 infusions of aduhelm to remove amyloid plaques in a clinical trial

add all those things up and this is why i am able to write this blog 14 years later

the organic green doctor


  1. Are you still able to drive?

  2. This comment has been removed by the author.

    1. yes
      i drive, do the shopping, do our taxes, do our financial planning, do our travel planning, and seem to be intact memory wise. TOGD