WARNING: you might find the following information to be DRY, however, keeping our minds bright for life is very, very juicy, so we’ll do what it takes, right? This applies to blood testing too. In case you’re still debating about whether or not to invest in testing, remember, testing matters! This first destination is THE most important on our way to a bright mind for life. We need to know our starting point before we can map out a route that gets us there in the most cost-effective way. While most of the information gathered is from blood testing you might decide that certain genetic and other tests are also warranted. DIY NOTE: If you have had blood testing done in the past year you might already have values for some of these items. Check your records so you don’t pay for a test you don’t need! But first…
I am not a doctor nor am I responsible for your health! Yes, dementia prevention testing matters, but please consult a physician before implementing any of the blood or other testing suggested below. If you are already having symptoms of memory loss you should seek professional advice. Click here to contact Dr. Bredesen. A good start is to scroll down the page to “Contact” in order to find out if there is a Bredesen-trained functional medicine practitioner near you. Most traditional Western medical doctors are not yet familiar with dementia prevention protocols and may just tell you there is nothing they can do.
Critical Substances for Brain Health
Let’s look at the next group of items (see here for the first group) on Dr. Bredesen’s extensive list of critical substances to measure in the blood for dementia prevention. I’ll give a nutshell explanation of each item’s importance, optimal levels in the blood, and Dr. Bredesen’s suggested remediation.
Our brains are unimaginably complex and many substances form the jigsaw puzzle that is Alzheimer’s disease. That’s why I’ve divided the list and put this information into a four-part article. It’s also why I created a convenient spreadsheet for the above information. Again, if you have had blood testing done in the past year for any of these items you can enter them on the spreadsheet and get a headstart on this jigsaw-puzzle process.
Thyroid stimulating hormone [or TSH] is released from the pituitary gland to communicate with the thyroid. If your TSH is high it’s sort of like your brain is shouting at your thyroid to work harder.From the website “A Functional Medicine Guide to Your Thyroid Labs by Dr. Will Cole
The thyroid gland converts iodine from our food into T3 and T4 and releases these hormones “… into the blood stream and transports them throughout the body where they control metabolism (conversion of oxygen and calories to energy). Hence, every cell in the body depends upon thyroid hormones for regulation of their metabolism.” From “Endocrineweb.” Read more here. If the body isn’t getting the T3 and T4 that it needs it will produce more thyroid-stimulating hormone as described in the quote directly below the heading “Thyroid Hormones.” In “The End of Alzheimer’s” pg. 128, Dr. Bredesen writes that most people with mild cognitive impairment (MCI), subjective cognitive impairment (SCI) or dementia have sub-optimal thyroid function.
Optimal: TSH <2.0 microIU/ml; free T3 = 3.2-4.2 pg/ml, free T4 = 1.3-1.8 ng/dL; reverse T3 < 20 ng/dL. The remediation if levels are low: take a thyroid extract like Armour Thyroid, NP Thyroid or Nature-Throid and get retested in six months.
Estrogen, Progesterone and Testosterone
These hormones need to be in balance for optimal cognitive function. There is some controversy surrounding this finding from Dr. Bredesen, but he goes into detail on pg. 129 in The End of Alzheimer’s about how estrogen, e.g. “…is a crucial player in the prevention of dementia.” The complexity of testing and remediation protocols is beyond the scope of this post. However, we should note Dr. Bredesen’s advice in the quote below. Most importantly, if our levels are low, we would be well-advised to discuss the matter with our doctors and take appropriate action.
Optimal: estradiol (a subtype of estrogen) = 50-250 pg/ml., progesterone = 1-20 ng/ml, testosterone (total) = 500-1000 ng/dL, free testosterone = 6.5-15 ng/dL. Get retested in six months.
… it is important to consult an expert in bioidentical hormone replacement, preferably one who has experience with cognitive decline. ….. Bioidentical estrogens are 17 beta-estradiol, estrone, and estriol. Non-bioidentical estrogens are, for example those in the urine of pregnant mares, which is the source of the drug Premarin.
From The End of Alzheimer’s, p. 206
Cortisol, Pregnenolone and DHEA
These are adrenal function hormones that regulate the body’s response to stress-inducing invaders or other sub-optimal conditions. Long-term stress produces an overabundance of cortisol which can damage hippocampal neurons. Consequently, as the master steroid, pregnenolone is critical in the production of other hormones.
Optimal: Cortisol (morning) = 10-18 mcg/dL; pregnenolone = 50-100 ng/dL; DHEA sulfate for women = 350-430 mcg/dL and for men = 400-500 mcg/dL. The remediation if cortisol levels are too low is to have further testing done to identify a potential problem in your stress response. On the other hand, if cortisol levels are too high, the remediation is also further testing because a high level can mean that hidden stressors such as ongoing infection are present. If pregnenolone levels are too low, discuss with your doctor the possibility of starting an over-the-counter supplement. Start at 10 mg. daily and increase the dose up to 25 mg. Get retested in six months. Dr. Bredesen does not offer a remediation strategy for low DHEA but one can find numerous websites offering possible remediation products. Do not begin hormone replacement therapy without consulting your doctor.
“DHEA (dehydroepiandrosterone) is a hormone made from cholesterol by your adrenal glands.”
From the Endocrine Society’s website called Hormone Health Network. Later, on the same website, “Some researchers have suggested that DHEA might be used to treat Alzheimer’s disease.”
Blood Testing for Heavy Metals
“Too much copper and too little zinc are associated with dementia.” From The End of Alzheimer’s, p. 132. Research by Professor George Brewer from the University of Michigan has revealed that most Americans are high in copper and low in zinc. Dr. Bredesen goes on to say:
… because zinc is critical for insulin synthesis, storage and release, zinc deficiency reduces insulin signaling, a critical feature of Alzheimer’s. Zinc deficiency also increases the level of autoantibodies, a source of inflammation; increases oxidative damage and aging, reduces hormonal signaling and neurotransmitter signaling and enhances sensitivity to toxins–all of which are characteristic of Alzheimer’s …The End of Alzheimer’s by Dr. Dale Bredesen, p. 133
Optimal: copper to zinc ratio = 0.8-1.2, zinc = 90-110 mcg/dL (or red blood cell zinc = 12-14 mg/L). If your ratio of copper to zinc is too high you can try any one or a combination of the following remediaton actions:
1.) take zinc picolinate, 25 -50 mg/day to boost zinc
2.) take alpha-lipoic acid, 30-60 mg/day to prevent oxidative damage from increased copper
3.) take 1-3 g./day of Vit. C to remove copper
4.) take 100 mg/day of Vit. B6 for detoxification
5.) take 15-30 mg/day of manganese for antioxidant enzymatic effects
6.) reduce stress with meditation or exercise
7.) avoid high copper content in multi-vitamins
8.) have blood testing done again in six months
Too Much Sushi, Arsenic, Cadmium, and Lead
Blood testing reveals that people who eat a lot of seafood often have high levels of mercury which can cause cognitive impairment. (Click here for the more complex details of one study demonstrating this). Groundwater, chicken and rice can contain arsenic. Cadmium exposure frequently occurs in chemical plants. Lastly, we all know about the dangers of lead poisoning whether from old paints or water sources. Therefore, it’s important to have these levels checked especially if you think you’ve been exposed.
Optimal: mercury less than 5 mcg/L; arsenic <7 mcg/L; cadmium <2.5 mcg/L and lead less than 2 mcg/L. Remediation: a treatment from Quicksilver called the Detox Cube which is known to be more gentle than traditional chelation.
Helpful Metals Magnesium and Selenium (a Metalloid)
For many years researchers have studied the effects of magnesium on brain health. In 2016 Dr. Guosong Liu of MIT published a study of 44 older, cognitively-impaired adults in which he found that an increase in magnesium over 12 weeks significantly increased overall cognitive ability. Additionally it nearly restored impaired executive (decision-making) function as compared to the control group which received a placebo. While that’s only one study, it points to the importance of this mineral to better cognitive functioning. Find a review of current studies here.
Dr. Bredesen points out that the lab’s blood testing should measure magnesium in red blood cells, (RBC) not in serum blood.
Optimal: RBC magnesium = 5.2-6.5 mg/dL. Remediation: supplement with 500 mg/day of magnesium glycinate or 2 g/day of magnesium threonate.
As Dr. Bredesen explains it on page 135 of “The End of Alzheimer’s” selenium (with glutathione) mops up dangerous free radicals that damage cell membranes and cell structure. Consequently, glutathione diminishes requiring more selenium to restore healthy levels.
Too Much Info!
Finally, I know all this testing info seems terribly complex and that’s why I’ve created a handy (and free) spreadsheet that will put it all at your fingertips. Find it here.
Have you had blood testing done for the hormones T3, T4, estrogen, progesterone, testosterone, cortisol, pregnenolone, or DHEA? How about for the heavy metals copper, zinc, mercury, arsenic, cadmium or for the helpful metals selenium and magnesium? If so, you can start filling in the attached spreadsheet and just keep adding to it as you complete more of the testing.
Have you had any other blood testing done in the past year? If so, you could use those values to start filling in the spreadsheet. Let us know how you were able to get a doctor to recommend the testing. I had to educate mine first and, fortunately she was somewhat open-minded about the Bredesen protocol even though she had not heard of it. I say somewhat because she was only willing to prescribe one round of tests. It was more difficult to convince her, after six months, that I needed some of the items to be rechecked.
Please leave a comment or email me with any questions or for more information. Stay tuned for Testing Matters, Parts Three and Four.