ReCODE or The Reversal of Cognitive Decline – a new treatment paradigm for Alzheimer’s Disease and other forms of dementia
For many decades, conventional medicine has had very little to offer regarding treatment of patients suffering from dementia or cognitive decline. Alzheimer’s Disease is now the third leading cause of death in the North America, after heart disease and cancer. It is estimated that dementia will afflict approximately 50% of the next generation of senior citizens (that would be every other person between the ages of 40-60 reading this blog right now). Most seniors today feel utterly helpless as they witness the methodical deterioration of their own cognitive abilities and some have even come to accept this as a normal part of the aging process. Dementia is not a normal function of aging and should not be accepted as that. We’ve all met cancer survivors, but no one has ever met an Alzheimer’s survivor – until now.
The ReCODE program (or Reversal of COgnitive DEcline) was developed over the past decade by Dr. Dale Bredesen, the director of research for neurodegenerative disease at UCLA and the author of “The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline”. This treatment program is based on addressing the several dozen mechanisms responsible for the expression of Alzheimer’s disease and is completely in alignment with the principles of integrative and functional medicine.
In 2017, Dr. Nikogosian trained under Dr. Bredesen in the implementation of the ReCODE program and he now proudly offers this program to his patients at Southwest Functional Medicine in the Las Vegas and Henderson area of Southern Nevada. For out-of-state and international patients, they may also access our services remotely via Skype or FaceTime consultation. For more information, please email us at info@swfunctionalmedicine.com or call us at (702) 616-4001.
Before proceeding, it is important to clarify some terminology. Many patients ask what are the differences between Alzheimers disease, dementia and cognitive decline. From the perspective of what the average person sees on a day to day basis – the answer is not that much. That is is the reason why you will see these terms used interchangeably when describing this affliction. For the record, cognitive decline is a general term denoting any loss of cognitive function of which dementia is a part of. Dementia is a syndrome used to describe symptoms which impact memory, communication and performance of daily activities of which Alzheimer’s Disease is a part of. Alzheimer’s Disease is the most common type of dementia associated with beta-amyloid plaque deposits in the brain and characterized by progressive worsening of memory, language and thought. Since Alzheimer’s is used by the general public to denote any form of dementia in general – I will use Alzheimer’s to mean that for the remainder of this blog.
So what exactly is the ReCODE program? To quote Dr. Bredesen:
“Imagine you have 36 holes in your roof — because we initially identified 36 different mechanisms involved — if you patch one hole, that’s not going to help you much. You want to patch all the holes.’ Now, a drug typically patches one hole … [but you need to] patch the other 35 as well.”
The ReCODE program is a full spectrum functional medicine approach for addressing all the physiological dysfunctions (or “holes in the roof”) which ultimately present as Alzheimer’s in the patient. Your brain’s ability to perform its various activities requires connections between brain cells (also known as neurons). You have approximately 100 billion neurons in your brain and each neuron has approximately 10,000 connections called synapses. Thats over 100 quadrillion synapses per brain !! When your brain is in a state of good health, this massive number of connections maintains balance between cultivating new connections and pruning old connections which are no longer needed. Looking at this problem from a root cause perspective, Alzheimer’s begins with an imbalance between synaptoblastic activity (building or cultivating synaptic connections between neurons) and synaptoclastic activity (destroying or pruning synaptic connections between neurons). It’s all about restoring balance to the brain.
What Dr. Bredesen discovered in people with Alzheimer’s was that they were on the wrong side of this balance. Their synaptic building activity (synaptoblastic) was too low and their synaptic pruning activity (synaptoclastic) was too high. Bringing this synaptic dynamic back into balance is the final goal of the “patching the multiple holes in the roof” approach of the ReCODE program.
One of the first steps of the ReCODE program in restoring this balance is determining what subtype of Alzheimer’s the patient has:
Type 1 – INFLAMMATORY or “Hot”
• These are patients with mainly inflammatory symptoms. They have a brain which is literally “on fire” and balance cannot be restored until the inflammation has been brought under control. There have been many similarities observed between adults with this type of Alzheimer’s and children on the Autism Spectrum – with a significant overlap of successful treatment modalities for both.
Type 1.5 GLYCOTOXIC or “Sweet”
• This is a mixed subtype in between inflammatory and atrophic. This is typically associated with diabetes and insulin resistance and is the most common form of Alzheimer’s which we see and treat.
Type 2 ATROPHIC or “Cold”
• These are patients in which disease is driven by a lack essential nutrients , hormone sor other growth factors. Withdrawal of any of these factors (such as testosterone, estrogen, vitamin D or essential fatty acids to name a few) will unfavorably alter synaptic balance.
Type 3 TOXIC or “Vile”
• These are patients with toxic exposures ranging from heavy metals to persistent organic pollutants (POPs) to biotoxin illnesses such as mold toxicity or Chronic Inflammatory Response Syndrome (CIRS). Treatment success for these patients is paramount on identifying and removing the toxic exposure.
Type 4 VASCULAR or “Pale”
• These are patients in whom their Alzheimer’s is driving by poor circulation of the brain. These patients will frequently have other vascular issues as well such as coronary artery disease or peripheral vascular disease.
Type 5 TRAUMATIC or “Dazed”
• These are patients in which disease is driven by traumatic injury to the brain. It can be one large traumatic injury, but more commonly is a result of multiple, recurrent minor head traumas – such as those seen in professional football players.
These subtypes are not mutually exclusive of one another and having one subtype does not exclude you from having another subtype. Most patients will have one predominant subtype driving their disease and then have varying degrees of the other subtypes as contributing factors to their dementia. In the ReCODE program, we address all the patient’s problems in due course.
Some other general areas which we will evaluate is status of: ApoE, mitochondria, methylation, hormones, gut microbiome and other core areas of investigation done with any thorough functional medicine diagnostic work-up.
A frequently asked question is, “What will I be given or what will I need to do for the program to work for me?”
The answer to that questions is literally a different answer for every individual. For one patient, the foundational treatment piece may be following a low glycemic diet far beyond the expectations of the patient’s PCP or endocrinologist. For another it may be correcting their nocturnal oxygenation as a result of their untreated sleep apnea for the past decade. For another it could be detoxifying them of the lead they had accumulated from a youth spent breathing in leaded gas fumes. Another, balancing their hormones and another controlling their inflammation from their autoimmune disease and so on and so on. That question cannot be answered until the individual patient has had a complete functional medicine evaluation.
The core treatment strategies of the program are based on diet, lifestyle, supplements, herbs and medications – usually in that order. This program has no magic bullets and if that is what you are looking for, then look elsewhere. If you are ready to claim your mind back with a full spectrum, multi-faceted approach to your neurological heath in specific and your overall health in general, then ReCODE is the right program for you.
To get started with your own personalized ReCODE program, make an appointment for a complete functional medicine evaluation by Dr. Nikogosian at Southwest Functional Medicine. Email us at info@swfunctionalmedicine.com or call us at (702) 616-4001 for more information. We also offer remote consultations, learn more here.