Hope and Hype for Alzheimer’s

Alzheimer’s sucks! It is a relentless, devastating, cruel disease that destroys patients’ memory and personality, making them no longer the person they used to be. It leaves its victims dependent on caretakers and eventually kills them an average of 4 to 8 years after diagnosis. Ten percent of the population over the age of 65 has it; the incidence is 3% at age 65 and rises to 32% at age 85. As our population ages, millions more will be afflicted, with resultant social and financial costs for society. Already today, 15 million Americans are unpaid caretakers for patients with some form of dementia.

Alzheimer’s can be definitively diagnosed only after death, at autopsy. A substantial percentage of those clinically diagnosed with Alzheimer’s actually have other causes of dementia. As yet, there is no reliable way to make an early diagnosis, and no way to change the course of the disease once it has been diagnosed. Today researchers are developing biomarkers (spinal fluid proteins) and brain imaging methods that improve diagnostic accuracy and may eventually permit early diagnosis before the onset of symptoms. Six drugs have been approved by the FDA for the treatment of Alzheimer’s, but the drugs alleviate only some of the symptoms.1 No drug slows or stops the progression of the disease. And there is nothing that can reverse the damage.

“Awakening from Alzheimer’s”

While this is all very discouraging, scientists are diligently working to understand the disease and find an effective treatment. Others apparently think they needn’t bother. A journalist and singer/songwriter named Peggy Sarlin interviewed “cutting edge doctors” who are allegedly already successful at treating Alzheimer’s, sometimes with dramatic results. She wrote a book and produced an online video series, titled “Awakening from Alzheimer’s,” claiming that Alzheimer’s is for the most part preventable and it can be reversed in 9 out of 10 patients. Wowzers! Wouldn’t it be wonderful if that were true? Sorry, but I’m skeptical. I never rely on videos for my scientific information; they tend to be sensational, one-sided, and agenda-driven. But I gave Sarlin the benefit of the doubt and suffered through her whole series of 14 videos. I was not impressed. In each video, Sarlin interviewed a doctor at length; each had a different approach.

Dr. Mary Newport recommends coconut oil and its extract medium-chain triglyceride (MCT) oil, describing how it miraculously reversed her husband’s symptoms (a “light switch went on in his brain after the very first dose”). She claims to have 400 testimonials from others who tried it, but no controlled scientific studies. Snopes calls her claims “unproven.” On Science-Based Medicine, Steven Novella concluded that the health claims for coconut oil are all unsupported by scientific studies and make little scientific sense.2 The American Heart Association has warned against coconut oil because the evidence shows it increases the risk of heart disease.3

Dr. Joy Faber claims that pre-Alzheimer’s can be diagnosed by imaging that shows decreased blood flow in the brain. She recommends the supplements vinpocetine, acetylcholine, magnesium, and taurine to target specific brain regions. Faber claims 75% of patients who take these are better in six months, but there are no published studies to back up her claim. She also recommends gingko, CoQ10, vitamin E, and GABA. She recommends that everyone take multivitamins, fish oil, vitamin D and a mixture of 7 supplements to ward off dementia. Among her many unsubstantiated claims, Faber says statin drugs cause memory loss (actually, there is some evidence that statins may help prevent dementia) and recommends people use red yeast rice instead. (News flash! Red yeast rice contains the same statin that is in the prescription drug Lovastatin!)

Dr. Pamela Smith recommends healing an inflamed brain with anti-inflammatory supplements such as curcumin and krill oil.

Dr. David Perlmutter stresses that gut health impacts brain health. He recommends a high fat diet and warns against carbs and processed foods that promote “leaky gut syndrome,” which “spews toxins to the brain.” (Leaky gut is a hypothetical condition not recognized by mainstream medical science.)

Dr. Michael Breus claims that consistent lack of sleep greatly increases your risk of dementia. He recommends banana peel tea and a small light box.

Dr. Vincent Fortanasce has developed a unique program of his own, the TEAM protocol, based on stimulating the hippocampus by doing things that are novel and emotional. He says 75% of patients improve with a combination of isometric exercise, olfactory and gustatory stimulation, music, photos, asking about old memories for 2–4 hours a day (!), and tactile stimulation (human touch or touching with a soft object). He says if you can get them to cry, you have succeeded. He recommends numerous dietary supplements and wine. He claims 3 out of 4 patients “re-wire” their brains and improve significantly, but he has published no studies.

He has figured out what causes Alzheimer’s: mainly obesity, along with lifestyle factors (sedentary, stress, lack of sleep, diet with trans fats and high fructose corn syrup, and lack of exercise). He says the average child sleeps less than six hours a night, a laughable claim.

Dr. Pamela Smith says a ketogenic diet can help reverse Alzheimer’s and is “perhaps the most important health discovery in the last 10 years.” (I don’t think so!) She does multiple non-standard lab tests and prescribes combinations of supplements, probiotics, and hormones. She recommends everyone take multiple supplements to prevent dementia.

Dr. Fred Pescatore focuses on glutathione, inflammation, and a nearly unknown probiotic, ME3. He says sugar is an “anti-nutrient” that depletes nutrients. He worries about toxins in the environment; he says there are over 700 toxins in a newborn’s cord blood. He recommends Alpha GPC and Blue Ness, mushroom extract, and green tea extract (he sells supplements).

Dr. David Katz says we can slash the risk of Alzheimer’s by 80% through diet and lifestyle changes.

Dr. Perlmutter thinks gluten is a major cause of cognitive loss.

Dr. Dale Bredesen proclaims The End of Alzheimer’s in Our Time with the Bredesen Protocol, which he calls the first effective treatment for reversing cognitive decline. It is a personalized, comprehensive therapeutic program involving multiple modalities designed to achieve metabolic enhancement for neurodegeneration. He has published a report of ten patients,4 with three case studies and a summary table that merely lists the other seven patients. Only half of them were diagnosed with Alzheimer’s; the others had mild cognitive impairment or subjective cognitive impairment. The case studies describe a complicated individual regimen. For example, one case was treated with fasting, a limited, mostly vegetarian diet, probiotics, coconut oil, strenuous exercise (swimming, cycling, running), melatonin, numerous herbs and vitamins, DHA and EPA. Nine patients had “subjective or objective improvement;” the tenth had advanced Alzheimer’s and failed to improve. He now claims to have treated 100 patients. The treatments are based loosely on his hypotheses about causation, with no clear rationale for the combination of interventions.

Bredesen thinks the amyloid deposits that characterize the disease are not the problem, but rather a protectant that kills microbes and fungi and protects from inflammation like from sugar. And he believes chronic Lyme disease (which doesn’t exist) is a critical factor.

His method looks at over 100 parameters: copper to zinc ratio, estradiol to progesterone ratio, vitamin D status, stress level, HSCRP, IL6, TNF alpha, etc. He says, “Most people don’t do well with gluten,” and says everyone should fast 12–16 hours at night to clean out the brain.

No Consensus, Just Hype and Slick Marketing

One of the doctors interviewed said there is an emerging consensus. I think you can see that there is no consensus at all, except that most experts agree that a healthy diet, exercise, adequate sleep and other lifestyle factors are important for general health and well being. Their promotion of a high fat diet (especially coconut oil) conflicts with the American Heart Association’s warnings against it. Many of them practice so-called “integrative” and “functional” medicine, which are basically excuses for doctors to make things up as they go along and pick from a smorgasbord of unproven treatments.

Let’s say you are impressed by the video interviews and want to prevent or treat Alzheimer’s. Where would you start? Which of the different recommendations would you adopt? All of them? Some of them?

The 14 videos were free online but each episode was only available for 24 hours, so it was easy to miss one. Never mind: they sell the videos and Sarlin’s book. I was bombarded with email offers for the books and videos, and for all kinds of supplements, blood type quackery, diets, “an incredible herb that can literally reverse memory loss in one hour,” a cancer cure (“one spoonful a day cures cancer”), and even lithium (a potentially dangerous psychiatric medication). One message said, “this is the last time I’ll bug you.” I received eight more emails in the following two weeks.

Conclusion: False Claims, False Hope

Let’s face it: the claim that Alzheimer’s is for the most part preventable and it can be reversed in 9 out of 10 patients is simply not true. I fervently wish it were, but harsh reality intrudes. Such claims are cruel and not supported by any credible science. We can’t reliably prevent Alzheimer’s, but we can adopt a healthy lifestyle. We can’t slow or stop the disease, but we can manage the symptoms to maximize patients’ quality of life.

Videos such as those done by Peggy Sarlin offer false hope. The real hope lies with researchers who are working hard to develop treatments and better ways to diagnose and prevent the disease and who understand the necessity of controlled experiments—research scientists who don’t just collect hypotheses, uncontrolled observations, and patient testimonials and throw everything but the kitchen sink at patients.

References
  1. http://bit.ly/2qaSPKj
  2. http://bit.ly/2zIxI3B
  3. http://bit.ly/2s9il2Z
  4. https://bit.ly/2fbeADa

This article was originally published as a SkepDoc column in Skeptic magazine.

Dr. Hall is a contributing editor to both Skeptic magazine and the Skeptical Inquirer. She is a weekly contributor to the Science-Based Medicine blog and is one of its editors. She has also contributed to Quackwatch and to a number of other respected journals and publications. She is the author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon and co-author of the textbook, Consumer Health: A Guide to Intelligent Decisions.