Alzheimer's, ADHD, Parkinson’s and other Neurodegenerative disorders

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

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Reducing the risk of neurodegenerative progression

With the realization that there is no single therapeutic measure found to be effective for the treatment of Alzheimer's, Parkinson's, and other debilitating neurodegenerative disease syndromes yet in 2015, and that these serious neurodegenerative diseases are almost always diagnosed too late, the public is growing very concerned about reducing their individual risk as they age. In 2014, large studies in the United Kingdom and other developed nations found that there may be twice the number of cases of early neurodegenerative dementia than previously thought, with a consistent failure to diagnose cases of early CNS dysfunction as neurodegeneration, especially in women. Assumptions that problems with memory and cognitive dysfunction, emotional and behavioral difficulties, and other signs and symptoms in patients under the age of 60, are due to psychological disease, ADHD or other health problems has led to a widespread misdiagnosis in standard medicine, and failure to institute preventive protocols. Also, in 2015, research was presented to the Alzheimer's Association International Conference that showed that women show much faster neurodegenerative decline in these diseases, due to metabolic and neurohormonal factors, such as higher levels of tau proteins, and that women are at higher risk than men for long-term cognitive and functional problems following surgery. Dr. Doug Brown, director of research at the UK Alzheimer's Society, was quoted in the Daily Mail as stating the "considerably more women develop dementia in the Western world than men and this isn't just because they live longer."

In 2010, the National Institutes of Health sponsored a jury of 15 medical scientists with no vested interest in Alzheimer's research to explore all of the current evidence. This jury of experts found that strong evidence of risk was associated with two factors: 1) the use of synthetic estrogens and progestins in hormonal replacement therapies and birth control, which doubled the risk for Alzheimer's, and 2) the presence of an E4 variant of the ApoE gene, which tripled the risk (see the link to a New York Times article on this NIH panel below). The ApoE gene is a gene that expresses apolipoprotein, or proteins that bind to fats, and is expressed in the now familiar LDL, HDL, VLDL, and IDL, which are often mistakenly referred to as cholesterol. These chylomicrons contain cholesterol as 1-3% of their makeup, but are mainly composed of triglycerides and phospholipids. Apolipoprotein E binds to specific receptors on liver cells, and peripheral receptors. There is a strong link via these lipoproteins between cardiovascular disease, metabolic syndrome, and Alzheimer's, as well as diseases of immune dysfunction, such as autoimmune disease. Genes consist of alleles, or base pairs, and the E4 allele of ApoE is implicated in both atherosclerosis and Alzheimer's disease. In addition, some respected research organizations (e.g. Northwestern University) have indicated that Alzheimer's might be realistically called "Type 3" diabetes, or a new type of Metabolic Syndrome. Metabolic concerns are now a primary concern with the onset and pathology of neurodegeneration and Alzheimer's disease, and some very commonly prescribed medications are now implicated. Artificial synthetic sweeteners such as Aspartame are now clearly linked to Metabolic Syndrome, and the pathophysiological link includes the adverse effects of synthesized sweeteners on the human Biome. Drugs widely prescribed to treat stomach acid, or GERD, called Proton Pump Inhibitors, are now clearly associated with risk of neurodegenerative diseases, commonly called dementia. To see a report and conservative medical advisory from the German Center for Neurodegenerative Diseases in 2016, printed in the Journal of the American Medical Association (JAMA) journals, click here:http://media.jamanetwork.com/news-item/proton-pump-inhibitors-may-be-associated-with-increased-risk-of-dementia/ . It is abundantly clear that standard medicine is more interested in protecting their business than in producing a thorough and comprehensive protocol to reduce the epidemic of neurodegenerative disease.

In 2015, a broad coalition of experts from many prominent university medical schools in the United States and Europe published a report in The Lancet Neurology stating that "increasing evidence suggests that Alzheimer's pathogenesis is not restricted to to the neuronal compartment, but includes strong interactions with immunological mechanisms in the brain" (PMID: 25792089). Reluctantly, a more holistic approach to prevention of progression of mild cognitive impairment to serious neurodegenerative dementia, utilizing the field of Neurohormonal Immunology, and Complementary and Integrative Medicine (CIM) is being acknowledged. The limited allopathic options in standard medicine are being found to be completely inadequate.

A number of metabolic and environmental concerns are now evident. Research has shown that there is a strong connection between neuron failure in Alzheimer's disease and depleted myelin cholesterol (via ApoE deficiency) that has been linked to cholesterol depletion and poor expression of cholesterol as a result of chronic use of statin cholesterol blocking drugs, or as an adverse reaction to statins. Since synthetic hormone therapies and statin drugs are prescribed to a large percentage of the population, this has become an issue of concern, even to standard medicine. To see a 2009 in-depth analysis of this connection between statin drugs and Alzheimer's disease by Stepehani Seneff of the Massachusetts Institute of Technology (MIT), click here: http://people.csail.mit.edu/seneff/alzheimers_statins.html. In addition, there is strong evidence linking accumulation of heavy metal toxins to neurodegenerative diseases, and most of these toxins exist as airborn lead and mercury molecules allowed into our air from coal fired power plants, smelters, chloralkili and concrete production. The instituting of clean coal technology has been woefully slow in the United States, and the highest levels of this type of pollution in the world has existed in the United States for a number of decades. In addition, the now widespread use of high fructose corn syrup, which purportedly introduces more mercury into the body, as well as contributing to a variety of metabolic pathologies, has also alarmed many experts. Adoption of clean coal technologies, elimination of high fructose corn syrup from processed foods, and a decrease in consumption of advanced glycation endproducts (AGEs) are ways to reduce risk of these neurodegenerative conditions. Decreasing iatorgenic causes of neurodegenerative diseases as well, by curtailing use of statin drug and proton pump inhibitors and integrating Complementary Medicine to help treat Metabolic Syndrome and Gastrointestinal functional disease should be an imperative. Use of safe chelation therapies may also be an effective preventive measure.

Studies in the last decade have clearly linked air pollution and toxins to the development of Alzheimer's disease, starting early in life. The pathology is linked to fine particular matter and other toxins breaking down mucosal immune protections, the protective barriers into the brain, and leading to a leakage of toxins into the brain from unhealthy blood vessels that causes a chronic inflammatory response and a protective response with increased amyloid beta plaque. This broad neurovascular pathology needs a more holistic approach to prevention and correction, as well as reduction in air pollution, and this should be part of a preventive medical protocol starting early in life, with consistency, not just initiated when Alzheimer's is diagnosed. Short courses of acupuncture stimulation with individualized herbal and nutrient protocol will help dramatically in achieving this goal. Standard medicine has nothing to offer in this regard, and while the protocol in such restorative medicine is complex and daunting to many, learning more about this subject and taking a proactive role together with the CIM/TCM physician will prevent the onset of neurodegenerative dementia later in life. This knowledge also helps to devise effective adjunct therapies with CIM/TCM when the disease progresses, and without addressing these underlying pathological mechanisms, pharmaceutical drugs and other treatments to inhibit or reverse amyloid beta plaque and pro-inflammatory cytokines will not be effective enough to insure a good outcome.

Besides use of CIM/TCM therapy clinically, the holistic approach to Alzheimer's disease prevention is sorely needed, and the Licensed Acupuncturist and herbalist, or TCM physician, is able to provide individualized advice. There are a number of healthy protocols that have been shown to reduce risk for neurodegenerative disease, and supported by the NIH panel in 2010. Increased regular exercise, a diet rich in fresh vegetables and whole grains, with less meat consumption, less sugar consumption, and healthy cognitive activities (exercising the brain and getting away from the television and idle internet browsing) have all shown to reduce risk. Reducing chronic inflammation, improving sleep quality, treating depressive disorders, and treating myofascial syndromes that may inhibit healthy blood flow to the brain, are also ways that are proven to reduce risk. Research done by the Scripps Research Institute in California, and supported by research across the world, has shown that mild use of marijuana in a patient's history is also associated with significant reduction of risk for Alzheimer's and Parkinson's diseases, and the THC actually prevents formation of lipoprotein plaque in Alzheimer's disease by preventing excess acetylcholinesterase activity. Stress reduction is highly recommended as well (refer to the article on this website to better understand stress). In other words, the treatment protocols and advice given by your Licensed Acupuncturist (minus marijuana use) for the last twenty years, especially one that incorporated the Tui Na physiotherapies into the treatment with acupuncture, herbal and nutrient medicines, provides an excellent overall protocol for reducing risk of neurodegenerative diseases. While no single herb or nutrient medicine has been found to be significantly effective on its own, and no large acupuncture clinical trials have been adequately designed as of yet, the information in this web article will show the potential for a broad protocol of a variety of treatments that have all been proven to show mild positive effect, and probably need to be taken together, as a thorough and holistic protocol, to show significant benefits.

Research presented at the 2011 Alzheimer's Association International Conference in Paris, France, by UCSF researchers led by Deborah Barnes PhD, noted that over half of Alzheimer's disease cases could potentially be prevented by treatment or prevention of chronic medical conditions along with diet and lifestyle changes. This worldwide study found that the biggest modifiable risk factors appeared to be smoking, lack of physical activity, depression, mid-life hypertension, diabetes or metabolic syndrome, and mid-life obesity. A lack of cognitive activity represented by low education and lack of cognitive challenges was also found to be a modifiable risk factor. In January of 2014, a multicenter study showed that 2000 IU of d-alpha tocopherol Vitamin E significantly slowed the progression of Alzheimer's disease, while one of the most promising pharmaceuticals, memantine, did not. Tocopherol Vitamin E is found in various whole grains, such as wheat and buckwheat, seeds such as flax and sunflower, and various vegetables, such as asparagus, sweet potato, and bell pepper, as well as soy and wheat germ oil, and may be taken as a supplement. Adopting a healthier lifestyle and utilizing Complementary and Integrative Medicine to help resolve chronic health issues is highly recommended to achieve these simple goals. While standard medicine has little to offer in real preventive medicine, much can be accomplished with a holistic regimen that utilizes acupuncture, herbal and nutrient medicine, and even soft tissue physiotherapies, to resolve metabolic problems, decrease stress and hypertension, and solve the problems associated with obesity, such as insulin resistance. The senior investigator with this large UCSF study, Dr. Kristine Yaffe MD, chief of geriatric psychiatry at SFVAMC, noted that the number of people afflicted with Alzheimer's disease is expected to triple over the next 40 years, and that the public should get serious about preventive measures.

Lifestyle, Diet and therapeutic regimens may be a key to successful prevention and therapy for neurodegenerative disorders

Healthy diet and exercise routines are very important in the prevention of Alzheimer's and Parkinsonian neurodegeneration, and possibly for other neurodegenerative diseases as well. As we age, or acquire health problems that could lead to a more serious neurodegenerative condition, we should increase our focus on an effective and efficient daily exercise routine and improve our diet. A Harvard study showed that the most physically active men cut their risk of acquiring a Parkinson's syndrome by 50 percent. Women showed a more modest beneficial effect from a lifestyle that included daily exercise. A University of Pittsburgh study showed how exercise prevented degeneration of nerve cells that are normally destroyed by disease. Researchers concluded that increased oxidative metabolism was probably responsible for the mitochondrial preservation within the nerve cells. A diet rich in antioxidants along with a routine of simple exercise is thus a key in neurodegenerative medicine.

A 2010 study by Columbia University in New York followed 2,148 older adults in Manhattan with an average age of 77 years, for four years. None of these subjects had dementia, or signs of neurodegeneration, at the beginning of the study, but 4 years later 253 had been diagnosed with Alzheimer's disease, which is an amazingly alarming percentage (over 10%). Of course, these people did not just suddenly acquire neurodegeneration, as this is a very slow process, and we can also assume that a much greater percentage of the subjects had a level of neurodegeneration that did not result in a full Alzheimer's diagnosis. The study followed the diets of this diverse cross section of the population. It found that those persons that ate a diet with sufficient dietary folates, essential fatty acid balance, and Vitamin E metabolites fared well, while those who ate more red meat, organ meat (lunch meats), and fatty dairy products fared poorly. The study concluded that a diet rich in dark, leafy green vegetables, oil and vinegar dressings on salads with hearty greens, fresh nuts, fish, poultry, and fresh fruit lowered the risk of Alzheimer's by over 30 percent.

A University of Toronto study of carbohydrates and cognitive function found a 37% increase in memory and cognitive function occurred in a group of subjects that ate a porridge of barley each morning. Simpler carbohydrates resulted in short lived memory and cognitive benefit. Complex carbohydrates may thus be very important to supplying your brain with the necessary chemicals for neuronal health. While barley may be difficult for many to incorporate into their breakfast diet, steel cut oats, amaranth and various whole grains can be made into delicious warm cereal porridge. Barley sprout powder can be used as a morning supplement, slowly pouring a tablespoon of the powder into warm liquid in a blender. Research concerning the effects of Ritalin on increased memory, cognition and control of hyperactivity in the brain showed that this drug increased glucose metabolism in the brain by 50%. It is suggested that an increased level of glucose bioavailability from a complex carbohydrate diet could achieve similar results.

Omega 3 fatty acids are also important to incorporate into the diet. Studies of Parkinson's patients found a consistent imbalance between Omega-6 and Omega-3 fatty acids in key areas of the brain. Deficiency of the Omega-3 DHA and EPA were common, and linked to various theories of metabolic dysfunction concerning inflammatory regulation and lipid peroxidation. DHA and EPA mutually support each other in the function of vascualar renewal, and deficiency could result in a poor vascularization that contributes to neural cell death or poor neural receptor function. DHA is essential to brain development and growth, and deficiencies have been linked to poor fetal development of brain function. These essential fatty acids are obtained from both foods and supplements. Various fatty ocean fish, as well as some fresh water fish are high in these EFAs, and this preformed DHA increases level more quickly than the foods and herbs rich in alpha-linolenic acid, but this latter class of foods is more commonly eaten and dietary changes incorporating these foods is recommended. The DHA levels rise more slowly from foods and herbs containing the Omega-3 alpha-linolenic acid, but the eventual change may be more dramatic.

Scientists long invested in treatment of populations with malnutrition of Omega-3 and Omega-6 fatty acids highly recommend using a combination of fatty fish with spirulina, blue-green algae and chlorella, which are rich and balanced with these nutrients. Salmon, mackeral and sardine are the fish highest in Omega-3 fatty acids. Trout, herring, anchovy, butterfish and tuna are also high in content. Various cooking, baking and salad oils are high in content, including pumpkin seed oil, and toasted walnut oil. Tempeh and dark, leafy green vegetables, such as collard greens, spinach, kale, chard, some endives, etc. are also rich in alpha-linolenic acid, the precursor to the DHA and EPA. Herbs such as digupi, and xuanshen that clear deficiency heat, and chaihu and cheqianzi, which benefit the liver and kidney, as well as duhuo, sangshen, gouqizi and nuzhenzi are all commonly used in TCM formulas and are rich in linolenic and linoleic acids. Nutritional benefits are one of the side effects of Chinese herbal formulas, a beneficial side effect.

Studies have also shown that excess alcohol consumption is proven to have a detrimental effect on the mitochondrial function of neurons. It is strongly advised that alcohol consumption be kept to a minimum in these disorders. Often, the habitual alcohol consumption increases with the neurodegenerative disorders, since depression and anxiety often result. The informed patient will find healthier means of calming anxiety and dealing with depression. Here, too, herbs, acupuncture, and nutrient medicine can help the patient deal with these problems and ease the elimination or reduction of alcohol consumption. This does not mean that all bits of alcohol must be eliminated, though. Many herbal chemicals need to be extracted into an alcohol medium, or tincture, to be effective, and small amounts of alcohol pose no risk of ill effects.

Studies in 2013 at the Centers for Neurodegenerative and Vascular Brain Disorders and Translational Medicine at the University of Rochester, Rochester, New York, found that problems with copper accumulation in the brain capillaries and parenchyma (neurons and glial cells) of the brain resulted in greater accumulation of amyloid-beta protein tangles that are highly associated with Alzheimer's disease. Unfortunately, this was not due to a simple excess or deficiency of dietary copper, but rather due to a problem with copper homeostasis (see study link below). Essential mineral homeostasis is highly regulated in the body, and minerals that have a higher electrical potential, able to supply free charged electrical ions easily, such as iron, copper and calcium, are of course regulated in a number of ways, including the control of absorption, transport and storage. Copper is essential in the diet because it is a key constituent of the enzyme complex cytochrome C oxidase, and is found in higher concentration in the liver, bone and muscle. Copper is bound and transported with albumin in the blood to the liver, where it is bound to other specialized transporting molecules, such as ceruloplasmin. Excess copper is excreted via the bile.

Copper also facilitates iron uptake and homeostasis, and is normally found in slightly higher concentration in the female. Copper deficiency is associated with anemia, neutropenia, bone abnormalities, osteoporosis, impaired growth, hyperthyroidism, abnormalities in glucose and cholesterol metabolism, and hyperpigmentation. Copper accumulation in the tissues is associated with Wilson's disease, a genetic abnormality, where symptoms include neurological, psychiatric and those associated with liver dysfunction. Chronic copper toxicity does not normally occur in humans because of the tight regulation of absorption, transport and excretion. The link between copper accumulation in the brain and Alzheimer's disease thus may involve both genetic and metabolic components, liver function, quality of the protein transporting molecules albumin and ceruplasmin, and aspects of copper homeostasis, such as regulation of the release of minerals from bone storage. Albumin, a carrier protein in the blood, binds about 15 percent of the copper in the circulation, but less tightly than ceruloplasmin, a protein enzyme that binds about 70 percent of the circulating copper. Since ceruloplasmin is also associated with oxidation of iron into ferric iron, where it is tightly bound and transported with transferrin, problems with iron homeostasis and iron overload toxicity may also play a part potentially in problems with copper homeostasis. Elevated levels of ceruloplasmin may also be caused by hormone imbalance, oral contraceptive use, hormone replacement use, lymphoma, and chronic inflammatory disease. A 2008 study at the Oregon Health and Science University, in Portland, Oregon, found that the copper transporter ATP-ase, is essential in a number of aspects of copper homeostasis, as well as normal function and development of the central nervous system (CNS), and could be a key component in the link between copper accumulation and Alzheimer's disease.