leukin-6) Non-Inflammatory. Atrophic (“cold” loss of trophic support) Reduction in synaptogenesis, re-duced support from sex hormones, brain-derived neurotrophic factor, nerve growth factor, insulin, vita-min D, often with increased homo-cysteine and insulin resistance. There is subtype noted as 1.5: Glycotoxic (“sweet”) Combines both 1 and 2 subtypes. 3. Cortical (“toxic”) An environmen-tal toxin related subtype with chronic inflammation presenting with more general cerebral atrophy. Affects more cognitive functions but not typically memory, seen in younger patients (<65yrs), more often in women, often in APOE negative. There are additional subtypes includ-ing vascular and traumatic have also been cited. (Bredesen, 2015). Although there are differences in these subtypes there are also unifying and overlapping causes. The first step in this approach is iden-tifying the subtype and then taking a wide approach, involving genetics and lifestyle factors that include diet, sleep, exercise and environmental exposures. Why is this important as a chiropractor? We have the ability to help guide and address key lifestyle areas with patients, and be a conduit for referral to Re-CODE doctors, or become certified in the ReCODE protocol. The ReCODE protocol looks at 36 metabolic imbalances. For optimal outcome all 36 points may be addressed. However, as Dr. Bredesen experienced with one of his first cases, addressing 12 of the 36 points may be enough to get over a threshold (Gustafson, 2015). An important point to remember in this program is the goal is to not only ‘nor-malize’ metabolic function but to ‘opti-mize’ metabolic function. An example of this are the optimal values to aim for in these specific areas: • hs CRP (<1.0mg/L) marker of sys-temic inflammation • Fasting insulin l<7mIU/L (18-48 pmol/L) marker of glucose metabo-lism • Hemoglobin A1c (<5.5%) marker of glucose metabolism • Homocysteine (<7umol/L) marker of methylation status 2. 24 Canadian Chiropractor May 2019 The therapeutic systems look to ad-dress the 36 holes identified in the protocol first developed and published in 2014. [Table 1. Therapeutic System 1.0 (Bredesen, 2014)] (Visit canadi-anchiropractor.ca/brainrecode to view the chart.) The processes are complex and inter-connected, addressing the list below helps to simplify the approach in a step-by-step process for repairing the 36 holes. One step builds on the other and the threshold for improvement is indi-vidually determined. • Reduce inflammation (use biomark-ers such as hs-CRP, IL-1, IL-6, TNF alpha) • Normalize glucose and insulin • Reduce homocysteine • Restore trophic factors including hormones and vitamin D • Reduce metal toxicity • Optimize levels of key nutrients in-cluding antioxidants, vitamins and minerals • Reduce stress • Improve sleep • Heal the gut The best way to demonstrate the proto-col is by one of the published case studies in the original 2014 paper (Bre-desen, 2014). Summary of Patient: • Professional male, 69yrs • 11-year history of progressive mem-ory loss. Lost the ability to quickly add numbers/columns in his head • Multiple testing including PET scan and neuropsychological testing indi-cating progressing Alzheimer’s dis-ease process was diagnosed • Labs indicated various markers out-side of optimal range including ho-mocysteine, Vit. D, CRP, sex hor-mones, zinc, copper, thyroid hormones Therapeutic protocol used: • Fasting 3 hrs before bedtime and 12 hrs between dinner and breakfast • Elimination of simple carbohydrates and processed foods • Increased consumption vegetables and fruits • Consumed non-farmed fish, occa-sionally consumed grass fed beef or organic chicken • Coconut oil, 1 tsp 2x daily • Slept eight hours nightly • Exercised strenuously (swam, cycled and ran) Supplements included: • Probiotics • Melatonin 2mg (.5mg 4x daily) • Bacopa monniera (250mg) • Ashwagandha (500mg) • Turmeric (400mg) • Methycobalamin (1mg) • Methyltetrahydrofolate (.8mg) • Pyridoxine 5 phosphate (50mg) • Citicoline 1,000mg (500mg, 2x daily) • Vitamin C (1,000mg) • Vitamin D3 (5,000IU) • Vitamin E (400IU) • CoEnzyme Q10 (200mg) • Zinc picolinate (50mg) • Alpha lipoid acid (100mg) • DHA 320mg, EPA 180mg Results: After six months on this program the patient, his coworkers, and his wife all noticed marked improvement. He re-duced his weight by 10 pounds. Recog-nition of faces, his memory for work schedules and his ability to quickly add numbers all returned. The rapid and significant cognitive decline in the past few years halted. Many of these action steps for repair may not be new to integrative doctors. The avoidance of processed foods, eat-ing diet leaning towards ketogenic, re-ducing inflammation, sleeping, optimiz-ing nutrients, and exercising may seem obvious to some, but the key is employ-ing all of these things to repair the 36 holes and aiming for optimal ranges in stated biomarkers. Visit canadianchiropractor.ca/brainrecode to read this story in its entirety, including references. www.canadianchiropractor.ca
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