One of the cases that stand out in my mind from the beginning days in practice was of a woman with Alzheimer's disease who was brought in by her husband for treatment. They were old time Vermonters - Earl, a farmer who prided himself on ingenuity and self-reliance, and Mary, a sturdy, strong looking woman. (Not their real names.)
Earl, being skeptical of pharmaceuticals and averse to losing her to a nursing home, was devoted to her care. He looked after her physical comfort, monitored her condition carefully, prepared food and even made home remedies.
Despite Mary's outwardly robust appearance, her nervous system was extraordinarily sensitive. She no longer spoke coherently, if at all, and it didn't take much to trigger episodes of extreme agitation or even rage. If not for her husband's attentiveness, it would have been easy to assume that these were random events. But Earl had observed that they were sparked by toxic exposures of one sort or another - for instance, a trip to the hairdresser or a meal at the senior center. The latter probably having to do with either the cookware since aluminum is commonly used in large scale kitchens or some type of food additive.
Mary was my first patients with dementia and her condition was quite progressed, at that. At the time, I was mostly using Oriental Medicine and only beginning to introduce homeopathy into my practice. Between the Earl's care and these treatments though, we were able to stabilize her somewhat and slow the cognitive decline.
Even so, I wished there were more tools at my disposal to help her, perhaps even to the extent of reversing the condition. At one point, I discussed her case with a physician, an excellent diagnostician with many years of experience and an open mind. His reply is still clear in my mind: "If she has Alzheimer's, there is nothing you can do."
It struck me how definitive he sounded, his prognosis seemed inevitable. However, I continued to work with them for a number of years, but as Earl himself aged and lost his capacity to care for her, she ended up in a facility. From that point on Mary's decline accelerated dramatically and she died in relatively short order.
As with many other aspects of life, I wish I knew then what I know now about dementia and cognitive decline. Although that physician's attitude is still prevalent in the conventional medical world, it is not accurate. In fact, there is a lot that can be done. Even if the patient isn't necessarily 'cured', the decline can be halted or s/he can go into remission.
But dementia is not a simple pathology and each individual suffering from it has his or her unique way of manifesting the symptoms. In fact, dementia really isn't even one pathology. It arises from different factors in different persons and treatment needs to be a individualized.
The concept of individualization, of course, is not new. It is the bedrock of homeopathic philosophy and treatment, as well as many other truly wholistic medical systems. But generally speaking, this idea is not highly valued in modern conventional medicine. People with the same diagnosis are treated in the same way, usually with a drug, a cocktail of drugs or a surgical intervention.
But that approach too may slowly be changing. Recently, I heard a series of interviews with a number of physicians who specialize in treating dementia and Alzheimer's. (www.awakeningfromalzheimers.com/). Not only was it was full of interesting, useful information, but it was tremendously encouraging to hear that almost across the board these conventionally trained doctors espoused a multifaceted non-drug approach tailored to the individual that included nutrition, herbs and supplements, exercise and other lifestyle recommendations.
What also came across loud and clear in these interviews was that drugs are not very useful and that if they have any positive effect at all it is generally minimal as well as temporary. One of the interesting facts that came up was that since the year 2000, there have been 244 trials for Alzheimer's related drugs, 243 of which were failures, and the remaining one trial only showed modest benefits.
Clearly the old reductionist medical model - that is, the tendency to reduce a complex condition into a simple one, and treat it with a 'magic bullet' will not work. A prime example of how this approach is unsuitable relates to the hallmark of Alzheimer's disease itself, amyloid plaques.
Amyloid plaques are a buildup of 'sticky' proteins that accumulate between and around the nerve cells in the brain and are toxic to them. So, it might seem logical that a drug that targets these plaques might be an effective treatment.
But as it turns out, research is showing that the plaques do not cause Alzheimer's but, quite to the contrary, are a response mechanism produced to protect the brain from the inflammation, toxins and deficiencies that are the true underlying cause of the disease.
There is an interesting parallel here to the debate over cholesterol and heart disease in that excess cholesterol too can be understood as a protective mechanism against the vascular inflammation that is underlying the development of arterial plaque. In both conditions, targeting the byproduct of the disease mechanism - the amyloid plaque or the cholesterol - is akin to shooting the firemen who show up at a fire.
(That is, if one believes that those people with hoses and funny hats who seem to always be showing up at fires as causing them instead of trying to put them out.)
Treating dementia and Alzheimer's means addressing the source of the problem. Generally speaking, these can be divided into the following, often overlapping categories: inflammation, toxicity, deficiency, circulatory disturbance, and disruption of the vital force.
A comprehensive treatment strategy begins with assessing the role each of these plays in any given case and implementing a program that includes diet, nutritional supplementation, mental and physical exercise, herbal medicines as well as homeopathy. This, of course, can only be successful if there are one or more caregivers who are willing and able to carry it out - someone just like Earl.
PART II
Alzheimer's Disease - and dementia, in general - is not something that happens to a person without rhyme or reason. Nor is it just a matter of inheritance. It is a response to the degradation of the internal environment of the body and, in particular, the brain.
Although much is being made of the discovery that there is a gene predisposing a person to Alzheimer's (known as apolipoprotein E or APOE), the presence of this gene does not determine if a person actually develops the condition or not. A person with APOE may be more apt to develop the disease than a person without it, but only if conditions are such that the gene will be 'turned on'.
The study of the factors that determine gene expression, that is whether a gene is turned on or not, is known as 'Epigenetics'. And what it has shown is that all of us have predispositions toward one type of disease or another that will vary according to our genetic inheritance, but this does seal our fate. There are extrinsic factors many of which can be controlled that influence whether a predisposition will lead to pathology. So, in this regard, Alzheimer's disease is really no different than most other degenerative illnesses.
Dale Breseden, a neurologist specializing in the study and treatment of Alzheimer's disease, provides a very useful paradigm to understand the multifactorial nature of the disease. Broadly speaking, aside from genetics, the major factors that influence the development of Alzheimer's fall into three categories: deficiencies, toxicity and inflammation.
The good news is that these factors can be addressed and in varying degrees rectified. Deficiencies can be reversed, toxins can be eliminated and inflammation can be eliminated or reduced. The challenge is that since these conditions have more than likely been at play for many years or decades before symptoms even appear, the treatment process can take time and considerable effort.
The deficiencies mostly relate to food and nourishment. Primary examples would be low levels of certain vitamins, minerals, hormones, essential fatty acids, neurotransmitters and other neuroactive molecules such as nerve growth factor (NGF) (a protein like molecule that plays a significant role in the development and maintenance of nerve cells.)
It is quite common for Alzheimer's patients to have low vitamin D, E and the B vitamins as well. Insufficient thyroid hormone is also not unusual. Deficiencies in other hormones such as pregnenolone, DHEA, testosterone and estrogen impact memory and cognitive function as well.
Poor brain circulation, though not a deficiency per se, leads to insufficient nourishment of the brain and thus plays a significant role in various forms of dementia. In fact, according to some experts in the field, a significant number of patients - somewhere in the neighborhood of 30 to 50% - originally diagnosed with Alzheimer's or another form of dementia do not have the disease, but actually suffer from impaired circulation or other deficiencies.
Unfortunately, because these conditions have become so common and the conventional outlook is basically one of resignation, many people who with signs of cognitive impairment are never truly tested or diagnosed correctly.
Toxic factors involve exposure and absorption of heavy metals, chemicals, and biotoxins. Biotoxins are harmful metabolites secreted by living organisms. There are many types, but two significant ones are mycotoxins and Lyme toxins. Mycotoxins, produced by fungi and molds, are quite widespread in food crops, but are also found in animals and humans. Candida albicans, a fungal infection produced by yeast, is an all too common source of mycotoxins that can significantly impact the brain. Likewise, Lyme disease is a common yet frequently undiagnosed chronic condition that results in cognitive impairment.
Inflammatory responses arise as a result of numerous possible factors including the fungal and spirochete infections mentioned above as well as other bacterial infections and high sugar intake. In fact, it is not only the over consumption of refined sugar but also of carbohydrates in general that produce inflammation in the brain.
This is why many Alzheimer's experts have designated the disease as 'Type 3 Diabetes'. Similar to Type 2 diabetes in which the cells throughout the body become insulin resistant, that is they no longer respond to insulin and glucose can no longer be absorbed to fuel energy production, Type 3 is an insulin resistant condition that occurs in the brain. Significantly, about half of persons with Type 2 diabetes go on to develop Alzheimer's.
Like Type 2, it is an inflammatory response most often triggered by the overabundance of glucose derived from simple or complex sugars. The deterioration of the brain's ability to metabolize glucose leads directly to a decline in cognitive function as well as degeneration in its size and structure.
One of the most effective ways to address the problem is to dramatically reduce the intake of carbohydrates in order to force the body - including the brain - to derive its fuel from a substitute energy source, fats. Known as a 'ketogenic' diet, it has been used medically for over a century, but mostly for cases of resistant epilepsy.
The body's capacity to switch its fuel source from glucose to fats is a protective mechanism that allows it to survive starvation conditions. But when the glucose metabolism is severely disrupted, as it is in a seemingly ever-increasing number of persons in modern societies, the intentional choice to transition to this alternative energy can produce dramatic benefits. It can severely reduce or eliminate altogether the inflammatory conditions that underlie any number of chronic conditions including diabetes, obesity, autoimmune illness and Alzheimer's disease.
PART III
Cognitive decline sometimes manifests soon after a brain injury, a significant emotional shock or, more often than is generally recognized, after surgical anesthesia. That being said, it is by and large not an acute condition that truly arises suddenly, but the byproduct of long-term systemic toxicity, inflammation and deficiencies that are often hard to recognize until a relatively advanced stage. By that time, of course, most persons, even if they can recognize their own condition, will not have the capacity to adequately help themselves and become reliant on the care of others.
So, the old dictum about an ounce of prevention being worth a pound of cure applies ten-fold when it comes to the health of one's brain. Whether signs of cognitive impairment are recognizable or not, whether a person has been diagnosed with Alzheimer's disease or another form of dementia or not, there are numerous ways to prevent, halt or reverse the symptoms.
Broadly speaking these include appropriate dietary changes and some combination of systemic detoxification, hormonal regulation, nutritional supplementation, as well as botanical and homeopathic medicines.
We have already seen how the change to a low carbohydrate diet without grains and sugars that features higher amounts of good quality fats supplies the brain with a powerful source of energy that can help to resuscitate cognitive function.
Consuming coconut oil in adequate quantities is also one of best-known and effective ways to stimulate cognitive function, and prevent or reverse dementia. Coconut oil contains medium chain triglycerides (MCTs) that are metabolized by the liver, cross the blood-brain barrier and directly fuel the brain. The oil can be taken straight and dosages in some cases reach 9 - 10 tablespoons per day. But such high quantities are rarely tolerated initially and it is important to begin with a teaspoon and slowly increase the amount over time.
In recent years, a 'super fuel' oil consisting of MCT extracted from coconut oil has also become readily available and can be substituted for at least some of coconut oil.
It is not only the kind of food but also its quality that matters. Pesticides, additives and other artificial chemicals only add to the toxins burdening encumbering the system. Research indicates that genetic engineering has also resulted in toxic foods. The herbicide glyphosate, although almost omnipresent in the food supply, is found in particularly high amounts in GE foods. Glyphosate has been shown to disrupt various metabolic processes, disturb the digestive function, produce mineral deficiencies and generally produce systemic toxicity.
Of the many other types of toxins involved in cognitive impairment, heavy metals are probably the most commonly implicated. Eliminating sources of exposure and promoting detoxification can address this. Two important steps are the removal of metal dental fillings and discontinuing the use of aluminum cookware. The latter would also include avoiding prepared or restaurant foods cooked with aluminum.
There are a number of methods remove of heavy metals including supplements, botanical and homeopathic medicines. Chlorella and cilantro, either in capsule or tincture form, are powerful cleansers. Zeolites, mineral compounds derived from volcanic lava, chelate with the metals and eliminate them via urinary excretion. Low potency homeopathic preparations of the various metals along with lymphatic cleansers also stimulate the body to cleanse itself.
Cosmetics and perfumes are also a common and significant source of chemical toxicity. If the label contains lots of chemical compounds in the ingredients - or doesn't list the ingredients at all, it is best to discontinue or switch to brands that rely on natural, organic ingredients. Zeolites and homeopathic detoxifying preparations are useful in ridding the body of residues of these chemicals as well.
One of the factors that can play a major role in person with dementia is allopathic medication. Many drugs are designed to act as 'anticholinergics' - that is, they block a key neurotransmitter called acetylcholine. The side effects from these drugs are extensive, chief amongst them being poor coordination, confusion, disorientation and impaired memory. The list of these drugs is quite extensive, making it extremely likely that this is an issue in geriatric patients who commonly are being prescribed numerous medications.
Oftentimes, reducing or eliminating medications will in itself bring a person out of their misdiagnosed dementia. In addition, supplements such as acetyl-l-carnitine, phosphatidylserine, and phosphatidylserine increase acetylcholine. Chinese club moss, known as Huperizine-A, also promotes acetylcholine production.
Amongst the biotoxins (toxins produced by microorganisms), Lymes disease and systemic mycosis (fungal infection) are quite common and can severely impact cognition. These are both challenging conditions to address and are best treated based on the particular history and individual presentation in each case. These strategies involve the dietary changes and a customized combination of supplements, herbs and homeopathic medicines.
Numerous hormonal imbalances can contribute to dementia. Perhaps the most common is insufficient thyroid hormones, but also deficiencies in the sex hormones estrogen and progesterone, as well as imbalances of endogenous steroid hormones like pregnenolone, DHEA and cortisol can be involved. Supplementation of these hormones can be helpful, but addressing the causes of glandular dysfunction is important. For instance, low thyroid function can be the result of heavy metal toxicity or other 'goitergenic' substances such as soy products.
Low thyroid function can often be addressed by iodine supplementation. In addition, iodine acts systemically to reduce inflammation throughout the body. Other mineral and vitamin deficiencies are also all too common. These include magnesium, Vitamin D, and the B vitamins.
It has been found that genetic mutations can impair certain metabolic processes that impact the brain. Supplementation with forms of B vitamins, specifically methyl B6, B9 (folate) and B12, as well as eating a diet high in folate can promote detoxification, increase cognitive function and stabilize moods as well have protect the heart.
There are botanical medicines too numerous to mention that stimulate healthy brain function. Some of the most well known are: Gingko biloba and Bombyx Mori enhance cerebral circulation; Bacopa, known as Brahmi in Indian Ayurvedic medicine, promotes nerve growth and signaling; the mushroom Lion's Mane, found locally in New Enlgand woods, is a brain tonic that stimulates the synthesis of nerve growth factor (NGF); Eleutherococcus senticosus - commonly referred to as Siberian Ginseng, is a powerful adaptogen that balances and restore physiological processes, increasing energy and reducing the effects of stress. Rhodiola is another powerful adaptogen that promotes on the one hand stimulates cognition and promotes memory while on the other calms the emotions.
PART IV
The prevalence of dementia and Alzheimer's disease is increasing dramatically. Nearly 10% of seniors over 65 and 50% of 85-year olds are diagnosed with Alzheimer’s disease. What’s worse is that this number is predicted to increase by 300% within the next few decades.
Some of the most important measures to prevent the onset of dementia have to do with lifestyle: eating appropriately, getting enough sleep, walking and other forms of exercise, learning new skills like a language or a musical instrument, exercising the mind by solving puzzles or playing games that develop various cognitive skills, socializing and just plain having fun.
One particular nutritional measure that is simple and inexpensive is the use of coconut oil. In adequate quantities, it is one of the best-known and effective ways to stimulate cognitive function, and prevent or reverse dementia.
The discovery of the cognitive benefits of coconut oil is credited to Mary Newport, a physician whose husband developed severe Alzheimer's disease at the age of 51. As detailed in a 2008 article 'What If There Was A Cure For Alzheimer's Disease and No One Knew?" (http://coconutoil.com/AlzheimersDiseaseDrMaryNewport.pdf), her own research into the medical literature led her to begin giving her husband doses of coconut oil in increasing quantities.
Improvement was nearly immediate and quite dramatic. Coconut oil contains medium chain triglycerides (MCTs) that are metabolized by the liver, cross the blood-brain barrier and directly fuel the brain. The oil can be taken straight and dosages in some cases reach 9 - 10 tablespoons per day. But such high quantities are rarely tolerated initially and it is important to begin with a teaspoon and slowly increase the amount over time.
For decades MCT oil - 'super fuel' oil consisting of MCTs extracted from palm oil - has been fed to premature newborns because it is easily absorbed and helps them develop faster. Subsequently, it became a popular ingredient in infant formula. In recent years, MCT oil has become readily available as a nutritional supplement and can be substituted for or mixed with some of the coconut oil.
Homeopathy is also another very powerful modality that can play a central role in the treatment of dementia and Alzheimer's disease. Homeopathic medicines engage the vital energies of the body, thereby restoring a healthy physiological homeostasis, activating the immune system, and promoting detoxification by dissolving acids, toxins and metabolic waste.
What is unique about homeopathic treatment is that it is individualized for each person based on his or her presentation and characteristic symptoms. There is both a science and an art in the choice of the most appropriate homeopathic medicines because it demands a careful history and an understanding of nature of the patient.
For instance, Alumina, a homeopathic remedy prepared from aluminum oxide, is sometimes called for in cases of dementia. This is no doubt partially the result of poisoning from aluminum cookware. These persons exhibit a slowness on the mental level and dryness on the physical. The thought processes are hazy, and they have difficulty expressing themselves. There is a great deal of confusion to the extent that they lose their sense of identity. They feel as though anything they perceive or say is being seen or said by another person, or that they are inside another person.
They can present as shy, weak willed and indecisive. Yet, internally they can feel both hurried and impulsive. The sight of a knife or blood can trigger an impulse to kill or to stab themselves. They may have desires to eat unusual, indigestible things like charcoal or uncooked rice. Typically, they dislike potatoes, which cause digestive upset.
Another remedy known for its application in cases of dementia in Baryta carbonica, derived from barium carbonate. These individuals have a marked childish quality about them. They lack self-confidence and feel incapable of taking on responsibilities. This can make them fearful of being laughed at. Thus they seek out support and reassurance as a child might. Their shyness can be greater than in Alumina and they fear strangers as well as new situations. This can develop into agoraphobia.
Physically, these patients are prone to develop hypertension and hardening of the arteries as well as glandular swellings. So, for instance, in a case of dementia with an enlarged prostate and high blood pressure, it may be a remedy to consider if it fits the above profile.
While Alumina and Baryta carbonica tend to be more passive persons, Hyoscyamus (a plant in the nightshade family commonly known as 'henbane') tends to be a more aggressive form of dementia. Often one will see a history of abuse or romantic disappointments in these persons.
They have a sense of being wronged, suffered injustices or being persecuted, leading to a general suspiciousness. They can become quite hostile, verbally or physically, and are prone to foul language. On the other hand, these persons can act quite foolish by making silly or lewd jokes, or displaying other antics. There is a strong sexual side as well and they have a tendency to exhibitionism or lecherous behavior.
It is possible to see in these examples how the each medicine has a particular configuration of symptoms or 'picture'. Being that there are many hundreds of different remedies from which to choose, the key to success is being able to match the peculiarities of each case - that is, what characteristics in the case go beyond the common symptoms of the disease, to the appropriate remedy picture.