Alzheimers and dementia: Using herbs and supplements to make a difference

Christine Herbert MAMH 2017
Recent news articles have told us that in England and Wales more people die of dementia and Alzheimer's disease (AD) than heart disease, and that 5% of people with dementia or AD are under 65. The proportion is on the increase.
 
Conventional medicine has for over thirty years focused on anti-cholinesterase drugs to remove or prevent formation of beta amyloid protein plaques in the brain. However, these medications really don’t help much. Aricept, the most commonly used, has been shown to neither
slow the onset of the disease nor delay taking the patient into care, according to a major double-blind, randomised UK trial of its effectiveness 1 .
Recent work now suggests that the plaques may be formed in the brain to protect it from infection or inflammation, suggesting that it is the root causes of AD and dementia that need addressing rather than the end results. It seems that amyloid plaques bind toxins, and are deposited in the brain. These need to be removed and their cause addressed.
 
Work done in the USA by Professor Bredesen, a neuroscientist who has been studying AD and dementia for 30 years, is now showing that the
cause is very often inflammation and/or toxicity from many sources. Prof. Bredesen states that as recently as five years ago he would not have said that diet, herbs or supplements could play a role in treating AD or dementia, but now he recommends these as the first line of action. His protocol has reversed symptoms in 90% of 110 people. This standpoint has caused controversy in some circles.
 
This article draws largely from Professor Bredesen's work. He states that “AD is not a mysterious untreatable brain disease – it is a reversible,
metabolic /toxic, usually systemic illness with a relatively large window for treatment.”
 
There are always multifaceted causes of AD and dementia so it is really important to treat the patient as an individual, just as we do for any other
illness. AD is the result of a protective response to three major metabolic and toxic perturbations:
• inflammation – as a response to infections especially Lyme and other chronic bacterial, viral or fungal infections, autoimmune disease, stress
• trophic withdrawal – removal of ovaries, hormone loss including testosterone, thyroid hormones, deficiencies of vitamins and minerals
• toxins – heavy metals, mycotoxins, breast implants etc.
Combinations of the above are common.
 
Other inputs such as poor sleep, trauma, vascular insufficiency, insulin resistance, stress and raised cortisol are very important as these are all causes of stress, inflammation and poor elimination of toxins. There may also be malabsorption causing vitamin and mineral deficiencies, which needs addressing with both supplements and herbs to improve digestion and absorption. B vitamins, especially B12, and Vitamins D and E in particular are often low, and supplementation can make a big difference.
 
Generally herbal intervention has several aims:
• increasing blood flow to the brain
• using anti-inflammatories and antioxidants
• treating any predisposing condition
• reducing anxiety and stress, both of which worsen AD and dementia
• using alteratives to detoxify and improve function of elimination organs.
There are several herbs that most of us would use to increase blood supply to the brain, specifically ginkgo and rosemary.
Ginkgo biloba has had numerous studies, which shown it to have good antioxidant and anti- inflammatory action. The best results have been
found when ginkgo is used alongside fish oils (DHA/EPA), B12 and folate supplementation.
Rosmarinus officinalis contains volatile oils that can cross the blood brain barrier and have been shown to be naturally occurring
acetylcholinesterase inhibitors. Inhalations of essential oil are quite effective, and dietary amounts can be very helpful. Aromatherapy
studies from Japan 2 have shown that using rosemary and lemon essential oils 2:1 in the morning for two hours and lavender and sweet
orange 2:1 in the evening for two hours as a room inhaler (spray or burner) or as a roll-on perfume can help with AD and dementia.
Suitable adaptogenic herbs will act on stress and anxiety as well as inflammation:
Eleutherococcus senticosus reduces the HPA response to stress; it is able to normalise blood sugar and blood pressure; it improves
learning and memory; it is antioxidant.
Centella asiatica has been shown to regenerate neuronal axons, inhibit amyloid and improve anxiety. Ayurveda considers Gotu cola rejuvenating to the brain and memory and to be best with continuous and long-term use.
Withania somnifera protects the body from the effects of stress with anti-inflammatory and antioxidant actions, and has also been shown to increase receptor-mediated clearance of amyloid at a dose of 500mg x2/day.
Curcuma longa is anti-inflammatory and reduces oxidative damage. It is liver-protective and helps to detoxify. It has been shown to be
neuroprotective and can reduce amyloid plaques and inhibit AD and dementia.
Phyllanthus emblica possesses memory-enhancing, antioxidant and anti-cholinesterase activity.
Uncaria tomentosa is anti-inflammatory and antioxidant.
Hericium erinaceus , lion’s mane mushroom, has been shown in many studies to heal and restore the motor and sensory nerves that
connect the brain and spinal cord to the rest of the body. 
Bacopa monnieri has shown a clear anti- dementia effect in several clinical trials. It is able to increase 5HT serotonin levels in the
hippocampus, hypothalamus and cerebral cortex; is procholinergic, antioxidant and anti- inflammatory; it increases circulation and removes
amyloid. However, it may be contraindicatedwith cholinergic / anticholinergic medications, acetylcholinesterase inhibitors and SSRI drugs.
 
A recent Iranian study 3 gave a group of elderly people with moderate to severe AD probiotics for 12 weeks and found significant improvement
in cognition, reduction in blood lipids and also reduction in insulin resistance.
 
Professor Bredesen's protocol includes the following pointers:
• it must continue to update and change with the person
• the earlier treatment is started the better the result
• it works better without AD medications
• nutrition is “arguably the single most powerful of all the protocol elements”, as “almost no-one with cognitive decline presents with an optimal diet”
• avoid simple carbohydrates, trans fats, low fibre medium chain fatty acids (MCT oils) – butter, palm oil, coconut oil, avocado – re important
and some must be eaten daily
• non-starchy vegetables are best – of all colours detoxifying vegetables include jerusalem artichoke, coriander leaf and brassicas
• low GI fruits only such as berries are used – no fruit juices
• meat should be grass-fed or pastured poultry – and not in excess
• fish – avoid high-mercury large fish such as tuna or swordfish; eat wild-caught oily fish including salmon, mackerel, sardines, anchovies and herring
• organic eggs
• avoid gluten and dairy as they are proinflammatory
• organic food – or at least clean fifteen
• treat insulin resistance – MCT oils (above), low GI diet, chromium
• mild ketosis is useful – 12 hours a day with no food, and 3 hours between meals
• heal gut – preferably with bone broth, otherwise L-glutamine
• prebiotics and probiotics
• sleep hygiene is important – more than 7 hours a night, beginning before midnight in complete dark and quiet, without EMF radiation. It is
important to exclude sleep apnoea and not to eat for at least 3 hours before bedtime.
• exercise is important, but not in the evening. Five times a week for 45–60 minutes – and get a pulse rate increase.
 
A sample protocol from Prof. Bredesen might include:
   Vitamin B12 1000mcg daily
 Vitamin B6 50mg
 Folic acid 800mcg
 Vitamin E 100mg
 Vitamin B5 75mg
 Zinc 15mg
 Vitamin A 800mcg
 Phosphatidyl serine 100mg
 Phosphatidyl choline 150mg
 CoQ10 20mg
 EPA:DHA 750:1500mg
 Magnesium 400mg
 Iodine 30mcg
 Vitamin D 4000iu
 Vitamin K2 100mg
 Green tea
 
For a holistic therapist treating AD and dementia is no different from treating any other form of ill- health. From the medical history there will be plenty of clues as to sources of inflammation, toxicity or trophic deficiencies and which are the areas that need addressing. We have the tools at our disposal to treat this epidemic that is affecting so many people.
 
 
1.Long-term Donepezil treatment in 565 patients with Alzheimer's Disease (AD2000): randomised double-blind trial. Lancet (2004); 363: 2105-15
2. Effect of aromatherapy on patients with Alzheimer's disease. Psychogeriatrics (2009 Dec); 9(4):173-9. doi: 10.1111/ j.1479-8301.2009.00299.x
3. Effect of probiotic supplementation on cognitive function and metabolic status in Alzheimer's Disease: a randomized, double-blind and controlled trial. Front. Aging Neurosci. (10 November 2016): https://doi.org/10.3389/f