The concept of metabolic morbidity is interesting – chronic dysfunction in metabolic state due to a multitude of factors, primarily decreased energy expenditure (poor exercise) and increased energy intake (poor food choices), resulting in impaired mitochondrial function, and manifesting in those organ systems where people are the most vulnerable due to their genetic heritage.

We have no control (at least not in this world) over our genetic heritage – it is the hand of cards we were dealt at birth, and with which we must live.

We DO have some control, however, over how we play that hand of cards, and how that genetic heritage is expressed. We can determine at least in part to which toxins we choose to expose ourselves.

Aerobic exercise – something that gets the heart rate up and makes us sweat a little – reduces blood sugar, protects against volume loss in the hippocampus in late adulthood, and can actually increase the hippocampal volume in older adults. Increased hippocampal volume is associated with improved memory function, even in those who already have some cognitive loss.

We have plenty of opportunities to choose healthier vs less healthy.

We decide to expose ourselves to things like alcohol, tobacco, and drugs – legal or illegal.

We have at least some control over exposure to herbicides like glyphosate RoundUp®, and pesticides like chlorpyrifos (Dursban®).

We make the decision whether to purchase non-stick cookware made with cancer-associated PFAS or cookware made with less toxic ceramic coating. Or whether to forego the non-stick aspect in favor of even safer alternatives like stainless steel or cast iron.

We can choose which foods we buy at the grocery store – whether organic or conventionally produced or genetically modified.

We make the decision whether to eat hyper-palatable fast foods or to take the time to make home-cooked meals.

We can choose to eat at restaurants that offer conventionally grown pesticide-laden foods, farmed fish, corn-fed beef and pork, caged poultry, etc).

We can also choose restaurants that offer organic vegetables and fruits, wild-caught fish, grass-fed beef, and eggs produced by free-range chickens.

We can choose whether to focus on high carbohydrate foods – breads, pastries, cookies – and drinks – high sugar sodas or even “diet” sodas, sweet tea, fruit juices – or lower carbohydrate foods – vegetables, green leaves, animal protein, legumes.

Each of these choices plays a part in which genes are expressed, and which subsequent dysfunctions (diseases) develop in our bodies.

Genetics loads the gun, epigenetics pulls the trigger.

More to the point, even in people with “normal” glucose levels, researchers find that higher fasting glucose levels are associated with atrophy of the hippocampus and cognitive decline. Pre-diabetes – with fasting glucose levels in the low 100s and higher fasting insulin levels but “normal” A1c levels – is not a diagnosis that we want to have. Perhaps we should be revising our concept of “normal” blood sugar levels – just because someone falls in the 95% range of the population does not necessarily mean that 95% of the population is healthy.

The Centers for Disease Control and Prevention (CDC) estimates that 38% of adults in the United States have pre-diabetes, based on fasting blood sugar or Hemoglobin A1c levels. If higher blood sugar levels are associated with cognitive decline in later life, no wonder we are headed for an Alzheimer’s disaster.

But there is hope. It’s never too late to turn the ship around.

When we think about declining functions in our later years, it is important to remember that there is a spectrum of decline, a slope of dysfunction. In the end, hardly anyone gets out of this world alive. But how we function as we near the end of our natural lives depends in large part on how we have functioned in our earlier years. Chronic inflammatory illness – diabetes, heart disease, autoimmune disease, infections – all tend to hasten the course of decline. Chronic healthy activities – clean diet, sufficient sleep, not trying to control things over which we have no control, the exercises of gratitude and forgiveness – all these promote health of the body and the mind and improve our function even as we get older.

Exercise is one of those things over which most of us have a significant amount of control. Have you seen the video images of exercises for amputees? A Google search on “exercise for amputees” brings up pages of options. And if we have all our extremities in reasonably good working order, then so much the better (and easier).

By the time we have lost many of our cognitive abilities – and the will to change – then things become much more difficult, if not for us individually, most certainly for our caregivers.

It is never too late to start exercising – moving off the couch, getting up off the office chair, just moving with some energy behind it.

Are there demonstrable benefits to cognition? Or is this really just opinion of people who exercise? The literature is mixed, but on the whole comes down on the side of “some exercise is better than none”.

Physical exercise changes the expression profile of microRNAs (small messenger molecules that alter the expression of genes and their function. Why is this important? Certain cancers demonstrate abnormal miRNA patterns. Healthy tissues have different miRNA patterns. Different miRNAs are active at different stages of development of the embryo in the uterus. Physical exercise actually is associated with antioxidant and anti-inflammatory molecules that protect the nervous system and brain – and is associated with functional cognitive improvements in both animals and in patients with Alzheimer’s dementia.

Does exercise actually improve circulation? There is considerable evidence of a positive association. And in both animals and human beings exercise appears to reduce inflammation in the central nervous system, resulting in reduced deposition of amyloid protein and enhanced clearance of amyloid beta, which is a major component of the plaques seen in Alzheimer’s disease.

We know that medical therapy devices like the BEMER improves the function of the pre-capillary arteriolar pump, thus increasing blood flow to the territory supplied by those capillaries. A video showing before and after images of capillary flow can be seen on YouTube. Just ignore the advertisements which are part of the YouTube experience. The video is well worth watching.

We know that exercise can improve the ability of people with dementia to perform their activities of daily living. An analysis of multiple trials did not find a clear benefit of exercise specifically on cognitive function, but at the very least if exercise improves the ability to get out of a chair or out of bed or take a shower, it seems well worth the effort for both the caregivers and for those afflicted with this dreadful condition. And if a program of physical exercise is started before there is evidence of dementia – while we are simply at the stage of forgetting where we put our car keys – chances are excellent that the improvement in blood flow will improve brain function. At the very least it won’t hurt brain function, and will improve muscle function and balance overall.

Does cognition benefit most from exercise? Does sedentary behavior – desk jobs, couch potato jobs – have a specifically deleterious effect on both brain and body function? Do new nerves develop because we exercise? Do they not develop because we sit? A rather whimsical article entitled “Revenge of the Sit” debates this issue, and concludes that “the sedentary lifestyle and eating behaviors enabled by the comforts of technologic progress may be reaping “revenge” on the health of both our bodies and brains.”

What kind of exercise is best? Moderation and balance in all things would be my advice. A friend of mine was an amazing athlete – ran like a gazelle – and had both her knees replaces in her mid-40s. One program that I have found beneficial – especially in Arizona, when the temperatures in the summer are already in the low 100s at 7:00 am – is a walk at home program. Tai Chi and Qi Gong are options, or Pilates, or yoga. Anything which gets the body to move without damaging it is helpful, as long as we practice on a daily basis – not just on weekends.

Why would you want to know if you are just having a “senior moment” or if you are on the path to Alzheimer’s disease? Conventional medicine tells you that there is no cure, there is only staving off symptoms for a little while before you become incapacitated. Our own government’s National Institutes of Health declares: “Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. It is the most common cause of dementia in older adults.” [They do, however, go on to say that] While dementia is more common as people grow older, it is not a normal part of aging.”

A report in the journal The Lancet discusses dementia prevention, intervention, and care. This report discusses potentially modifiable risk factors which could theoretically prevent 40% of diagnosed cases of dementia worldwide.

The mortality rate assigned to dementia alone in otherwise “healthy” individuals is estimated to be 1.55 million individuals worldwide.

An online newsletter called “Alzheimer’s News Today” estimates 44 million people worldwide living with Alzheimer’s disease, 5.5 million of whom live in the United States. About 200,000 of these are under the age of 65 and have so-called “early onset Alzheimer’s Disease”.

The Centers for Disease Control, on their “Alzheimer’s Disease and Healthy Aging” page, cites 5.8 million residents of the United States diagnosed with Alzheimer’s in 2020, with a projection of the numbers tripling to 14 million people by 2060.

If dementia is not a normal part of aging, then why are so many of our elders becoming demented, and end up living in nursing homes because they cannot take care of themselves, and no longer have the mental capacity to realize how badly dysfunctional they are?

Many causes have been proposed. We will review some of the literature on these proposed causes, and seek to determine whether any of them might have any effective treatment.

It will be important to determine whether the treatment needs to be prophylactic – i.e. start before the symptoms of dementia become manifest – or whether the treatment is effective once dementia is already diagnosed.

The following factors have been proposed to be associated with the diagnosis of Alzheimer’s disease:

• Age – the incidence of Alzheimer’s disease is estimated to double every 5 years beyond age 65. A friend (who died at the age of 99) sent me a birthday card that read “Age is a question of mind over matter. If you don’t mind, it doesn’t matter.” Nevertheless, age is not a modifiable factor, at least not in this Universe as we know it. But we certainly do have control over how the number of years we have been alive affects our mental and emotional well-being. We even have significant control over how rapidly our cells age and die – the term is “cellular senescence”.
• Mitochondrial dysfunction – the brain has the second highest number of mitochondria in the body, second only to the heart. Since mitochondria are the intracellular powerhouses that provide energy for metabolism, it makes sense that dysfunctional mitochondria would result in both cardiovascular disease and neurologic disease.
• Nutrition – do those who eat fast foods, drink sodas and alcohol, and lots of sugar have the same incidence of Alzheimer’s as those whose diets and habits are healthier? We will examine the literature.
• Exercise – do “couch potatoes” have the same incidence of Alzheimer’s as moderate exercisers or marathon runners?
• Fungal infections – yeast overgrowth – do these play a part?
• Lyme disease and other chronic infections – is the incidence higher in those with similar infections? We are already beginning to see signs of cognitive impairment in people diagnosed with “long COVID”. Is it possible that the issue is more the chronic infection and oxidative stress and less the specific infection?
• Heavy metal burden – does accumulation of mercury, lead, arsenic, cadmium, and even gadolinium play a part in the development of the disease?
• Pesticides, insecticides – we spray our crops religiously. We are in the process of decimating the bee population – as I can attest with regards to my own garden. Are we that different from the bees that we think we are not affected by these metabolic poisons?
• Pharmaceutical drugs – many are associated with “brain fog” and even cognitive decline. Others have been shown to improve cognitive function – at least in rats, if not yet in humans.

There appears to be debate about whether lifestyle interventions are worth the effort.

On the one hand, the Lancet 2020 study on aging states: “a growing body of evidence supports the nine potentially modifiable risk factors for dementia… less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and low social contact.” 

On the other hand, an article written apparently in response to that Lancet statement says: “evidence from large clinical trials is not conclusive to support that a third of dementia cases might be prevented.”

And there are always financial considerations, as this somewhat cynical article suggests.

So… prevention is possible.

So… it’s not worth trying to prevent because

• Prevention is a lot of trouble.
• Prevention has not been shown to be effective in a six-month period over a limited number of study subjects.
• Therefore we should wait for more studies to be carried out, before deciding whether prevention is “worth the effort” as a public health measure.

One paper actually looked at costs of intervention over time vs the cost of caring for demented patients, and concluded: “The results suggest that the multidomain approach of BBL-GP is highly likely to be cost-effective.”

We know that Alzheimer’s disease is diagnosed after death, on autopsy, by finding amyloid plaques in the brain, and by seeing the nerve cell tangles under a microscope.

So… if there is no way to diagnose the disease before death, and there is no treatment for it anyway, who in world would want to know if they are going to get it? That sounds like an exercise in masochism.

Maybe not so fast… we know that amyloid plaque in the brain can be seen without having to cut into the brain – that’s good news. We can test for elevated levels of amyloid plaque by seeing it on a PET scan of the brain. We can test by doing a spinal tap and pulling spinal fluid from the spinal cord and measuring specific proteins in the spinal fluid – that’s a pretty invasive procedure.

So let’s talk about risk factors – what you can do to minimize the chance of developing dementia.

It appears that there are several risk factors that would be susceptible to intervention BEFORE dementia (or even mild cognitive impairment) develops. These risk factors are present in all people, no matter their age, race, or socioeconomic status.

Dementia does NOT have to be a normal part of aging.

A Convenient and Simple Diagnostic Test to screen for Early Alzheimer’s

Arizona Center for Advanced Medicine offers Amyloid Beta (Aβ) screening, which research has shown to have a 90% accuracy in detecting Alzheimer’s disease, as part of our medical services for individuals and families in Scottsdale and its surrounding areas. The primary screening method is a simple blood test that we perform through a patient-funded study in association with the Young Blood Institute, a 501 (c) (3) non-profit clinical research organization studying new indications for therapeutic plasma exchange. Our doctors can recommend additional screening depending on your results and possible treatment options if necessary.

This screening costs a little under $1,000 and getting an early diagnosis can make a critical difference in your chances of successful treatment. We are dedicated to empowering you with all necessary information so you can play an active role in your well-being. Our staff members are here to answer any questions you may have about the screening or your treatment plan.

What Does Amyloid Beta (Aβ) Testing Involve?

Our Amyloid Beta (Aβ) screening at Arizona Center for Advanced Medicine uses a simple blood test to check your levels of amyloid-beta plaque. Scientific research has shown that this test has an accuracy of greater than 90% in detecting sufficiently high levels of this substance to predict the likelihood of contracting Alzheimer’s disease.

If your results indicate excessive levels of amyloid-beta plaque, our doctors can order diagnostic image testing, usually a PET scan. This additional test, can help to visually confirm the presence of amyloid plaque in your brain.

When both tests confirm high levels of amyloid-beta plaque in the bloodstream and the brain, we can create a treatment plan for using plasma exchange to remove Amyloid Beta (Aβ) plaques, with the intention of stopping the progression of Alzheimer’s disease or preventing it altogether. For those who have concerns about cognitive decline, we can incorporate standardized cloud-based software testing to assess your level of cognitive impairment. This standardized instrument assesses orientation, language, memory, praxis, attention, abstract thinking, perception and calculation. For those with no signs of cognitive impairment but having high levels of Amyloid Beta (Aβ) plaques, we can use plasma exchange as a treatment modality to attempt to remove or halt further development of the plaques and prevent or mitigate any development of cognitive impairment.

The June 2019 Web-MD magazine, delivered to my office door, has an article entitled: Guarding the Mind: the latest research points to ways you can lower your odds of developing dementia.

The first paragraph of the article is less inspiring than the title: “The number of people around the world with dementia is staggering – and growing. The mind-robbing disease has no cure, but recent research is beginning to show how you may best be able to lower your chances of getting it.”

WebMD writes: “The mind-robbing disease has no cure.” So do the newspapers. And none of the drugs used to “treat” Alzheimer’s disease have any measurable impact on either the current condition or the progression of the disease into the black hole of silence and immobility which is the ultimate expression of Alzheimer’s dementia.

We have been taught that dementia is a slow slide into the inevitable Alzheimer’s disease. It’s a very scary thought. We have complete “Memory Care” facilities now in almost every city. In 2015, we diagnosed 9.9 million new cases of dementia – 30% more than in 2010. Prevalence (percentage of people of a certain age with the disease) seems to be decreasing somewhat – but the numbers are still frighteningly high. Many papers are available in the literature that discuss numbers of affected individuals more specifically.

We are consumed with the need to identify risk factors. One researcher affirms that age, APOE4 genotype, vascular disease and diabetes are the strongest predictors for developing dementia. It is quite clear that any APOE4 genotype confers increased risk of dementia.[i]

One risk factor – getting older – is not modifiable in this lifetime. Nor can we change our genetic structure. We have to play the hand of cards we were dealt at birth.

Other risk factors are potentially possible to change. Controlling the factors related to obesity and diabetes – including blood pressure, metabolic markers like cholesterol, average blood sugar levels – has been shown to decrease the incidence of dementia. And some experts are even going so far as to say that when healthy diet and lifestyle changes are adopted early, the risk of developing dementia later in life decreases. As your grandmother told you, “Eat your veggies, they are good for you.” It’s too bad that we, as children, do not take on those good habits are we reach the age of supposed reason.

Does dementia happen all at once, like flicking a light switch? As it works out, there are plenty of early warning signs – we can’t remember where we put the car keys, we forget people’s names, we don’t show up at scheduled meetings because we forgot, we used to be able to remember 10 digit phone numbers but now have to look two or three times to be sure the number is correct… In the world of medicine, we call this Mild Cognitive Impairment, or MCI. Sounds a lot less scary than Alzheimer’s, right?

Is the development of dementia inevitable? A slippery slope that has no exit ramp? How can we determine our risk of developing dementia?

Age: We cannot help getting older – it’s what happens in this linear world.

Genetics: We cannot change our family history. If our grandparents and parents died with dementia, chances are very good that we ourselves are at considerable risk of also developing MCI or Alzheimer’s. There is evidence that some genotypes age much better than others. Any copies of the ApoE 4 gene confer an increased risk of cognitive decline.So the more copies of APOE4 we have, the more careful we should be to ensure that we are living a life conducive to health. Beyond that, we do not have control over our genes – only over their expression.

Food choices: What about food choices? Is there in fact evidence that eating McDonald’s is less healthy for us than eating steak and potatoes or plant-based foods? Is the “organic” vs “conventional” debate worth learning about?

There is evidence that the Mediterranean diet slows cognitive decline through eating of neuroprotective foods, including things like green leafy vegetables and berries.Food choices play a large part in health of the body, the brain and the mind.

Body Exercise: There is significant evidence that those who engage in some form of daily exercise – which may be as simple as walking – have overall better cognitive function as they age.And if the exercise involves both mind and body (as in Tai Qi), the effect is even better.

Brain exercise: People who have had more education (brain exercise) have also better overall better cognitive function with age, even if they have two copies of the APOE4 gene.

How is MCI – Mild Cognitive Impairment – diagnosed?

First, if you think your brain is not working as well as it used to work, you have some degree of MCI, whatever the tests say. You have an ICD10 diagnosis code of G31.84, Mild Cognitive Impairment, so stated.

We can test for MCI with a conventional memory test, involving both simple and more complex tasks.

• Do you remember the date (day, month and year)?
• Can you tell me the time?
• Can you count backwards from 20 to 1?
• Can you say the months of the year backwards? (That one is a little harder…)
• Can you remember an address that has five components to it (name (first and last), street number, street, City) after you have done the backwards numbers and months of the year…
• Some of the tests require you to draw a clock face and place the hands in the correct location – that one may be harder in the future for children who have only grown up with digital clocks.

Many people have to go back and look at a phone number while they are dialing it – 10 numbers is a lot to remember. Typically, most people can remember at least five things. Someone who has a PhD in physics can be expected to remember more things than someone who does not have this level of education.

At some point in our lives, we may come to the place where we say to ourselves: “Boy, I used to be able to remember better than I can now.” Our concern may not be immediately evident on the surface – we can still go to the grocery store, get groceries, remember how to get home, put the groceries away, lock the front door, etc – and yet, we may still feel some slowing down, some deficiency in the way our brains are functioning now compared with the old days.

This condition is defined, in the ICD10 rule book, as code G31.84, AKA “Mild cognitive impairment, so stated”. We don’t have to flunk an MCI test, a mini-mental status exam, a 6CIT test in order to be given that G31.84 diagnosis by a medical professional.

And if we are given that diagnosis – it’s OK, not shameful or hopeless, because we can do something about it. Mild cognitive impairment, fading memory, CRS disease in colloquial terms, is not something to be ashamed of, to hide in a closet.

So, what can we do about it? First, rather than just being afraid, we can actually do a test which will either confirm or disprove our fears.

The lab tests are obtained through Sonora Quest Laboratories. The combination of tests and the report which is generated can both validate our concern AND give us some options for treatment so that the cognitive impairment diminishes or goes away, instead of progressing to dementia.

AND Medicare covers the cost.

AND most conventional insurance covers it, because there is a “medical necessity” code attached to it – that ICD10 G31.84 code.

The whole program is called the Restore-U Method. It is available through Sonora Quest Laboratories, and you can have your blood drawn at your doctor’s office or at any Sonora Lab draw station.

The report also includes a period of guided interventions, for those who need help learning to shop and cook differently, learning to do physical and mental exercise. The interventions are personalized to the abilities of the individual who is tested – there is not a general “one size fits all” diet or list of prescribed exercises for everyone.

Why do we not shout this information from the rooftops? Why is this test not widely available?

• First, it was only recently developed and validated.
• Second, it’s not complicated for the lab to run – but does require a few more tubes than the standard purple and tiger topped tubes.
• Processing the blood requires some extra steps – whether done at the lab or in your doctor’s office.
• The RestoreU report takes more than 5 business days to get back to your doctor. You will receive your standard lab report from Sonora Quest Laboratories in 5 business days and in addition you will receive a Restore-U cognitive focused report with potential treatment options from UMethod Health in about 3 weeks.
• Explanation involves a good deal more than a simple “Everything looked fine on your blood work” that we are used to hearing. You will want to go over the report in detail with your doctor.
• Last, but not least, for improvement in your condition to occur, it requires effort on your part. It’s not just a pill you take every day. It’s a way of life.

Why would you want to know if your impression of slowing down mentally is real? Because you can actually intervene – change things – to improve your outcome. You have some control over whether you choose to slide into that slow “inevitable” decline or crawl out of the hole back on to level ground. It’s not that hard. It just requires determination on your part, and finding a doctor’s office that will do the testing and get you the help you need. Any doctor’s office can do it – they just need to be willing to spend the effort and the time needed to help you get well. There is no prescription pad remedy – it requires your active participation.

We can promise that you will not regret being willing to change your lifestyle, because you will see good results, simply from changing your food choices to healthy ones. Supplements may be recommended, to improve the way your cells function – thus improving both muscle and brain function.

For more information, go online to https://umethod.com/memory-loss/. And then get the test done, and get back on track with your life.

Talk with your regular doctor about it.

Feel free to call us for a free 15-minute phone consultation, to determine whether the Restore-U Method is right for you, and whether we can help you negotiate your way back to a state of health.

Have you wondered why we are seeing so much osteoporosis?

Introduction

Founded in the backwoods of the Missouri frontier at the close of the 19th century, osteopathy (or osteopathic medicine, as it has more recently been called) is perhaps the only uniquely American form of complete medicine in existence today. In fact, many believe they were the world’s first medicine. My own experience with the therapeutic uses of essential oils began a little over a decade ago. at that time, a patient I was treating had what was called by D. Gary Young, the dynamic and sometimes controversial founder of the essential oil movement in the united States, an “awakening.” I will have more to say about that encounter shortly. as a physician, integrative medicine practitioner, and herbalist, I was vaguely familiar with essential oils. having studied with the late herbalist dr. John Christopher, I learned that essential oils were volatile, aromatic compounds usually distilled or extracted from herbs or plants.

I knew that essential oils had strong aromas, and they sometimes could be used to confuse the body’s pain mechanism, relieving headaches and relaxing tight muscles. In medical school, I learned about the use of smell to stimulate the brain in cases of traumatic brain injury or coma.

While other healing systems have fallen by the wayside, osteopathy as a profession has persisted by means of osteopathic hospitals, specialists, surgeons and a unique philosophy of healing and medical care. Today, most Americans have never heard of osteopathy. However, using figures derived from the website of the American Association of Medical Colleges, nearly 11% of all American physicians hold a doctor of osteopathic medicine (DO) degree (Cohen, 2005). Unfortunately, the practices of many modern day DOs are indistinguishable from their MD counterparts. The majority of today’s DOs are either unaware of osteopathy’s extensive teachings and techniques, or perceive the healing philosophy as too obscure. Lured by the quick fix of pharmaceutical intervention, many DOs may also consider as overly burdensome the delicate, precise, and perceptive palpation skills required for proper osteopathic diagnosis and treatment.

Nonetheless, a small and growing number of osteopathic physicians continue to practice traditional osteopathy. Traditional osteopaths, who remain dedicated to understanding the anatomy and physiology of the human organism, use their hands to diagnose and treat the body, words to comfort and touch the mind, and hearts to encourage and find health for their patients. Moreover, after persistent national and international research, multicenter studies, and publication of clinical results in mainstream journals such as Pediatrics, there is now a renewed and heightened enthusiasm for the benefits of traditional osteopathic care for both adults and children.