Dr. Bruce Hoffman joins Pandora Peoples on WOMR and WFMR radio to discuss the origins of The Hoffman Centre and the benefits of the integrative approach to functional medicine. Dr. Bruce Hoffman utilizes the ayurvedic model through a program he developed called, The Seven Stages of Health & Transformation™ that brings to light the hidden causes of what may be making you sick, and what you can do to heal yourself.
[vc_row][vc_column][vc_column_text]Alzheimer’s disease is a devastating condition for both patients and their families. Unfortunately, Alzheimer’s disease (AD) is also on the rise globally. Effective treatment of AD has been of growing concern within the medical community because its prevalence continues to spread. The fact of the matter is that Alzheimer’s treatment demands a different approach.
While our treatments of many other chronic diseases ( heart disease, diabetes, cancer) have improved over the years, effective Alzheimer’s treatments continue to remain incomplete and disappointing.
Alzheimer’s disease not only impacts patients’ health, but it is physically, emotionally, and financially taxing on their families as well. It is estimated that AD will directly impact over 15% of the US population, meaning its indirect effect on families and caretakers is widespread and includes hundreds of millions of people.
Unfortunately, as a society, we have come to view cognitive decline, a precursor to Alzheimer’s disease, as an accepted sign of aging.
However, this is a myth that needs to be immediately dispelled. The types of cognitive decline associated with AD are NOT normal signs of aging.
Still, there is good news when it comes to Alzheimer’s disease. New methods have shown promise in completely stopping and even reversing cognitive decline in patients.
Let’s look more deeply into these methods and uncover ways you can help yourself or your loved ones who are suffering from this devastating disease.
Today, there is more hope than ever before for those touched by Alzheimer’s.
Alzheimer’s Reaches Epidemic Proportions
According to the World Alzheimer Report 2016, approximately 47 million people globally live with dementia, and estimates for 2050 are projected to be more than 131 million. In fact, Alzheimer’s disease (AD) is now considered the third leading cause of death in the United States, just behind cardiovascular disease and cancer.
Women are at the heart of this epidemic. About 65% of all those who develop AD are women, and 60% of all caretakers of those affected by AD are women. Women are now more likely to develop AD than breast cancer. Many believe this is because women live longer than men, but this reasoning still does not explain or justify why this condition is on the rise. Of significance is that only 5% of Alzheimer’s cases are familial, i.e., having a genetic basis that causes early onset Alzheimer’s. The rest are caused by lifestyle factors that are influenced by many variables over which patients have a significant degree of choice and control.
Nonetheless, the question remains: Why is Alzheimer’s worsening, and what can be changed in how we approach the treatment of such a deadly and heartbreaking disease?
Other treatments of chronic illnesses such as cardiovascular disease, HIV, and cancer have improved because of the combination therapies that have been applied, and yet a majority of AD treatment has been focused primarily on monotherapeutic drug treatments. It is a startling fact that neurodegenerative diseases have not benefitted as other diseases have from advances in modern medicine. Only through tackling a disease like Alzheimer’s with multiple therapies can we find a successful approach to reducing the growing global impact it is having on our society.
Research has found that AD involves extensive networks of molecular interactions, which means the disease demands a network-based, multi-system treatment approach. The key issue in understanding Alzheimer’s is that it is not a single disease; the different biochemical imbalances involved require different treatments. There is no single drug that will cure Alzheimer’s, and nor will there ever be one. Present Alzheimer’s drug treatments make only slight differences to symptoms but do little to address disease progression.
At the forefront of this functional medicine approach to AD is Dr. Dale Bredesen and his team from the Buck Institute for Research on Aging. Through careful examination of the pathogenesis of Alzheimer’s, Dr. Bredesen and his team have found promising results. They have developed a multiple modality approach to achieving what they call metabolic enhancement for neurodegeneration (MEND), now referred to as Reversal of Cognitive Decline or ReCODE.
Through the approach Dr. Bredesen has developed, patients have been able to dramatically improve cognitive function, achieve reversal of symptoms, and in some cases, return to work. The ReCODE program includes lifestyle interventions, therapeutic diets, and targeted nutrients.
Before we dive into Dr. Bredesen’s program, it is important that we understand the pathogenesis of AD and its six subtypes. Let’s take a closer look at this disease, how it presents itself, how it develops, and what can be done to prevent it.
The Development of Alzheimer’s
The reason a multifaceted approach is needed for the treatment of Alzheimer’s is because its cause is not due to any single factor. Many metabolic processes are at play. In fact, there are six different subtypes of AD, distinguished by the different metabolic abnormalities that underlie the root causes of each form of this condition.
An individual usually develops Alzheimer’s disease after the age of 65. Symptoms begin showing as general memory loss and eventually progress to further impact daily life. The 10 warning signs and symptoms of Alzheimer’s disease versus normal signs of aging are listed below.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_empty_space][vc_column_text]
|Alzheimer’s disease Symptoms||Signs of Normal Aging|
|Memory loss that disrupts daily life, especially forgetting newly learned information||Forgetting newly learned information such as appointments or names but being able to recall them later|
|Having difficulty solving everyday problems such as paying bills||Making occasional errors but none that are significant or out of the ordinary|
|Struggling to complete familiar tasks such as driving home or to work||Needing help setting up new equipment or electronics|
|Losing track of dates, seasons, or time||Temporarily forgetting the day but having the ability to recall it later|
|Difficulty judging distance, spatial relationships, and contrast||Worsening vision caused by cataracts|
|Trouble recalling words for things, following conversations, and speaking||Occasionally having difficulty finding the preferred word while not forgetting names of items|
|Misplacing items and not being able to retrace steps||Being able to remember steps to find misplaced items|
|Poor judgement or decision-making; inability to multitask||Occasionally making poor decisions, but rarely with major negative consequences|
|Social withdrawal||Preferring to socialize a bit less|
|Changes in personality and mood||Becoming irritated when things are not done a particular and preferred way.|
[/vc_column_text][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Click here for an Alzheimer’s Questionnaire.
Signs and symptoms of AD are not normal signs of aging. If you or someone you love is experiencing any of these symptoms, it is important to make an appointment with your functional medicine doctor as soon as possible because AD worsens over time.
AD is a progressive disease and although there is no cure, Dr. Bredesen’s protocol has been able to slow and reverse cognitive decline. Remember, the earlier AD is caught, the easier it is to successfully treat the condition.
Once a person has noticeable symptoms, they are in the later stages of cognitive decline. AD has an initial “silent phase,” where brain degeneration is occurring but these changes are not detectable using objective tests. Patients may, however, notice slight memory and cognitive changes. See the image below.
Alzheimer’s disease (and dementia) does not begin suddenly.
Before AD develops, there is a noticeable slow decline in mental health. It has been estimated that the pathophysiology of the disease exists for approximately 20 years before any diagnosis is made. This means that many individuals have the beginnings of the disease without actually realizing it.
Preclinical begins with a subtle loss of neurons and a subjective sense of the brain’s mental processes not being as sharp as they once were.
Mild Cognitive Impairment is said to be present when a noticeable decline in mental functioning is noticed by others, and objective cognitive testing (performed simply by doing a mini-mental exam, computerized cognitive testing such as the CNS Vital Signs test, or a more sophisticated workup by a neuro-psychologist) is decreased. Activities of daily living have not yet been affected.
Dementia is said to occur when cognitive decline is sufficient to interfere with daily life. Objective testing such as PET scans and Neuroquant MRIs will show distinct patterns of brain changes such as cortical and hippocampal atrophy, reduced glucose uptake, and amyloid-beta-production.[/vc_column_text][vc_empty_space height=”16px”][vc_single_image image=”1907″ img_size=”full” onclick=”link_image”][vc_empty_space height=”16px”][vc_column_text]
What exactly is Alzheimer’s disease?
Simply put, Alzheimer’s has been observed to occur when the genes associated with the disease cause brain cells to become suicidal. The question that Dr. Bredesen asked was, “What are the fundamental processes and mechanisms that drive these genes to turn on and cause brain cells to die?”
Based on numerous studies, we now know that AD results from an imbalance in the destruction of neurons and synapses and the building up and maintenance of synapses and neurons. It has been observed that a molecule known as amyloid-beta accumulates in higher than normal concentrations in the brain, which causes the synapses, along with the neurons essential for memory, to die.
Where does amyloid-beta come from? It is derived from the amyloid precursor protein (APP), of which amyloid-beta is but a small portion. The APP, once produced by neurons, is cut by molecular scissors called proteases, which can cut at any of the three spots along the APP or at one distinct site. If the APP is cut at three particular sites, the four peptides produced from this action underlie the process of the synaptic loss and neuronal death that characterize AD. If, however, the APP is cut at just a single site, the two peptides that result cause just the opposite to occur; synaptic connections are maintained and neuron growth is nourished. These two peptides are referred to as the anti-Alzheimer’s peptides. See image below.[/vc_column_text][vc_empty_space height=”16px”][vc_single_image image=”1908″ img_size=”full” onclick=”link_image”][vc_empty_space height=”16px”][vc_column_text]Thus, the APP appears to act as a molecular switch that mediates plasticity-related processes. In summary, in order to reduce your risk of AD, you have to maintain all the necessary lifestyle practices and therapies that induce the two brain-affirming, anti-AD peptides and reduce all the factors that induce the production of the four pro-AD-inducing peptides. How exactly to achieve this, forms the basis of Dr. Bredesen’s ReCODE program.
AD is similar to other chronic illnesses in that there is an age-associated imbalance between the building up of cells that mediate neural plasticity and the destruction of cells. In AD, this occurs at the level of neuronal synapses, called synaptoblastic (building up of synapses), as opposed to synaptoclastic (destruction of synapses) activity. These intricate processes happen over time, in reinforcing cycles.
Six Subtypes of Alzheimer’s disease
Understanding the different Alzheimer’s subtypes is also critical for creating the best treatment plan for each patient.
There are numerous metabolic processes involved in contributing to AD, with six different subtypes that have been identified by Dr. Bredesen. These six subtypes are based on three papers by Dr. Bredesen: The first paper, in 2014, describes the initial contributions to his protocol (first called MEND), the second paper in 2016 outlines 10 case studies, and the third paper, also in 2016, describes neurodegeneration due to biotoxin exposure.
These subtypes are not widely used in diagnostic workups and clinical protocols at this time, but understanding the differences is essential to creating a comprehensive treatment plan. The six subtypes of Alzheimer’s disease are as follows:
Subtype 1 (inflammatory or “hot”) Alzheimer’s: Patients with this form of AD have predominantly inflammatory symptoms. These proinflammatory factors include cytokines, chemokines, acute-phase reactants, and other inflammation-causing mediators.
Patients with subtype 1 AD also have increased levels of c-reactive protein, high interleukin-6, and a low albumin-to-globulin ratio. The microglia and activated astroglia (brain structures) are also inflamed.
There is also an antagonism between the sirtuinT1 enzyme (anti-inflammatory) and NFkB (the nuclear factor k-light-chain enhancer of activated B cells [proinflammatory]); when NFkB inflammation is activated and SirT1 is suppressed, it can alter gene transcription and turn on gamma-secretase and beta-secretase. Gamma-secretase cleaves to the APP and contributes to synaptoclastic destructive processes within the brain.
The inflammation in subtype 1 primarily involves the innate immune system, and usually (but not always), there is systemic inflammation. Onset of this subtype typically occurs in an individual’s 70s or later.
Subtype 1.5 (glycotoxic or “sweet”) Alzheimer’s: This subtype is the in-between of subtypes 1 and 2 because it involves both inflammatory perpetrators and atrophic processes. Glucose regulation is impaired, resulting in insulin resistance and inflammation due to hyperglycemia (increased blood glucose). This glucose dysfunction also disrupts hormone-signaling and trophic factors (molecules that allow neurons to maintain and create neighboring connections).
Subtype 2 (atrophic, non-inflammatory, or “cold”) Alzheimer’s: Patients with subtype 2 AD have atrophic symptoms, meaning there is degeneration and dysfunction of neurological functions due to the insufficiency of certain nutritional and metabolic factors. Even though this underlying cause is different from inflammation, it still results in the same disease.
Similar to subtype 1, subtype 2 causes the APP to create amyloid plaques. Subtype 2 AD is associated with declining trophic factors, such as nerve growth, brain-derived neurotrophic factors (BDNF), testosterone, estradiol, vitamin D, thyroid hormone function, and insulin levels.
All of these declining trophic factors cause your brain to stop synaptogenesis (creation of new synapses), which is why learning new things becomes more difficult and worsens over time.
Subtype 3 (toxic or “vile”) Alzheimer’s: Subtype 3 is caused by toxin exposures, most commonly inhaled toxins (such as mold mycotoxins), and is sometimes called inhalational Alzheimer’s disease (IAD). One 2014 study showed fungal proteins in the brains of Alzheimer’s patients, and another study in 2015 showed fungal infections in the brains of Alzheimer’s patients. Fungal DNA and proteins were detected in the brain tissue from AD patients, but not in controls. Fungal particles could also be detected in the neurons of the same AD patients. Herpes simplex type 1 (HSV-1) and chlamydia pneumoniae have also been associated with amyloid protein production in AD.
Many patients with subtype 3 AD have markers of chronic inflammatory response syndrome (CIRS) but do not fit the official criteria for a CIRS diagnosis. Dr. Bredesen says that those with IAD will have lab results similar to those of CIRS patients, but their symptoms are mostly Alzheimer’s-like dementia.
Typically, patients with this form of AD have high levels of the complement component C4a and the transforming growth factor beta-1 (TGF-b1), both of which are specific inflammatory cytokines, as well as high levels of matrix metallopeptidase 9 (MMP9), an enzyme involved in the cell membrane penetration of inflammation. Patients also have decreased levels of the melanocyte-stimulating hormone (MSH), the vascular endothelial growth factor (VEGF), and the antidiuretic hormone (ADH). Usually, there are other abnormalities present such as high levels of cortisol and low levels of the adrenocorticotropic hormone (ACTH) and the antidiuretic hormone (ADH).
Symptoms of subtype 3 AD are similar to those of the other subtypes in that they include memory loss and difficulty with word recall; however, patients may also report having a metallic taste in their mouth and an increased sensitivity to smell. These patients rarely have the respiratory complaints, chronic fatigue, muscle pain, or other symptoms usually associated with CIRS.
Subtype 4 (vascular) Alzheimer’s: Alzheimer’s development in subtype 4 patients is a protective response to vascular insufficiency and results in a triggered amyloid response.
Subtype 5 (traumatic) Alzheimer’s: This subtype is characterized by head trauma, and these patients typically have significant personality changes. Not all head trauma patients will develop AD. One major study showed an 2.3 times increased risk of developing AD in older adults with a history of moderate traumatic brain injury than seniors with no history of head injury. Those with a history of severe traumatic brain injury had a 4.5 times greater risk of developing AD. Traumatic brain injury changes brain chemistry by inducing beta-amyloid and tau proteins, the hallmark proteins linked to AD. Traumatic brain injury may be more likely to cause dementia in individuals who have either one or two of the APOE-e4 genes. There are no studies linking mild brain injury or concussion to the development of AD.
Genetics and Alzheimer’s Disease
It is important to note subtypes 1, 1.5, and 2 are all associated with the ApoE4 gene mutation. Although 95% of all Alzheimer’s cases are not caused by genetics, genetic testing is essential to determine if there is a propensity for these forms of Alzheimer’s. In fact, what is called familial Alzheimer’s is very rare, appears to be clustered in families, and presents earlier in life. That said, two-thirds of AD patients carry one or two copies of the ApoE4 gene.
Individuals who are ApoE4-positive with one copy of the gene (approximately 75 million Americans) have a 30% lifetime risk of developing AD. Those with two copies of the gene (approximately 7 million Americans) face a 50% lifetime risk of developing AD.
Interestingly, scientists have found that while the ApoE4 gene increases the risk of subtypes 1 and 2, it decreases a person’s risk for developing subtype 3. This is believed to be due to the protective nature of ApoE4, which can fight off the microbes that cause subtype 3 AD. Ultimately, ApoE4 is thought to be an advantage in your youth but can contribute to chronic illnesses as you age.
You can be tested for ApoE4 with your functional medicine doctor. This is a good idea because if you have the ApoE4 gene mutation, there are certain measures you can take to decrease the chances of developing Alzheimer’s. The website www.apoE4.info is an excellent resource for individuals with one or two copies of this gene.
One fascinating behavior a person with the ApoE4 gene can implement in order to favorably influence the outcome is 12-hour fasting. The ApoE4 gene helps you survive famine, and so it makes sense that intermittent fasting can help those with the gene avoid Alzheimer’s. The ApoE4 allows your body to use fat more efficiently and go longer without eating. This means if you find out through testing you have this gene, fasting can be used as a tool to have your body switch to burning ketones for energy over glucose, which is believed to aid in preventing AD.
Even if you do have the APoE4 gene, you can still prevent Alzheimer’s disease from developing, but you have to be proactive, educate yourself, and implement as many of the lifestyle factors as you possibly can. Let’s look at how to do that.
What Do All Forms of Alzheimer’s Disease Have in Common?
There are 36 mechanisms that Dr. Bredesen has identified as contributing to Alzheimer’s, but mitochondrial dysfunction is at the core of all of these.
Your mitochondria are the powerhouses of your cells, creating the energy molecules (ATP) every cell of your body needs to function. Additionally, free radicals (damaging molecules produced as byproducts of normal metabolism but enhanced by toxic exposures, genetic detoxification, and nutritional deficiencies) tend to be created in your mitochondria. When you have a higher incidence of free radicals in your cells, your mitochondria suffer damage and cannot produce adequate amounts of ATP, resulting particularly in neuronal cell death.
Through his research, Dr. Bredesen found that the APP makes amyloid in response to your cells being under attack by free radicals and toxic substances. Your body’s trophic support may also be decreased. Together, both low trophic factors and increased amyloid levels contribute to cognitive decline.
The complexity behind the pathogenesis of Alzheimer’s disease is why a comprehensive, multivariable approach is necessary. With that in mind, Dr. Bredesen’s recommendations include addressing these 36 mechanisms:[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_empty_space height=”16px”][dt_vc_list style=”2″]
- Increasing mitochondrial function; mitochondria produce ATP, the necessary chemical responsible for the energy needed for nerve growth, health, and maintenance.
- Increasing mitochondrial protection
- Decreasing beta-amyloid production, the main component of amyloid plaques found in Alzheimer’s
- Increasing beta-amyloid degradation
- Decreasing beta-amyloid oligomerization, i.e., the creation of longer molecules of beta-amyloid
- Increasing the brain-derived nerve factor (BDNF), a neuropeptide with growth effects on neurons
- Increasing the nerve-growth factor (NGF), a neuropeptide involved in the growth and maintenance of neurons
- Increasing the granulocyte-stimulating factor (G-CSF), a growth factor that has neuroprotective effects and that increases neuronal growth
- Increasing the activity-dependent neuroprotective protein (ADNP), a protein essential to brain health and cognitive function
- Decreasing p-tau; neurofibrillary tangles are aggregates of hyperphosphorylated tau proteins, which are primary markers of Alzheimer’s disease.
- Decreasing homocysteine, a proinflammatory protein
- Building synapses
- Increasing beta-amyloid breakdown
- Increasing the albumin/globulin (A/G) ratio, indicative of inflammatory AD
- Decreasing inflammation
- Inhibiting NF-kB, a protein complex that controls inflammatory cytokines
- Increasing glutathione (GSH), a major antioxidant
- Increasing antioxidants, which decrease neuroinflammation
- Decreasing iron, a pro-inflammatory mineral
- Increasing cerebral blood flow
- Increasing acetylcholine, a neurotransmitter involved in memory
- Increasing alpha-seven nicotinic acetylcholine receptors (α7), a critical link between neurodegeneration and AD
- Increasing amyloid-beta transport
- Increasing amyloid beta clearance
- Decreasing the ApoE4 effect; this gene determines increased risk for AD, with the 4/4 gene having the highest risk
- Increasing gamma-aminobutyric acid (GABA), a calming and neuroprotective neurotransmitter that downregulates glutamate, an excitatory neurotransmitter
- Decreasing N-methyl-D-aspartate receptor activity (NMDA), a receptor that regulates the activity of glutamate, an important neurotransmitter in the brain involved in learning and memory
- Optimizing hormones, especially estradiol, progesterone, testosterone, DHEA, and thyroid
- Increasing vitamin D
- Decreasing the pro-form of the neuron growth factor (pro-NGF), a protein expressed at higher levels in brains of AD patients
- Decreasing caspase-6, the activity of which is associated with increased risk of AD
- Decreasing the N-terminal fragment of the beta-amyloid precursor protein (N-APP)
- Enhance detoxification
- Increasing vascularization
- Increase telomere length
- Reduce toxic metals
[/dt_vc_list][vc_empty_space height=”16px”][vc_column_text]Dr. Bredesen explains that these are like holes in a roof, which need to be individually addressed in order for a full recovery to be made.
It is important to realize that AD is a protective response to three major metabolic and toxic disturbances:
- Inflammation- be it infectious (viruses) or sterile (modified inflammatory proteins)
- The withdrawal of trophic support (e.g. nerve growth factor, estradiol, testosterone, vitamin D etc.)
- Exposure to toxins such as mercury, aluminum, mold mycotoxins.
Dr. Bredesen has identified a number of factors that induce the APP receptor to go in the right direction of trophic or building synapses and neuronal health. The APP responds to dozens of molecules that assist brain health and anti-Alzheimer’s protection. Our brains have 100 billion neurons, and each neuron has approximately 10,000 connections, called synapses. Synapses are critical for cognitive functioning, memory storage, decision-making, and neurotransmitter communication. One’s brain has nearly one quadrillion energy-demanding synapses to power and run efficiently with energy-producing raw materials. In short, the APP has to constantly assess if the incoming data is shifting the lever in the direction of neuronal building or in the direction of neuronal destruction.
The sum total of the way one lives one’s life minute-to-minute affects this highly complex algorithm shift in either one of two directions—towards brain protection and maintenance, or towards brain inflammation, destruction, and reduced neuronal death. It really does come down to choice. AD begins with the loss of function of the synapses, the loss of the synapses themselves, and eventually, the loss of brain cells themselves, leading to brain shrinkage that is visible on MRI scans.
When one is young, the ratio between neuronal growth and destruction is equally balanced between the two. As we age, the destructive (clastic) part of the process tends to dominate over the building (blastic) part of brain preservation. We must decide to do all we can do to downregulate any of the factors that induce inflammation and further clastic activity and upregulate anything we can that induces growth, blastic activity, and hence, neuronal plasticity.
The realization that multiple factors induce brain growth as well as brain destruction will explain why the single drug model of AD treatment has not borne any fruit. There is no single drug that can ever address the complexity of all the metabolic factors that contribute to brain health maintenance and optimization. Dr. Bredesen’s analogy is that of a roof with 36 holes in it. A roofer called in to fix only one hole where the rain is pouring in will never be able to stem the flood of water pouring in through the other 35 holes no matter how well he patches the one hole.
Robert M Cardiff, MD, Commissioner of the Food and Drugs Administration (FDA) concurs with this observation:
“Multimodal therapy approaches that combine interventions aimed at different aspects of disease are emerging as potential-and perhaps essential-ways to enhance clinical outcomes for patients with psychiatric and neurological disorders. Indeed, for most chronic diseases, multiple pathways are involved simultaneously, making it unlikely that a single treatment will prove sufficiently effective.”
From these insights it is important to realize that we do not get Alzheimer’s for no reason. There are many possible reasons and the doctors of the future will be trained to investigate and look for many if not most of these factors identified to date.
Dr. Bredesen’s ReCODE program aims to achieve the following:
- Optimize metabolic parameters to the maximum, not just simply normalize them.
- Address as many of the causative network components as necessary with the understanding that combination effects will be additive and cumulative and will create an effect that is more than the sum of the many single therapies.
- The more that patients are able to achieve in terms of their therapeutic input, the more likely it is that a certain threshold will be reached that will tip them over from a pathogenic process to a therapeutic benefit. This implies that a combination of therapies will be more than the sum of individual parts.
- A personalized approach is needed with a prioritization of therapeutic inputs, which needs to be computerized and analyzed according to the laboratory values affecting the plasticity networks.
- Repetitive application of therapeutics is necessary to optimize outcomes over time.
- The goal of therapy is to use a physiological approach with as much of an upstream causative approach that can possibly be implemented.
A Therapeutic System was developed by Dr. Bredesen
Therapeutic System (adapted from Bredesen, 2014 and cited by Ash, 2015)
The critical role of several factors in Alzheimer’s disease necessitates several therapeutic interventions. The required interventions seek to:
- reduce inflammation
- address autoimmunity
- minimize insulin resistance
- decrease amyloid-beta (Aβ)
- reduce excess cortisol and the corticotropin-releasing factor (CRF).
In so doing:
- the hypothalamic adrenal axis is supported
- antioxidant function is optimized
- blood glucose is balanced
- acetylcholine synthesis is supported.
Interventions identified by Bredesen (2014) to achieve these aims include:
- Diet optimization to minimize simple CHO, inflammation, and insulin resistance: Simple CHO, inflammation, and insulin resistance are minimized by providing patients with a choice of several low-glycemic, low-inflammatory, and low-grain diets.
- Autophagy and ketogenesis enhancement: Autophagy and ketogenesis are enhanced by having the patient fast for 12 hours each night (including at least three hours before bedtime), thereby reducing insulin and Aβ levels.
- Stress reduction: Stress is reduced by having the patient engage in personalized stress reduction activities (e.g., yoga, meditation, music, etc.) that target the stress axis, reduce cortisol, and equilibrate the CRF.
- Sleep optimization: Sleep is optimized by having the patient follow a sleep regimen, including eight hours of sleep per night, the use of 0.5 mg melatonin and/or 500 mg of tryptophan if awakening, in addition to ruling out possible sleep apnea.
- Exercise regimen: Patients are provided with an exercise regimen, including 30–60 minutes of physical exercise 4–6 days per week.
- Brain training and stimulation: Patients are provided with BrainHQ or related brain-training software programs.
- Homocysteine optimization: Homocysteine is optimized to <7 using methylcobalamin (Me-B12), methylfolate (MTHF), pyridoxal-5-phosphate (P5P), and, if necessary, trimethylglycine (TMG). Optimization of serum B12: Serum B12 is optimized to >500 using methylcobalamin (Me-B12).
- Lowering c-reactive protein: Due to the critical role of inflammation in Alzheimer’s disease, c-reactive protein is lowered to <1 through the use of optimized hygiene and an anti-inflammatory diet that includes curcumin and fish oil (DHA/EPA).
- Insulin optimization: Due to the role of inflammation in Alzheimer’s disease and the relationship it shares with type II diabetes, insulin levels are optimized to <7 (fasting) and hemoglobin A1c (HbA1c) to <5.5 through the use of an anti-inflammatory diet.
- Hormone optimization: Hormones are optimized, including free T3, free T4, the thyroid-stimulating hormone (TSH), pregnenolone, progesterone, estradiol, testosterone, cortisol, and dehydroepiandrostenedione (DHEA).
- Restoration and optimization of gastrointestinal health: Gastrointestinal health is restored, repaired, and optimized, including the use of prebiotics, probiotics, and avoidance of inflammation and autoimmunity.
- Reduction of a-beta Levels: A-beta (Aβ) levels are reduced using curcumin and ashwagandha (an Ayurvedic adaptogenic herb).
- Cognitive enhancement: Cognitive enhancement is achieved through the use of bacopa monniera (an Ayurvedic herb known for its cognitive enhancing properties) and magnesium threonate (MgT).
- Optimization of vitamin D3: Vitamin D3 (25-OH-D3) levels are optimized to 50–100 ng/ml (US levels), using vitamins D3 and K2.
- Nerve-growth factor optimization: The nerve-growth factor is increased using h. erinaceus or acetyl-l-carnitine.
- Provision of synaptic structural components: Provide synaptic structural components using citicoline and docosahexaenoic acid (DHA).
- Optimization of antioxidants: Optimize antioxidants using mixed tocopherols and tocotrienols, selenium (Se), blueberries, n-acetyl-cysteine (NAC), ascorbate, and a-lipoic acid.
- Optimization of the zinc:copper (zn:cu) ratio: Optimize the zn:cu ratio based on values obtained.
- Ensure nocturnal oxygenation: Ensure nocturnal oxygenation through treating or ruling out sleep apnea.
- Optimize mitochondrial function: Optimize mitochondrial function through optimizing CoQ or ubiquinol, a-lipoic acid, pyrroloquinoline quinone (PQQ), n-acetylcysteine (NAC), N-acetyl-L-carnitine (ALCAR), selenium (Se), zinc (Zn), resveratrol, ascorbate, and thiamine.
- Increase focus: Increase focus using pantothenic acid as required for acetylcholine synthesis.
- Increase SirT1 function: Increase SirT1 function using resveratrol.
- Exclude heavy metal toxicity: Evaluate mercury (Hg), lead (Pb), and cadmium (Cd) to confirm or exclude heavy metal toxicity; chelate if indicated to address the effects of heavy metals on the central nervous system.
- Increase medium-chain triglyceride (MCT) oil effects: Use coconut oil or Axona.
According to Dr. Bredesen’s research and discussions, the effects of various targeted therapies may be additive, multiplicative, accumulative, and synergistic.
A functional medicine approach is the most effective way to implement these approaches.
7 Things You Can Do to Prevent Cognitive Decline Right Now
Here are some things you can do right now to work on your own personal cognitive health, using similar principles to those found in the Bredesen ReCODE Protocol.
1. You Must Get Quality Sleep
Getting seven to eight hours of quality sleep each night is critical to promoting cognitive function because during sleep is when your body removes metabolic waste from your body.
If you have sleep apnea, you must address it. Your brain is starved of oxygen when you have sleep apnea, and it directly impacts your cognitive abilities. Ask your doctor to refer you for a sleep study.
2. Implement Overnight Fasts
By putting your body in an overnight fast (12 hours at least), you induce ketogenesis (you also need a low-sugar and low-carb intake to promote this). When your body is in ketogenesis, your insulin levels are lowered. Additionally, amyloid-beta levels are reduced, which are a main contributor to the amyloid plaques found in Alzheimer’s patients. A low-sugar and low-carb diet makes overnight fasting surprisingly easy.
3. Reduce Carb and Sugar Intake
Diets with few carbs and little to no sugars are the best for reducing inflammation in the body, and they reduce your chances of developing insulin resistance. Additionally, low-sugar and low-carb diets have been linked to a decreased risk of developing Alzheimer’s disease.
4. Reduce Your Toxic Load
Reducing toxin exposure gives every bodily system a better chance at functioning properly, and your mitochondria and metabolic systems are no exception.
You can reduce your toxic load through having good air and water filters in your home. Additionally, avoid toxin-containing items such as:
- Non-stick and aluminum pans
- Harmful personal care products (you can check your items against the EWG Database)
- Harsh cleaning products (opt for natural solutions)
- Paints with volatile organic compounds (VOCs)
- Metal dental fillings
- Fish high in heavy metals
- Plastics with BPA
- Charred and fried meat (high-lipid peroxidation)
Remember, if your lab results are coming back similar to those of a CIRS patient, yet you are not having typical symptoms of CIRS, check for signs of Alzheimer’s and other indicators of toxin exposure due to building damage from mold and water (inflammagen exposures).
5. Add These Supplements
Dietary changes are at the heart of the Bredesen Protocol, and by adding certain supplements, you can protect your brain. Consider the following supplements because each has shown to promote healthy brain function.
- Vitamin B12—methylcobalamin
- Vitamin C – must be taken twice daily as it is water soluble and is excreted quickly
- Vitamin E—mixed tocopherols
- Turmeric—a lipophilic form is best
- Vitamin D—measure your 25 OH Vitamin D levels to achieve the optimal dosage for you
- DHA (found in fish and fish oil supplements)
6. Exercise Every Day
Having an exercise routine has been unequivocally linked to a reduction in cognitive decline. Studies have found that even a walk each day significantly slows the decline of Alzheimer patients.
I encourage you to get up and move at least once a day. Even a quick 15-minute high-intensity interval workout has been shown to be as effective as an hour-long workout.
7. Reduce Stress
Stress causes high levels of cortisol and CRF, which are both linked to Alzheimer’s. Add stress-reducing habits to your day. These can include quick meditations, yoga, listening to calming music, or taking walks.
Reversing Cognitive Decline Is Within Reach
We are living in an exciting time when it comes to Alzheimer’s treatments. Through a comprehensive approach to this illness, we may be able to slow down and even reverse most cases of Alzheimer’s.
While the Bredesen Protocol works to reverse cognitive decline, we can take the same science and apply it to our lives today to prevent Alzheimer’s from developing in the first place. We can even take these concepts one step further and optimize brain health to improve function overall.
Share this article with someone you know who would benefit from hearing about this monumental approach to a devastating disease. The future of Alzheimer’s treatment is bright.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_empty_space][vc_column_text]
The End of Alzheimer’s. Dale Bredesen Avery – An Imprint of Penguin Random House 375 Hudson Street New York, New York 10014, 2017
A recent study has concluded that SSRIs, when treating for major depressive disorder, are not that much better than placebo. Depression as a symptom and as a formal diagnosis, is too simple a label to attribute to a person who feels and experiences life without joy or pleasure and who may have real physiological changes that render his/her life unpleasant, if not unbearable. By attributing a diagnosis to a person such as “depression,” the patient and the diagnosis become frozen in time and separated from all possible antecedents, mediators and triggers. All further enquiry into the timeline of causation comes to an end and the patient (and the doctor) now objectify and identify with the diagnosis, as if some foreign entity, called “depression” just mysteriously fell out of the sky. Add to this scenario the fact that ones entire medical school training is not aimed to enquire as to upstream causation. In the truest N2D2 tradition of medicine (name of disease, name of drug), we are trained to thread together a constellation of symptoms, arrive at a diagnosis and prescribe a treatment1; all under the 15 minute timeline and the approximately $40.00 fee that the Canadian health care system provides for a consultation. It does not take much to deduce that this is a hopelessly inadequate scenario and not one to foist onto ones worst enemy.
Depression, as a diagnosis, has a litany of possible antecedents (ancestral and genetic predispositions and inheritances), triggers (events that trigger the manifestation of the constellation of symptoms that coalesce to form a diagnosis) and mediators (lifestyle events and behaviours – diet, sleep, food, stress, exercise – that continue to contribute to the diagnosis). From ancestral trauma (that we now know to be epigenetically inherited), to early conception and birth trauma, to adverse childhood experiences and complex trauma, to head injuries, to genetic weaknesses in detoxification and methylation (creating scenarios of over and undermethylation) nutritional and hormonal inadequacies, to toxic insults such as mercury, lead, copper toxicity, mold, Lyme disease and co-infections, to sleep apnoea, to relationship struggles, workplace difficulties, transition from first half of life ego demands to second half of life soul demands; the list is long and complex.
Unless doctors/healers of the future are trained in a new paradigm (Functional Medicine is putting up a valiant effort to educate future health care providers in this methodology), have sufficient life experience and have spent a large portion of their learning years investigating and researching the multiple layers and levels of complexity (7 Stages to Health and Transformation) that may contribute to the origins and continuations of symptom or disease processes, you, as a health care consumer, will always be at the mercy of their experience (or inexperience) along this continuum. That is why it is imperative that all patients, as much as they can muster the lifeforce to do so, become advocates of their own health and treatment protocols. Patient self-advocacy, combined with a serious intent to do what it takes to get well, is always at the root of successful health outcomes. Or, if faced with a depressive illness or episode, we can hand over all power to the physician/healer we have consulted, take an antidepressant and hope for the best. Your choice.
If you are suffering from chronic symptoms such as asthma, fatigue, or brain fog, and you’ve struggled to find a proper diagnosis or relief, it might be time to examine your environment more closely.
Toxic mold illness and its effect on the immune system, called chronic inflammatory response syndrome (CIRS) is a perfect example of the power of our environment to impact our health in a dramatic fashion.
Many toxic molds are formed in buildings that have suffered water damage through flooding, condensation or high humidity. It is estimated that as many as 50 percent of homes have poor indoor air quality with water damage and the resultant mold biotoxins and associated inflammatory particles being one of the major contributors. With indoor air pollution accounting for up to 50 percent of all illnesses in the United States, this is a very serious contributor to patients' suffering, and deserves to be raised as a major factor when enquiring into patients' health history and timeline of symptom presentation.
Globally, air pollution is an epidemic, killing an estimated seven million people and is responsible for one in eight global deaths each year. This is a staggering number, and the fact that mold illness is one of the contributors to this epidemic, is still relatively undiscussed and unknown in traditional medical clinics, needs to change. Let’s shed some light on this invisible illness.
The Invisible Illness
Mold is quite literally an invisible killer because often you cannot see it. Caused by multiple different types of fungi, mold reproduces by forming tiny spores, which float away and are unseen by the naked eye.
Not only are mold spores invisible, but they produce even smaller secondary mycotoxins which are able to sneak through the body while wreaking havoc and remaining undetected by the immune system. These mycotoxins are extremely small, fat soluble molecules.
These molecules are particularly dangerous because they are capable of passing through your cell membranes without being carried through the bloodstream – making them extremely difficult for your immune system to identify.
Without identifying and helping your immune system recover from a buildup of toxin exposure, you could unnecessarily suffer from long term negative health consequences. Helping the public understand and become aware of CIRS is one of the best ways we can rectify unnecessary suffering.
Let’s examine the 13 symptoms of mold illness or CIRS, 4 common misconceptions, and 11 steps you can take towards effective treatment.
13 Symptoms of Toxic Mold Illness
The problem with toxic mold illness is it can feel like a phantom illness. The symptoms seem unrelated and can cause doctors to look in all the wrong places for a diagnosis.
Many sufferers of mold illness or CIRS first endure years of misdiagnosis or are even dismissed as having an illness that’s psychosomatic (in the mind). If you are suffering from a myriad of seemingly unrelated symptoms, it’s time to consider your home and work environments.
Here are the 13 most common symptoms of toxic mold illness (Dr. Shoemaker has identified 37 symptoms in total). It’s time to see your doctor if you suffer from any of the following:
- Cognitive issues such as headaches, brain fog, memory problems, difficulty concentrating, and mood swings
- General fatigue and weakness
- Muscle aches, joint pain, and morning stiffness
- Numbness and tingling of the skin
- Light sensitivity, blurred vision or red eyes
- Asthma, persistent coughing, sinus issues or shortness of breath
- Skin tingling or numbness
- Vertigo and tremors
- Metallic taste
- Temperature fluctuations or night sweats
- Increased urination and excessive thirst
- Changes in appetite
- Abdominal pain, nausea, diarrhea, and bloating
As you can see, the symptoms of mold illness are varied and may even appear unrelated. It’s the nature of these broad reaching symptoms that keeps the cloud of mystery over CIRS.
Only through drawing more public attention and dispelling common myths around CIRS can we get closer to achieving better diagnoses and treatments. Let’s start that process by taking a closer look at the four common misconceptions surrounding mold illness.
4 Common Misconceptions of Mold Illness
Toxic mold illness is gaining traction in the media but with that come some misconceptions. Let’s clear up some of these fallacies regarding mold illness right now.
1. Mold Illness Isn’t That Common
Even though mold illness isn’t widely discussed, it is very prevalent and the public needs more information on CIRS. Approximately one in four have the potential for developing CIRS if they are exposed to sufficient biotoxins and inflammagens (other toxic compounds released by water-damaged buildings).
And unfortunately, these biotoxins are estimated to impact as many as half the homes in the United States, making CIRS an illness of major concern. It’s important to spread awareness of mold toxicity and prevalence so that people can take the right steps to keep their family safe in their homes and places of work.
2. Mold Illness is Caused by Mold
Even though “mold” is in the description, mold illness is actually a complex health condition that fits more appropriately under the title of chronic inflammatory response syndrome or CIRS.
Originally described by Dr. Ritchie Shoemaker in the late 90s, there are now over 1700 scientific articles on CIRS to date.
The causes of CIRS are collectively known as biotoxins and are frequently associated with water-damaged buildings, though they can occur without water damage.
- Fungi with mycotoxins
- Bacteria with secondary endotoxins (including Borrelia and Babesia - organisms associated with tick-borne illness)
- Beta Glucans
- Hemolysins (toxins produced by bacteria, often residing in deep nasal passages).
- Microbial Volatile Organic Compounds (VOCs)
- Cell wall fragments
- Building material VOCs
Not everyone will become sick if they are exposed to sufficient levels of any of these toxins. They are fortunate to be part of the 75 percent of the population whose immune system recognizes these toxins and is able to neutralize them.
However, those with specific human leukocyte antigen (HLA) genes have an immune system that isn’t able to identify these toxins. If your body can’t identify these biotoxins, then it is unable to eliminate them from the body. These biotoxins initiate a significant inflammatory response called CIRS.
3. CIRS Looks the Same for Everyone
Actually, it appears that everyone has differing levels of mold sensitivity. Genetic predisposition seems to play a role in how likely you are to develop CIRS.
About 25 percent of the population is genetically susceptible to developing CIRS, while two percent are highly sensitive and more likely to experience disabling symptoms when exposed to biotoxins.
The varying levels of sensitivity to biotoxins makes CIRS a difficult illness to diagnose. Furthermore, those suffering from mold illness are often misdiagnosed or their condition is overlooked altogether.
Only through additional studies, examination, and public awareness can we begin to improve diagnosis rates for CIRS.
4. Removing Environmental Exposure Cures the Symptoms
It seems obvious that the first step of tackling your CIRS would be removing exposure to biotoxins. But that isn’t always enough.
Sure, removing the source of toxins is great in theory, but even professionals have a hard time fully eliminating all the mold and spores. If it’s at all possible, a complete move from the contaminated area is best. Unfortunately, many cannot afford to completely remove themselves from the toxic environment.
Luckily, there are other steps you can take to help your body repair some of the damage caused by harmful biotoxins or improve your health if you are not able to completely remove yourself from the environment.
Take Action – 10 Treatments of Toxic Mold Illness
If you’ve been diagnosed with CIRS there are steps you can take to help alleviate your symptoms.
The steps of the Shoemaker Protocol outlines a detailed treatment plan on the impacts of toxic mold. 10 treatments I recommend include:
- First and foremost, remove yourself from the environment to the best of your ability. Begin the process of remediation of your water-damaged environment. It is best to consult an expert in the field who has been trained in the Shoemaker method of mold remediation.
- Invest in a high-quality indoor HEPA air filter capable of removing particles less than 0.1 microns. Most commonly purchased HEPA filters only filter particles to 0.3 microns and above.
- Test for and treat any nasal bacterial growth, such as MARCONS .
- Use cholestyramine, Welchol (known as Lodalis in Canada) to aid your body in removing the toxins by binding to them. Be sure to avoid constipation while using binders. Add magnesium oxide or citrate powders to prevent constipation during your detoxification process.
- Eliminate gluten and remove mycotoxin-rich foods, including wheat, barley, rice, oats, rye, peanuts, and brazil nuts.
- Eliminate amylose rich food, sugar and alcohol.
- Correct androgens such as DHEA and testosterone.
- Correct your cortisol and ACTH levels.
- There are several other biomarkers that can be examined and corrected with the guidance of your doctor such as ADH/osmolality, MMP9, VEGF, C3a, C4a, TGF beta-1, and VIP. Be sure to discuss these factors with your doctor.
It’s really a wonderful thing to finally see a comprehensive look at human health begin to hit the mainstream. And while it’s an approach you’ve been following for some time now, it’s important that it continues to spread far and wide.
Through the 7 Stages of Health and Transformation we can examine health impacts such as toxic burden through a lens that’s more complete and acknowledges the complexity of human health.
Mold illness is a perfect example of how toxins found in the 1st stage – the Extended Body – can lead to an array of seemingly confusing symptoms. If you are suffering from chronic illness – especially any of the symptoms listed above – be sure to consider mold and its resultant toxic effects, as a possible contributor.
Do your symptoms improve when you’ve been on vacation? Have you been looking for solutions to an illness with little to no success? Mold toxicity is not usually a factor many practitioners look at first. Mold illness is quite literally “out of sight, out of mind” but it could be the solution to your mysterious health woes.
As we mentioned earlier, CIRS is still a relatively unknown illness and spreading the word is vital to helping those that suffer. Share this article to help spread awareness and aid in calling attention to a debilitating and misunderstood illness.
Also, if you’re interested in digging deeper and learning more about CIRS and finding a complete description of both the diagnosis and treatment, you can find out more by clicking here.
When a patient is considering a return to full health and wellness, I, as an integrated medical practitioner, and you, as an informed, self-actualizing person, can no longer use only the antiquated Newtonian method of diagnosing and treating conditions. Although this is still taught at both medical schools and naturopathic colleges around the world, we’re now working in an expanded, systems-based paradigm.
Medical school prepared me for the linear process that identification of symptoms is followed by identification of the disease then the determination of the drugs or surgical procedures that are required. This process may apply if a patient has symptoms suggestive of acute meningitis requiring immediate intravenous antibiotics, but it will do nothing to address the myriad of antecedents, triggers, and mediators of complex, chronic, multisystem symptom processes. Patients suffering from a multitude of complaints that defy traditional diagnosis, a situation that is only too common today, require a much more complex method of assessment and treatment.
This new model of integrative medicine must ground itself in the more comprehensive models of environmental and ecological medicine, functional medicine, energy medicine, early developmental trauma, sociology, traditional and depth psychology, family systems, and models of consciousness as proposed by neuroscience and spirituality research. In complex cases of healing, we need to expand the lens of inquiry to help identify the multilayered factors that are hindering our wellness and self-fulfillment and determine what aspects of ourselves are affected. Furthermore, we must listen to our symptoms and our bodies for any clues that will help us to integrate the neglected parts of ourselves that are hidden from our conscious, rational points of view and may be hindering the realization of our full potential.
For integrated practitioners, an education in an array of disciplines is imperative to a successful outcome. A new curriculum must be written for these new healers and a different method of selection employed. I don’t propose training traditional medical personnel to embrace this task. We need them to continue practicing disease-based medicine with the latest technological advances. However, for those that wish to embrace the expanded paradigm, a new wellness curriculum is imperative, a curriculum that will be highly dependent on a healer’s personal experience and level of education. This is complicated territory to imagine and traverse. A highly educated healer lacking the necessary life experience to have developed compassion and empathic understanding cannot embody the knowledge and the compassion represented by the twin snakes entwined around the caduceus, the ancient Asclepian symbol of medicine and medical practice.
In addition, if all we do when patients present is to tell them what they could read in a book or online, there’s probably no reason for them to see us again. It’s essential, in the new paradigm, that healers strike a chord that resonates in the core of the patients’ being and creates a shift in energy or information, forming a new image that will allow them to perceive themselves and their issues very differently. This will usually entail a radical shift in their value systems whereby health issues become their top priority and other values, such as work, family, or recreation, take a temporary back seat. Under the old model, this is seldom the case unless a patient presents with a life-threatening illness.
To assist in the diagnostic and therapeutic processes required in the new paradigm, I’ve developed the 7 Stages to Health and Transformation™ model (for a detailed explanation, click here). Each stage looks at a different aspect of the individual so that diagnostic and healing methods can be focused on the true causes of illness.
First Stage – Environmental Body
We must first examine the influences of the external environment and the effects of infections, pollutants, heavy metals, and dental materials on our physiology. We must also optimize the body’s detoxification mechanisms.
Second Stage – Physical Body
This is the biochemical and structural stage. We must optimize the biochemistry and homeostatic mechanisms of the body’s regulatory systems. These include diet, gut ecology, hormones, neurotransmitters, the immune system, and brain function. Any structural defects and injuries must also be attended to.
Third Stage – Energy Body
At the electrophysiological, any disturbances to the body’s energy systems must be addressed. The effects of man-made electrical fields on the autonomic nervous system and the balance between stress and relaxation responses need to be taken into consideration. The status of the brain’s electrical circuits, as determined by QEEG analysis, must also be addressed.
Fourth Stage – Emotional Body
Early developmental trauma and emotional wounds need to be examined, brought to conscious awareness, and processed accordingly.
Fifth Stage – Mind/Ego Body
An individual’s sense of an authentic, separate psychological self, his value systems, his internal dialogue, and his general orientation to and defenses against the world at large need to be examined and assessed. Just how balanced and stable are his mental/cognitive processes and how well equipped is he to handle the slings and arrows of a typical stress-filled life? It’s been estimated that our nervous systems are designed to handle one or two challenges every three months. Yet in the modern era the number is more likely to feature six or seven challenges on a daily basis.
Sixth Stage – Soul Body
At this stage one has to turn to the personal unconscious, the more hidden aspects of ourselves and the lessons we’ve learned from Jungian and depth psychology, to ascertain what the deepest part of the individual wishes to express. The question at this stage is not what the ego still strives for but what the soul wants. At this level, we also turn to the influences of the family soul and, through Family Constellation therapy, begin to unravel the entanglements and family secrets that lie hidden in the patient’s intergenerational field. These entanglements and secrets often present as symptoms or as an illness in the patient, who is usually entirely unaware of the connection.
Seventh Stage – Spirit Body/Unified Field
About a hundred years ago, there was an infusion of ancient souls into Western science, great beings like Heisenberg, Niels Bohr, and Albert Einstein who began to wake us up by mathematically deducing that the objects of our perception aren’t physical. Beyond the masks of molecules, beyond the façade of material matter, beyond the limits of space and time, there’s a vast mystical domain of energy and information. Human beings are composed of these same networks of energy and information and are thus locked in a dynamic exchange with the energy and information of our extended body, which we call the universe. We’re part of the ‘unified field’ proposed by particle physics. At this level, an individual deepens a relationship with a witnessing self, observing the world of phenomenology rise and fall but with little or no attachment to its outcomes or a personal self. In the seventh stage, all personal agendas are surrendered to intelligence greater than ourselves. This intelligence that causes our hearts to beat and organizes both the migration of birds and the movement of the intergalactic cosmos achieves a greater significance than our own personal, mortal agendas. It is to this intelligence that we can turn for help and guidance. At this stage, we’re not identified with our physical, emotional, or mental bodies but with that which is timeless within us. When patients present with complex symptoms or well-entrenched disease processes, how well equipped they are to proceed with the healing process varies widely from case to case. There are also many possible combinations of the seven stages that they may seek to address. Some may simply want to cure their irritable bowel symptoms, while others want to heal across all levels. Consequently, it’s important, at the outset, for the practitioner to establish what exactly the patient wants or expects to be healed and to narrow or widen the diagnostic and therapeutic lens accordingly.
The standard Dorland’s Illustrated Medical Dictionary defines healing as ‘a restoration of wounded parts’, but the Oxford English Dictionary definition is ‘to make whole or sound.’ These definitions are profoundly different from each other. The first refers to the treatment of a symptom or the setting of a broken bone, the fixing that which is broken. The Oxford definition is more congruent with the true etymology of the word health, which is to make whole or holy. In truth, healing is an extraordinary miracle about which, despite our 2,000-year effort to understand it, we know very little. It’s a profound, courageous, and spiritual act of coming to wholeness, where the body is relatively healthy, the emotions are stable, the mind is clear and focused, one’s destiny is clear, and yet one remains humbled to a greater intelligence from which one derives daily guidance and sustenance and to which thanks are given. Alternatively, healing can mean that the deepest essence of the individual is in an integrated or individuated, whole place, one where he knows and inhabits his authentic self, in spite of the body’s experiencing symptoms or a disease process. We identify with that which is timeless within us. We’re aware that we aren’t physical machines that have learned how to think. As Deepak Chopra likes to say, we are not ‘skin-encapsulated egos squeezed into the volume of a body in the span of a lifetime.’ We’re not the constricted, isolated individual entities that Western medicine would have us believe. At our core, we identify with that which is defined as an unbounded, infinite, eternal, ever-present witnessing awareness. We’re consciously aware of being a network of energy and intelligence that’s inextricably interwoven with the web of life.
However, given that definitions vary, healing is dependent on where the individual or the healer places the emphasis or the location of the patient’s concerns, whether this is mind, body, soul, or spirit. When a patient presents, part of the intake process is to ask what his intention is in seeking out the doctor/healer’s advice and on what stages, such as environmental, physical, energetic, emotional, mental, spiritual, he wishes to address his concerns. Many people aren’t interested in pursuing higher levels of health, so one of a physician’s first responsibilities is to determine and clarify each patient’s intentions and respond accordingly. There are four possible intentions.
In the first instance, many if not most patients will view their symptomatology, whether this is physical or emotional, as a nuisance that has to be removed as soon as possible. They’ll turn to healers, whether allopathic or alternative, to provide the most powerful external treatment that can be found to treat worrisome symptoms at the level of the physical body, which is at stage two of the model. They subscribe to the consensual reality of our culture, which entails identifying the cluster of symptoms, naming the disease then finding a drug or surgical procedure to treat it. . At medical schools and naturopathic colleges today, students are still taught that human beings are collections of molecules encapsulated by skin and bones, physical machines devoid of any influential states of consciousness. If you’re feeling a little depressed, it’s because there’s a problem with your serotonin molecules, the implication being that if you take a selective serotonin reuptake inhibitor like Prozac or Effexor, or a herb like St. John’s wort, it will prevent reuptake of your serotonin molecules and you’ll no longer be depressed. Likewise, if you’re having trouble sleeping at night, it’s not because you’re worrying about your marriage or your kids. Instead it’s because you have a deficiency of gamma-aminobutyric acid molecules, which Ambien, Xanax, or a GABA supplement will fix. Increasing your concentration of gamma-aminobutyric acid molecules will allow you to sleep soundly and the symptom will be eradicated.
The problem with this model is that it works too well in the short run. Mahatma Gandhi lamented that the problem with Western medicine is that it’s too effective. If a patient mentions to his doctor that he’s regularly woken at 3 a.m. by heartburn, he’s prescribed Tums or Nexium and the symptom disappears. In the standard six-minute doctor visit, very few inquiries are made into the fact that, before bed, the patient always eats cookies and has a whiskey nightcap. As a result, if you pop a couple of tablets and ten minutes later the symptoms are gone, what you’ve learned at this level of healing is that you should have taken your heartburn medicine before going to bed. Instead of fixing the problem, this mode of treatment perpetuates the ongoing cycle of symptom, diagnosis, and remedy. This is symptom treatment and has nothing to do with healing. At this level, patients see the source and the solution of their problem as being outside of themselves. In turn, their healing becomes dependent on changes in situations and on circumstances outside themselves.
It’s interesting that the original definition of a ‘quack’ was someone that treats symptoms. This approach has little chance of activating any inner process within the patient or resulting in healing on a deeper level. All too often, patients with significant diseases such as cancer sit in front of me and demand to be cured. The prospect of a deeper healing experience is extremely remote in these cases.
The second possible intention involves some patients arriving in the consultation room willing to go a little further. They look at physical symptoms as entry points into a larger inquiry. They ask much deeper questions and use their symptoms as allies in their quest for meaning, well-being, and integration. They might inquire about what emotional patterns may underlie their disease and recognize the role of unresolved emotional issues, anxiety, stress, and other mental factors in the development, perpetuation, and recurrence of illness. They may learn about their individual Meyers-Briggs typologies, their defense mechanisms and complexes, and their Ayurvedic doshas. This deeper understanding of themselves allows them to respond to the stresses of life in a less reactive manner, one that won’t cripple their growth, individuation, or consciousness. They begin to use a more conscious, mind-body approach to healing, making use of stages one through five in the 7 Stages model™.
As these factors are explored, it becomes possible to tailor a series of mind-body approaches such as integrated body psychotherapies, relaxation techniques, yoga, neurofeedback, and biofeedback. These patients recognize their personal role in suffering and disease, they link cause and effect and, to an extent, they substitute internal remedies for external ones. They’re beginning to move from the more limited definition of healing, namely fixing a broken part, to the more expanded definition of restoring wholeness.
As psychologist Alastair Cunningham has said, the qualities that best predict spontaneous remission among cancer survivors are an openness to change, a commitment to daily practices, a deep sense of self-worth, and a degree of autonomy and inner authority.
The third possible intention has patients seeking a state of health because they aspire to something more than an absence of symptoms and desire an overall state of wellbeing. They’re fully engaged in a deeper relationship with self-healing and are seeking a sense of wholeness, either for themselves, their loved ones, or the planet as a whole. They’ve learned about the signs and symptoms of disease and are now learning about the signs and symptoms of health. These include a deep sense of inner vitality, integration and self-knowing, healthy relationships, and a sense of meaning and purpose in life.
A patient I’ll call Jane was primarily interested in eliminating or at least managing her symptoms. This is true for many new patients until I teach them the 7 Stages of Health and Transformation™. Once Jane increased her understanding of optimal health, she said she wanted more than to simply get rid of her symptoms. She wanted to find meaning in her life and enjoy herself and her family. She wanted to achieve overall well-being. Her three-year inquiry into her symptoms had produced a lot of information about the signs and symptoms of a disease, but now she was open to learning about the signs and symptoms of health. With that goal in mind, she became fully engaged in deeper relationships with herself, her loved ones, self-healing, and with the planet.
This desire to be whole is a profound evolutionary urge that prompts many of us to seek out a vast array of healing techniques, from physical to spiritual. In the East, such seekers, upon a certain attainment, are referred to as enlightened. Carl Jung called them individuated and Abraham Maslow’s term was self-actualized. “As far as we can discern,” Jung said, “the sole purpose of human existence is to kindle a light in the darkness of mere being.” To me, this means leading a life of inspired, self-actualized creativity rather than an existence of mere tolerance set against a backdrop of the mundane.
For many people, this desire to shine with their true essence emerges around the midpoint of their lives. Until that point, what our deepest, instinctual self, or our soul, wants is often hidden from our conscious view, clouded by the innumerable and overwhelming demands of the first half of life and by vague value systems that we have yet to develop fully. Often, what brings these individuals into the office is a conflict with a midlife transition. Their symptoms often arise as a result of a discrepancy between what their egos want, such as endeavors in the first half of their lives, and what their deepest, unconscious selves desire, namely the aspirations related to the second half of life. What drives us to achieve our life goals in the first half isn’t what serves us in the second half. What drives us in the first half of life are often the wishes and wants of outer authority figures, including parents, society, or our culture at large, as well as the innate, Darwinian selfish gene that wishes to perpetuate the species by mating with the most suitable partner from whatever gene pool is available. Thus, with the help of a hormone-drenched physiology, we develop a strong sense of an ego-driven self. We strive to achieve the highest standards that our gene pool is capable of. We educate ourselves, fall in love, marry, create financial security, and buy the most suitable home to provide safety for our offspring. We feel accomplished on achieving some modicum of success in these areas.
It’s usually in the second half of life, which begins between ages 35 and 55, that the first whisperings of our hidden potentials and possibilities emerge. We may be plagued by lingering doubts: “Is this all there is?” “Is this what I really want?” “Am I fulfilling my true potential?” “Is this partner really aligned with my values?” “Does my partner really see who I am?” “Should I be doing something else with my life?” We may also start to develop symptoms or signs of an illness or disease process. It’s at this exact interface between what the ego has striven to achieve and what the soul really wants that symptom may appear, as if to draw us into a deeper inquiry with ourselves. It’s been my observation that symptoms at this level serve as feedback mechanisms of our core selves, drawing our attention to that which is most neglected within us and which most needs our attention. Perceived in this way, symptoms may be said to have teleological intent, drawing us into a deeper, unimagined unfolding of our life’s journey, previously hidden from our conscious view.
In such cases, the task of a healer is to help patients identify the factors that are preventing them from achieving what their souls are seeking and what their ego-based minds are incapable of determining. When patients are in this position, no amount of ‘goal setting’ or ‘life-purpose’ strategizing will fulfill their deeper motivations. Often, the continued pursuit of the goals and life-purpose strategies of the ego-based first half of life is the very reason for a lingering sense of malaise and can even make patients sicker, driving them further from the very aspects of themselves that are calling for attention.
Somewhat problematically, the therapist/healer’s success is highly dependent on his own level of differentiation, autonomy, and stage of life individuation. If any healing is to take place at all, the healer must be highly aware and conscious of his own stage of life preparedness, his own ‘woundedness’, and must refrain from projecting his own agenda too heavily. Similarly, but in an opposite direction, the client must become aware of the inner healer/healed part of himself, the part that needs to be activated and made conscious. Tragically, this is rarely the case in most current healing exchanges, where mutual cause and effect inquiry is ignored. This practice limits the patient’s involvement in their own care and projects the power to heal onto some outer authority. The doctor is seen as all-healthy, while the patient is often seen as all-sick. The patient frequently identifies with their diagnosis in order to derive some form of identity and meaning from this one-sided relationship. It’s a means of barter and exchange within the allopathic system. The implication is that when this transaction occurs, the patient’s inner physician, the healthy part of themselves, completely shuts down.
This atrophy is particularly tragic, since it’s been my observation that it’s the physician within the patient that needs to be activated if a true transformation is to occur. The inner physician’s healing action is as vital as that of the physical doctor appearing on the scene. Similarly, if the inner healer isn’t mobilized by the conscious act of intention by the patient, the possibility of a true healing experience is somewhat dissipated. If nothing shifts in the internal dialogue and mental field of the patient, if they aren’t fully engaged in cause and effect enquiry and totally committed to changing previous behaviors and decisions that had led to the symptom presentation, then the possibility of something shifting at the physiology level is somewhat muted and no true or lasting transformation takes place.
Furthermore, it’s at this third possible intentional level of healing that the answer to the patient’s malaise will surface only after a deep inquiry and a deep surrender are made, a surrender to their own unconscious and to a larger wisdom than their own ego-based minds. At this level of healing, one has to listen to the many ways the psyche expresses itself in its desire to make conscious its hidden intentions.
Actively listening to our bodies, our symptoms, and for messages from our unconscious are some of the profound tools we can use to seek information outside of our rational ego-based mind-set. Dreams are spontaneous messages from the unconscious, suggesting symbolic ways of seeing issues that we cannot see or understand with our conscious minds. Synchronicities, when an event in the outer world coincides meaningfully with a psychological state of mind, may also provide us with clues to the directions our souls may want to take.
Symptoms or illness can also arise from an issue within a family system, perhaps some entanglement or hidden secret that’s never been consciously exposed. In this way, symptoms provide a voice to the silence in the family system. They help shine a flashlight into the system, revealing what normally cannot be seen. We know from recent research on the epigenetic transfer of life experience that the unresolved emotions and traumas of our ancestors can affect family members for multiple generations. Family Constellation therapy can cover the unconscious bonds and loyalties that underlie many physical and emotional symptoms. It’s been my observation that very often the inner healing process cannot be accessed if the patient is not fully aligned with his birth mother or father.
When my patient Jane told me that she despised her mother, it was a very clear indication that she didn’t have access to her full life force and inner healer. It’s vital to keep in mind that we inherit half our gene pool and the epigenetic transfer of their life experiences from our mothers and her ancestors and half from our fathers and his ancestors. We’re literally half our mother and half our father. If we disown or otherwise remove a parent from our lives, we’re literally disowning half of ourselves and all that this parent represents to us. I’ve never seen a patient fully recover without first realigning themselves in the correct way with the parents that birthed them, no matter what the story they tell themselves consciously regarding why this may not be possible.
Jane had symptoms of crippling fatigue, anxiety, depression, and body pain that had been present for three years. She said that the symptoms had started when she was 44 and that she’d seen many medical doctors and naturopaths, been to the Mayo Clinic, and undergone numerous blood tests and special investigations. The diagnosis was atypical depression. This is the catchall of the medical profession when no discernible causative factor or factors can be ascertained.
Although further tests did reveal significant biochemical imbalances, what was most revealing to me was her obvious dissatisfaction with her life, her anger toward her mother, and a generalized sense of boredom.
“I am my father’s daughter,” she said, through clenched teeth. “I despise my mother.”
She later elaborated about her father.
“I’m an engineer like my dad, but I haven’t worked for 12 years because I wanted to stay home and bring up my daughter.”
After a long dialogue investigating her family dynamics, it was clear that her rejection of her mother and her overidentification with her father had led to an imbalance in her psyche between the masculine and feminine lineages. It’s been observed in family system dynamics that the energy we take from our mothers provides us with our day-to-day relational energy, nurtures us, and gives us life. A father’s energy organizes and provides a context for the unfolding of our life force. It’s possibly not ironic that the mitochondria, the organelles within our cells that transform food into life-giving ATP or energy, our life force for healing and repair of all bodily functions, are obtained entirely from our mothers. For a very long time, Jane had been under the influence of her father’s desires, negated her mother’s character and positive influence, and subjugated her own deeper, soul-based desires to the point of total silence. It’s common that people experiencing fatigue are living not according to their own inner value systems but according to those of outer authority figures that have been unconsciously adopted as one’s own, in this case those of Jane’s father. She’d also silenced and rejected her mother’s voice, hence abandoning half of herself, creating a perfect, dual causation scenario in which life-crippling fatigue could arise.
It took many months of listening intently to the symptoms of her body, paying attention to her dreams, asking her body for guidance, and turning inward to the inner healer within for her to see the path of her true, creative self more clearly. She realized that being only a wife and a mother was not her true vocation. Her symptoms had escalated until she could no longer ignore the issue. Although much work was done to optimize her adrenal function, treat her Epstein-Barr virus infection, balance her glutathione levels and tweak her hormones, involving treatment at the outer, physical level, it wasn’t until she turned inward that the healing occurred. When she saw her symptoms not as some curse to be eradicated but as harbingers, whisperings of the need for a deeper inquiry, she did what it took to begin her healing journey to return to wholeness.
She saw that what she’d proudly worn as a badge of honor as Daddy’s little girl was a trap from which she had to escape. She realized that she wasn’t living her life based on her own authentic values but on those of her father. As she softened her stance toward her mother, accepting and seeing her through a more compassionate lens for the first time, she felt a certain lightness return to her mood.
As she turned inward, Jane’s inner healer was activated. She learned to trust her body and her instincts for the first time. She’d resisted this progress for years and seen countless excellent physicians/healers to get the latest outer remedies, all to no avail. But once she recognized her symptoms as messages from her soul and learned how to pay attention, her healing was dramatic.
If successive generations of a family have struggled with parenting problems, the patient will often be unconsciously entangled in an unresolved, energy depleting, family system issue. The only way to resolve this is to uncover the hidden dynamics of the ancestral family. No amount of personal nutrition, bodywork, or herbs could heal Jane. She had to uncover the entanglements in her ancestral lineage that were hidden from her conscious view and she had to learn to listen to the messages of her own soul.
The following visualization exercise, entitled Creative Imagery: Listening to Your Cells, will help you to listen to your body for clues regarding what your soul is seeking and how your conscious mind may be obscuring from its view.
Come into contact with yourself and taste your own presence. Welcome and cherish your own presence in this world.
Breathe in, breathe out.
Let go of any physical tensions and relax any mental tensions. Focus your attention on your heart and your soul.
Allow your attention to go to the place within you that has a lot of pain or symptoms. It can be a mental place or a physical place, a muscle or an organ.
Approach this area with respect, tenderness, and care. Talk to this area. You’re talking to these cells in a time of difficulty. Memories may arise.
Say, “I am here now to listen to you.” Let whatever comes from that place speak to you.Allow the messages of the cells to come to you. These cells represent the strength of life trying to talk to you and connect with you. This attitude of listening and respect, without discussion, is already healing you.
Now that your cells or your symptoms finally have your attention, and you’ve heard their message, say to them, “You don’t need to keep showing up in this way. You now have my attention.”
With the same care and respect, begin to transform. Imagine your stem cells coming from your shoulder blade or hipbone, where your bone marrow is active, and flooding the tissue that’s in need of healing.
Imagine your stem cells flowing through to the place where you’re suffering. Imagine them dancing and producing color and light.
Let this dance take part in all your cells and in your entire psyche, producing an experience of healing. Soon your entire body is light and warm. Rejoice in the health that these stem cells bring. Imagine yourself becoming luminous from this sensation, nourishing yourself and everyone around you.
Imagine what you will do with yourself once your health is restored. Where will you go to nourish your health and what creative choices will you make? Imagine yourself doing things you like, things that give you an intensified love of life.
When you’re ready, open your eyes and make a note of what you experienced, what you saw, and what new image or images have arisen for you.
Finally, the fourth possible intention involves individuals aspiring to a level of health that’s fundamentally and radically different from those described above and can only arise following a leap in consciousness. They don’t seek simply self-regulation or self-improvement, but self-transformation.
Such people usually achieve this only after traversing each of the preliminary stages. For them, healing’s center of gravity progressively shifts from the physical to the psychological to the soul to the spiritual. They’re defined by their attention to a spiritual inner process rather than an outer remedy, herb, or potion. They become witnessing selves rather than active ‘doers’ in an external life. The internal reference point shifts from ego to spirit.
Chopra Center co-founder David Simon said this process occurs when “we stop thinking of ourselves as this skin-encapsulated ego that’s been compressed into this physical body for the span of a lifetime and we remember on a daily moment-to-moment basis that our essential nature is unbounded, infinite, eternal, unlimited, unborn, and undying.” Buddhist M.D. and author Elliott Dacher states that this occurs when we’re fully engaged in the broadest and deepest vision of health and healing and define what’s possible rather than what is considered to be customary.
At this level of healing, we suspend our rational left brains and personal agendas and ask for guidance and help from the intelligence greater than ourselves, namely G.O.D. or grand organized design, or the unified field. We surrender and we listen. We trust that at our deepest core we’re part of and connected to the unified field. We discipline ourselves, through daily practice, to surrender, tune in, and trust. Since we’re no longer identified with the mortal body, our fear of death disappears.
This is the deepest possibility for a transformed, healed individual. In achieving this, we’ve moved from the relative purpose of medicine to the absolute purpose and possibilities of a healing experience.
The Quest: From Relative to Absolute Health
Relieving symptoms and curing disease, fixing people, eradicating tumors, normalizing blood tests, alleviating pain, creating clear CT scans, and prolonging life are the culturally sanctioned notions of what physicians are supposed to do. This is the quest for relative health and relative health should be realized with the least amount of effort, expense, and sense of personal responsibility. This mindset also dictates that all illness is negative, to be eradicated. As a result, illness is not used as information to bring about self-transformation.
Yet some people choose to seek a level of health that is even beyond wholeness, a level that might be called absolute health. They want to heal their physical bodies so they can live out their lives in a state of maximum potential and in the fulfillment of love and purpose, feeling the joy, wisdom, and compassion in their lives more fully.
We achieve this not by medicating symptoms but by using them as feedback mechanisms to show us where we need to become more conscious. We learn to “lean into the sharp points of our lives,” as Pema Chodron has said. With this knowledge, we don’t retreat from the world. Rather we consciously engage with the world as we start to wake up to the wonder of our existence.
We start to address the questions raised by the poet Mary Oliver, such as what are we going to do with this one wild precious life? This is indeed a precious life, a fragile treasure. Recognizing this is the second most essential step on the path to integrated health and life. The first is to recognize that our true nature is more than our bodies, our emotions, our minds, and our possessions and that there’s an intelligence guiding us that we can turn to and trust. When we do this, we start to celebrate the miracle and sacredness of our human existence.
Einstein said there are only two ways to live your life. One is to live as if nothing is a miracle, the other to live as if everything is a miracle. The word miracle comes from the Spanish mirari, which means to wonder, to smile, to break into joy, and to release. If you have feet to walk with, that’s a miracle. And isn’t the fact that our bodies are subatomic particles of frozen light also a miracle? Isn’t water a miracle? Isn’t breath a miracle? Isn’t the human brain a miracle? Isn’t the eye a miracle?
We make a mistake if we wait until we’re on our deathbed to say thank you, to show our gratitude for having been given this one precious life. Meister Eckhart said, “If the only prayer you say in your life is thank you, that will suffice.” If we don’t recognize the preciousness of life, we will neither care enough about it nor feel the urgency to let go of the thoughts, idea, values, and concepts that no longer serve our expanding sense of self and the world in which we live.
Once we hold the preciousness of life near and dear, its importance no longer fades with the busy nature of daily life. And when we die of physical diseases, it isn’t a tragedy. We die fully healed, with an open heart and the realization that our true self is nonlocal, outside of space and time and incapable of death.
- Alastair J. Cunningham. Can the Mind Heal Cancer? (2005)
- Elliott Dacher. Integral Health. (Basic Health Publications, 2006)
- Carl Jung. Memories, Dreams and Reflections, revised edition. (New York: Vintage, 1989)
- Ken Wilber. The Integral Vision of Healing. (Philadelphia: Churchill Livingstone, 2005)
- David Simon. Keynote address at Ayurvedic conference, University of California, Berkeley, 2002.
- Pema Chodron. When Things Fall Apart. (Boston: Shambhala, 2002)
- Guy Corneau. Lecture at Jung Society, Calgary, Alberta, 2012.
- James Hollis. The Middle Passage. (Toronto: Inner City Books, 1993)
- Dietrich Klinghardt. Five Levels of Healing Model. www.klinghardtacademy.com
- John Demartini. The Breakthrough Experience. (Hay House, Inc. 2002)