Don't give up! Some new treatments on the horizon

I hear from some people who are very discouraged because they do not see improvement in their loved one with Alzheimer's. About half of the people in the MCT oil studies declined minimally rather than improving, but declined less than the people who took the placebo. So this strategy may be worthwhile continuing even if results are not obvious in the beginning. Also, some people improve rather slowly but over two to three months, the changes may become more apparent, or perhaps you will see that things are not worse.

If you are considering giving up on this, you might consider the possibility that this strategy could at least stabilize or slow down the process for your loved one. Hopefully we will be able to learn why some people improve and others don't. After attending the American College of Nutrition Conference at the beginning of October, I have some ideas about why this happens. It could be that the cells are so depleted of the various substances they need to make energy inside the cell that the cells don't recover simply by providing ketone. I learned more about other disease processes where there is also a problem with energy production in mitochondria, the organelles inside of the cells that manufacture ATP, the very basic energy that drives the whole function of the cell. Each cell has hundreds to thousands of mitochondria.

Dr. Stephen Sinatra discussed several dietary supplements that help people with severe congestive heart failure by providing certain subtances involved in manufacturing ATP in the mitochondria in the cells. In the case of congestive heart failure, the cardiac cells have become depleted of these substances and are not making enough ATP to keep the cell going. Three of the supplements we have been giving Steve for quite some time, CoQ10, L-carnitine and magnesium, but the fourth I did not know about, D-ribose. D-ribose is a simple sugar normally made inside the cell from glucose, and is one of the building blocks for ATP. It makes sense that if glucose cannot even get into the cell that the cell will not be able to make D-ribose, which is critical to making ATP. It is not stored elsewhere in the body and it is not present in any quantity in foods, but is used by body builders and available as a supplement. For people with cardiac diseases, Dr. Sinatra recommends taking about 5 - 7 grams of D-ribose per day. It comes in a powder (disappears without much taste in coffee or any drink) or chewable tablet (not so good to my tastebuds.) I have many questions about it, such as does it cross the blood brain barrrier and how does it enter the cell, and of course, it is safe? I have not been able to find out much about it. If there is a chemist or other scientist out there with more information about D-ribose, I would appreciate hearing from you. When I learn more I will post something about it.

Dr. Sinatra has a book called, "The Sinatra Solution: Metabolic Cardiology" that discusses these supplements in detail, but is very technical. I believe that this strategy could help people with AD since the mitochondria work the same as far as producing enery in all of the cells. After reading up about this, part of the problem in AD may be that the cells become depleted of these substances, such as CoQ10, from some of the medications our people with AD are often on (anti-depressants, statins.) Also the whole process of making energy in the mitochondria depends on being able to get glucose (or ketone bodies as an alternative) into the cells in the first place and this is not happening.

Just as a point of interest, the earliest work by Dr. Veech and his group was studying the effect of ketone on the heart - the additon of ketone to glucose increased the energy output of the heart by 25%. If insulin was also present, the energy out put increased by 37%.

We also recently attended a research update at our local Johnnie Byrd Alzheimer's center, which is part of University of South Florida, and they have learned that caffeine may increase cognition in AD - they suggested 500 to 600 mg a day - you can buy caffeine tablets very inexpensively at the drug store. I started Steve with a 200 mg tablet and increased by one tablet weekly to 600 mg; I always give it at breakfast. It doesn't affect his sleep at all or cause any other symptoms. They are also studying a substance called GM-CSF which is already in use to increase white blood cells in people with cancer, etc. In mice is cleans out the beta-amyloid plaque rather quickly, over a week after just one injection. Absolutely amazing. Hopefully they will be able to get studies in people started soon.

There are some new clinical trials starting up that are using intranasal insulin and also immune globulin. You can learn about what clinical trials may be available in your area at www.clinicaltrials.gov . We live in a very small town and have a small research that has several different Alzheimer's studies going. In other words, you may not need to be near a large center to participate in a study.