As many of you know, I have been working with Dr. Dale Bredesen for several years, both directly and through his information-rich website Apollo Health. I highly recommend it as an adjunct to care in our office or, if you’re not seeing us as a patient, you can learn a lot through membership on his website. The site also offers referrals to physicians trained in the Bredesen Protocol. I’ve been listed on that site for several years, and somehow, I managed (did you know this about me? My friends & family do!) TO PROCRASTINATE finalizing the orientation to the use of the website. (“Details, details!”) But I’m almost done now, and out of great appreciation and respect for the information available there, I’ve decided to do a series of “APOLLO Brain Pearls” in as many newsletters as I can manage this year!

So, let’s hope for a happy and healthy 2025, and here’s a pearl:

Alzheimer’s Risk and Your Genes

One of the first questions I ask a worried patient is whether they know if they have the ApoE4 gene. All of us have 2 copies of the ApoE gene, one from each parent. Most of us received a “3” from each, and are thus ApoE3/3, but 25% of us are ApoE3/4 and 2-3% are ApoE4/4.

The bad news is that the ApoE4 gene is strongly associated with the risk of Alzheimer’s, but the really good news is that we know a LOT about HOW the ApoE4 gene increases your risk. And as you know from life in general, a LOT of the time if you know how something is going wrong, you’re well on your way to making it right again.

ApoE4 genes have been around for a LONG time and they are good in many ways:

• Many, if not most, ApoE4 folks are high achievers in their working life or profession.

• ApoE4’s are really good at creating inflammation in the face of an infection, which is great if you know how to tune it down after it helps with healing.

• In a time of famine, ApoE4’s are great at absorbing and storing fat for later use.

As you can imagine, the latter two features are not so valuable in our modern world.

Here is the PEARL for today:
I’m going to share with you five steps (for 2025) that can help protect a healthy ApoE4 brain and start to help heal one that is having problems.

1. If you’re reading this newsletter, you already know to eat a low sugar, low grain, high nutrient diet rich in healthy fats, especially from olives and avocados.

2. Exercise your body and brain in a variety of ways to keep both strong.

3. Pamper your whole mouth, not just your taste buds! Floss or Waterpik your gum line and brush your teeth twice a day. Use gentle products (avoid chemical antibacterial mouthwashes unless you’re fighting off an infection) like the Dentalcidin rinse and toothpaste (my fave!) available in the office or on the online store. And finally, EXERCISE your mouth as well: it LOVES to chew on things like carrots, nuts, and especially to get meat off the bone. CHEWING stimulates your brain (via BDNF or brain-derived neurotropic factor) to create new brain cells for your personal use!

4. Think carefully about brain training, and do three kinds of brain training:
   
   1. Something you love to do, find a way to make it harder. Reading a novel? Remember the whole name and something unusual about each character. Like trivia? Do harder crossword puzzles.
      

   2. Something you do NOT love to do usually, but can find a fun way to do it. Hate trivia? Do an easy crossword! Hate numbers and math? Get an easy puzzle book, SUDOKU for just logic with numbers, and KENKEN for logic, numbers, and some math.
      

   3. Do some form of brain relaxation unusual for you, such as guided meditation, walking meditation, or breathwork. (My new fave breath exercise is IN through the nose for a count of 4 and right away another count of 1, and then a deep exhaling sigh, nose or mouth, for a count of 8.)
5. Sleep smart for your brain! I imagine you know a lot about good sleep hygiene (no cell phones in bed, cool and dark room, etc.) but did you know that ONLY YOU decide if your brain is prepared to do its nightly brain-cleaning in the wee hours of the night? And you make that happen only if you stop eating at least 3 hours before you go to bed. If you’re eating carbs or protein to sleep better, understand that you’re paying a bit of a price for it—see if there’s a workaround to bedtime snacks! Frankly, it’d be better to have your bedtime snack halfway through the night—still not ideal—than an hour before bed! If you have the ApoE4 gene, you should extend that pre-bed fasting window a bit into the morning, so you go without eating for 13-16 hours.

I hope you enjoy APOLLO Brain Pearls, and let me know if you’d like them to address anything in particular in the coming months!