Help with Cognitive Decline: 4 Part Program

Help with Cognitive Decline: 4 Part Program

Join us for a 4 part program to help you slow and recover from cognitive decline.

What is cognitive decline?

Brain fog, failing memory, and loss of mental sharpness are all things that can happen as we age. Foggy days, stumbling over words, and losing our keys can leave us looking at the ceiling, wondering how much time we have left before we completely lose our minds. Or even worse, being found out and being labeled as someone with cognitive decline.

Alzheimer’s dementia is one of the most feared diseases. A poll conducted in 2010 of 1,007 people found that 31% of people in a recent poll feared being diagnosed with the disease only trailing behind cancer which 41% of people feared. And this is for good reason! Who wants to lose past memories, become unable to form new memories, lose fine motor function, not sleep as well, and lose their executive functioning and problem solving ability.

Why would you want to address difficulties with Cognitive Decline?

You have spent your life sorting through, cultivating, and improving the processes and habits that allow you to live a productive and happy life. As neurological degenerative changes occur, these complex neural networks being to wilt. Left unchecked, the connectivity between the neurons is reduced, and this ultimately means loss of function. And not just executive function, I’m talking about sensory and motor function as well. As the brain’s connectivity and mass is reduced, your ability to interact with the world around you decreases.

Ultimately you are only one person, and what happens with you doesn’t necessarily have to affect those around you right? Wrong. One of the most stressful things that I have seen my patients go through dealing with is a parent who isn’t able to take care of themselves. It isn’t to say that family doesn’t want to do it, its just that undue stress is put on the family in these cases.

As if the cost to you and those around you enough to make you cringe, the cost to society is monstrous as well. Memory care (nursing homes designed to take care of people with cognitive decline) costs ~ $8,000 per month and is rising 5% annually. Estimates in 2015 were that around 15 million caregivers were providing 18.1 billion hours of care to people with Alzheimers and other dementias, running up a bill of 221 billion. (considering a wage of $12.20 per hour). If family members aren't able to care for the person, then society’s safety net tries to catch them. In 2016, Medicare and Medicaid paid out 236 billion to people who had dementia. The safety net is there for now, but who knows how long it will be.

But by then you will already be old, already have contributed to social security, and just want to be taken care of right? This sounds like a rationalization for not wanting to look at what is really going on. And for people who want to leave this world a better place than it was when they got here, a cognitive dissonance creating nightmare.

"I’ll cross that bridge when I come to it”, is a popular phrase. It is a great way to compartmentalize things and make them more simple. Putting something that you recognize as being important aside is like saying “I'm not there yet so I’ll ignore the things that I am doing right now that are affecting it.” This emotional decision is commonly rationalized by: "I have too much going on to take care of myself, to give up my vices and do the things that I know I should be doing for my health.” Well I am here to tell you, my patients who do the best rarely set aside their health completely for other short term gains.

Ignorance is bliss, but the truth is what sets you free. The nihilistic argument that nothing matters therefore we shouldn't take responsibility is one way to incur much more suffering in life than is necessary. It is by being more conscious of issues and our role in their creation that gives our life meaning. Being at cause can produce some existential anxiety in the short term, but pays off in the long term. Being at effect (the victim) has benefits in the short term (for example, not having to take responsibility, getting attention, etc.), but always leads to worse outcomes in the end. The price of having a meaningful life is that everything you do matters. It takes courage and an aim at the highest good that you can image to live this way. And when it comes to mental faculties, the things that you do everyday really do matter.

The fear around this condition, let alone the devastation that it brings to families and society would make you think that the modern medical industry would be pouring resources into it. New Drugs and procedure developed with this research would reduce the risk of getting to the diagnosis, improve outcomes, and help people who have degenerative neurological conditions to live better lives. The fact is, major pharmaceutical companies have cut funding for researching alzhiemers drugs because they have failed to show any improvements during clinical trials. All of the drugs intending to cure Alzheimer’s disease have so far failed, and the allopathic medical system is giving up. We have better and better methods all the time of diagnosing issues in an exquisitely specific way. The effective treatment of these problems is where the conventional medical system is falling short.

You can choose to be a victim of this system which won’t be there to catch you when you fall. Or you can take responsibility for your own health and be at cause.

On top of this, we are living in a world where chemical and electrical pollution is growing. While the situation isn’t dire yet, the idea of better living through chemistry and technology does have an impact on our bodies and minds.

How we can help...

Despite all of this, there are people who maintain their faculties until the day they die. In my practice I have helped hundreds of patients with different types of neurological issues. This is because over my years in practice I have constantly been learning about what causes neurological issues and have distilled the highest yield interventions into a 4 module CORE Protocol.

Program Outline

Module 1: Clear Interference

Regardless of the amount of energy a system has, if there is interference in the system, then there are inherent inefficiencies.  We use multiple different methods to clear the interference caused by emotional trauma, chemical toxins, and chronic infections.

The chemical milieux of the body also has an impact on the function of the nervous system.  Out bodies have amazingly sophisticated systems for maintaining homeostasis, the likes of which today’s technology has no way of coming close to replicating.  These systems can start to decompensate after a certain amount of  destabilizing influences occur.

One of these is chemical toxicity.  Most of us have seen the video of a growing neuron being exposed to mercury and quickly shriveling up and dying, ingeniously set to Peer Gynt Suite No. 1.  If you haven’t, make a note to perform an internet search for “neuron mercury”, you won’t regret it.  Our body uses powerful and efficient detoxification molecules to neutralize and excrete these toxins.  These molecules do take energy, and building blocks to make however, and ultimately our defense mechanisms can be overrun if we are deficient in the necessary nutrition for some reason.

Another common source of biochemical interference is the chronic / subclinical infection.  These are infections that are not addressed, because they don’t have any noticeable signs or symptoms like swelling, redness, and fever.   A good example of a common, true subclinical infection is that of an infection under a tooth which has had a root canal procedure performed on it.  I have referred many patients to their dentist / endodontist after finding an issue with a tooth, confirmed by a cavitation (bone being eaten away by an infection) found on X-ray.  More commonly though, they are overlooked because the patient claims that the symptoms caused by them are “normal”.  For example, the chronic head congestion, headaches, and pressure being caused by allergies, later found to be a fungal sinus infection.  Or alternating constipation and diarrhea caused being “the way it has always been”, later found to be an intestinal parasitic infection.

The problem with these infections is that they wear our systems down by being a constant drain on our immune system, and they require energy and nutrients to keep at bay.  They produce toxins which are inflammatory and short circuit our own biochemistry, and this wears us out.  For example bacterial lipopolysaccharide (LPS) is like gas on the fire of inflammation.

By finding and cleaning up intestinal infections and augmenting the detoxification systems of the body, we interrupt the cycle of inflammation and free up resources for the body to use in healing, and maintaining strong neural networks.

When a stressful event happens, the more emotion that is going on in the moment, the more likely it is to get wired into the brain.  For example, if you are petting a dog and that dog turns around and bites you, you might feel feelings of fear, surprise.  The degree to which you feel those feelings might differ based on the size of the dog.  A chihuahua might not cause you to fear for your life, but it might be a different story with a pitbull.  There can also be stimulus generalization, which means that if it was a fluffy white dog, then seeing a man with a fluffy white beard may trigger the same emotional response, even later in life.  This is the basis of PTSD, the more triggers, and the stronger the emotional response to those triggers, the greater the degree of debilitation.  Our inclinations, the things that we tend to like to do, or dislike doing can be influenced by emotions as well, even without our complete awareness in the moment.  For example, a near drowning experience as a child making the act of drinking and swallowing water uncomfortable, therefore they don’t do it and become dehydrated.

Disconnecting the emotional response from its trigger, we can free up energy in the nervous system by allowing people to respond to their lives the way that they want to.  This means more emotional neutrality around habits and lifestyle choices, which makes it much easier to break unwanted destructive habits, and start new functional and pleasurable ones.

Module 2: Optimize Metabolism

If the gastrointestinal system is inflamed, then your brain is inflamed.  This Gut-Brain axis is mediated via the vagus nerve, the 10th cranial nerve, which connects the brainstem with the heart, lungs, and gut.  In mouse studies, when the misfolded alpha-synuclein proteins (which are found in the brains of Patients with Parkinson’s disease) are injected into the gut, they end up in the brain and cause parkinsonian-like conditions in the mice.  When the vagus nerve is severed, this doesn’t happen and the mice don’t ever get movement disorders4.  One way to interpret this is that if you cut your vagus nerve, then you can eat whatever you want! While this would be beneficial in some ways, your nervous system wouldn’t be able to coordinate the functioning of your intestines.  The take home is that what you put in your mouth does have an effect on your nervous system.

Leaky gut, Leaky Brain no more. We remove pathogens from the gut, restore the normal conditions that optimize gut function, repair the lining of the gut, and re-inoculate the gut with beneficial microflora. These upgrades to the gastrointestinal tract both reduce the stress on the brain from excessive inflammation and leakiness of the gut brain barrier

And facilitate the absorption of the nutrients that the brain needs to function optimally.

Mitochondria are the organisms in the cell which produce cellular energy.  By burning sugar and fat and harnessing that energy by creating high energy molecules (ATP) that enzymatic processes at the cellular level.  These high energy molecules are used to repair DNA, protein synthesis, muscle contraction, and quite importantly, maintaining cell membrane potential in neurons.  Neurons use have pumps (which burn ATP) which maintain the concentration of positively charge ions more highly outside the cell, and negatives charged ions inside the cell.  This creates a net negative charge inside the cell, which is called the resting membrane potential.  When an excitatory neurotransmitter (or a drug for that matter) binds to a receptor on a neuron, this causes a channel to open in the cell membrane that allows sodium to flow into the cell, which “depolarizes” the neuron.  And once the neuron reaches a threshold of depolarization, the neuron is activated and sends its signal to the next neuron.

This turns out to be quite important because if your mitochondria are being interfered with, or don’t have what they need to turn sugars and fats into energy, then this resting membrane potential isn’t maintained to the same degree.  This means that neurons are more easily stimulated to send action potentials which can lead to over-stimulation of the brain.  This can be exacerbated by things like monosodium glutamate (MSG) in the diet,  and neuronal cell death due to brain trauma.  Both of these situations increase the amount of glutamate in the brain, which overstimulates neurons and causes them to fire indiscriminately.  This process is called excitatory neurotoxicity.

Enhancing mitochondrial function improves cellular integrity overall, but it also stabilizes our cell’s resting membrane potential, buffering our neural networks against the effects of chemical insults and physical trauma.

Water is the source of life, and it is our own internal water based fluids which bring nutrients and oxygen to our cells.  As if this fluid isn’t doing enough, it also carries waste products away from our cells, and transports immune cells to where they are needed to fight infection.  When we talk about the fluid dynamics of the body, we are talking about the cardiovascular and lymphatic systems.

The cardiovascular system is the heart and blood vessels.  The heart is basically a pump which pushes blood throughout the body into areas that it wouldn’t necessarily get to if it were to rely on gravity and osmosis alone.  If the heart isn’t health, or if the arteries are weakened or inflamed and clogged, then the perfusion of the brain suffers.  This means less oxygen and glucose and decreased function.  The extreme example of this is diabetes, where the nerves that bring in sensory information from the hands and feet end up dying because they aren't being perfused. This happens via the same process as above, and the indiscriminate firing of the neurons due to oxygen and glucose deprivation causes the tingling and burning neuropathic pain that come along with it.

The heart is also an electrical organ.  Its pacemaker initiates muscle contraction which spreads from the upper chambers to the lower chambers.  The electrical conductivity of the heart again depends on mitochondrial function.

The lymphatic system is the network which carries back the fluid that has left the cardiovascular system and gone in to perfuse the cells.  The lymphatic system that clears up the metabolic waste around neurons in the brain is called the glymphatic system.  If this system is improperly draining, congestion can result and metabolism slows down.

The flow of fluid carries the life force that feeds and nourishes our body and our neurons. Maintaining the electrical conduction through the heart, and the vessels that carry blood ensures a healthily nourished nervous system

Module 3: Re-Education of the Neuromuscular System

Most (~70%) of the sensory input that the body has to process and deal with comes from the physical body itself. This is called proprioception, and it lets the brain know what is going on with the joints, muscles, ligaments, tendons, and fascia. When proprioception is distorted by scars, dislocations, tendon tears, and injury patterns the brain’s map of what is going on in the injured area is different than what is actually going on there, which creates a discrepancy. This discrepancy must be accounted for (which takes processing power) in order for the brain to form a central understanding of the condition of the area. Also, when the body is injured, there is an automatic reflex pattern which is set up that doesn’t always go away (depending on what your brain is doing metabolically). Think of what happens when you touch a hot stove. Your muscles react with a withdrawal response before your brain even registers that what you are touching is hot. This is called the crossed-extensor reflex, and it can set up an injury pattern that doesn’t go away. This means your brain is running a pattern in the background as though the injury is still happening.

By clearing interference caused by injuries and scars, we decrease pain, increase range of motion, improve coordination, and make life easier by allowing the nervous system to go through life without having to adapt to all of the ways it has come under threat physically.

Module 4: Enhance Regeneration
Brain-derived Neurotrophic factor is a hormone which stimulates the growth and connectivity of neurons.  It goes without saying that we would want to increase the levels of this hormone by any means right?  You would be right, except that it is metabolically expensive to be growing new brain cells and getting them to connect together.  This is why this module is last.  If you are deficient in B vitamins and your mitochondria aren’t humming along producing ATP, other nootropic interventions won’t have as big of an impact. We can increase BDNF production through living well, doing things like socializing, meditation, fasting, and high intensity interval exercise.  There are also medical interventions that can do it. One of the most profound medical interventions that I have seen for improving the brain is Low Level Laser Therapy or Cold Laser therapy.  The low level / cold refers to the amount of power the laser unit emits, being a level that doesn’t heat tissues.  This is important because it is the wavelength of light that actually has the effect. Red light at 635 nm wavelength improves mitochondrial function by photo-biomodulation, making it easier for mitochondria to produce energy.  This overall can relax muscles, speed healing, repair DNA, reduce inflammation, and restore neuron function.  Laser therapy has also been shown to improve cerebral perfusion, increasing blood flow to the brain.  Increases in BDNF can be measured after exposure to LLLT, and they can reduce beta amyloid plaqueing and tau phosphorylation.  Ill say that again.  The neurofibrillary tangles and plaque formation that are responsibly for Parkinson’s and Alzheimer’s dementia symptoms are reduced with the use of LLLT over the brain! Another powerful intervention that we have available to us is ketamine therapy.  Ketamine acts on the brain by blocking the NMDA receptor, the same receptor that we mentioned earlier which glutamate binds to to cause nerve cell depolarization and excitatory neurotoxicity.  It also increases BDNF levels, which ultimately helps the brain to do new things.  So the way that I see ketamine treatment is that it is a great reset for the nervous system.  It temporarily stops the over activation of the parts of the nervous system that are over-excited, thereby stopping the momentum of the old way of neural processing.  It then allows the nervous system to grow and build new neural networks, which allows new momentum in a different direction to start.  Both of these actions together make it excellent for treating depression that is caused by chronic stress, PTSD, anxiety, addiction, and even complex regional pain syndromes that are neuropathically produced. The third major intervention that we have available is the NAD+ IV or intramuscular injection.  NAD+ is a derivative of vitamin B3, or Niacin.  NAD+ is one of the molecules that stores energy as it is liberated from the breakdown of sugars and fats.  It is also an enzymatic cofactor of the proteins that repair DNA.  Levels of NAD+ in the body decrease with age, and this can play a role in mitochondrial function, genome stability, and cell survival.

We leverage our modern understanding of light therapy, and stack those effects with medicines which improve our brain’s ability to grow and make new connections.

Just because your brain works a certain way now, doesn’t mean that it has to continue to work that way.  And if nootropics haven’t worked either, you might have not gone deep enough to get to the root of the problem with your cognition.
Dr. Evan

About Dr. Evan

Dr. Evan van Driel, BSc, ND is a Naturopathic Physician specializing in the treatment of trauma, mood disorders, and chronic pain. He graduated from Southwest College of Naturopathic Medicine in 2014 with a doctorate of Naturopathic Medicine and has since pursued post-graduate studies in neuro-emotional technique, muscle physiology, psychoneuroimmunology, and regenerative medicine, including certification from the International College of Applied Kinesiology and multiple certifications in injection techniques and the application of ozone.

Dr. Evan’s mission is to help people to be stronger so that they can handle more. By helping people to reduce pain, improve their mood, and re-wire their brains after trauma, Dr. Evan has noticed that people can be more themselves and show up differently in life. He sees the nervous system as innately intelligent, adaptable, and having a high degree of plasticity. Being able to leverage his knowledge of this fact structurally, biochemically, and mentally/emotionally means that what people experience doesn't have to be what they experience.

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