Table 1. Therapeutic System 1.0.
| Goal | Approach | Rationale and References |
|---|---|---|
| Optimize diet: minimize simple CHO, minimize inflammation. | Patients given choice of several low glycemic, low inflammatory, low grain diets. | Minimize inflammation, minimize insulin resistance. |
| Enhance autophagy, ketogenesis | Fast 12 hr each night, including 3 hr prior to bedtime. | Reduce insulin levels, reduce Aβ. |
| Reduce stress | Personalized—yoga or meditation or music, etc. | Reduction of cortisol, CRF, stress axis. |
| Optimize sleep | 8 hr sleep per night; melatonin 0.5mg po qhs; Trp 500mg po 3x/wk if awakening. Exclude sleep apnea. | [36] |
| Exercise | 30-60′ per day, 4-6 days/wk | [37, 38] |
| Brain stimulation | Posit or related | [39] |
| Homocysteine <7 | Me-B12, MTHF, P5P; TMG if necessary | [40] |
| Serum B12 >500 | Me-B12 | [41] |
| CRP <1.0; A/G >1.5 | Anti-inflammatory diet; curcumin; DHA/EPA; optimize hygiene | Critical role of inflammation in AD |
| Fasting insulin <7; HgbA1c <5.5 | Diet as above | Type II diabetes-AD relationship |
| Hormone balance | Optimize fT3, fT4, E2, T, progesterone, pregnenolone, cortisol | [5, 42] |
| GI health | Repair if needed; prebiotics and probiotics | Avoid inflammation, autoimmunity |
| Reduction of A-beta | Curcumin, Ashwagandha | 43-45 |
| Cognitive enhancement | Bacopa monniera, MgT | [46, 47] |
| 25OH-D3 = 50-100ng/ml | Vitamins D3, K2 | [48] |
| Increase NGF | H. erinaceus or ALCAR | [49, 50] |
| Provide synaptic structural components | Citicoline, DHA | [51]. |
| Optimize antioxidants | Mixed tocopherols and tocotrienols, Se, blueberries, NAC, ascorbate, α-lipoic acid | [52] |
| Optimize Zn:fCu ratio | Depends on values obtained | [53] |
| Ensure nocturnal oxygenation | Exclude or treat sleep apnea | [54] |
| Optimize mitochondrial function | CoQ or ubiquinol, α-lipoic acid, PQQ, NAC, ALCAR, Se, Zn, resveratrol, ascorbate, thiamine | [55] |
| Increase focus | Pantothenic acid | Acetylcholine synthesis requirement |
| Increase SirT1 function | Resveratrol | [32] |
| Exclude heavy metal toxicity | Evaluate Hg, Pb, Cd; chelate if indicated | CNS effects of heavy metals |
| MCT effects | Coconut oil or Axona | [56] |
CHO, carbohydrates; Hg, mercury; Pb, lead; Cd, cadmium; MCT, medium chain triglycerides; PQQ, polyquinoline quinone; NAC, N-acetyl cysteine; CoQ, coenzyme Q; ALCAR, acetyl-L-carnitine; DHA, docosahexaenoic acid; MgT, magnesium threonate; fT3, free triiodothyronine; fT4, free thyroxine; E2, estradiol; T, testosterone; Me-B12, methylcobalamin; MTHF, methyltetrahydrofolate; P5P, pyridoxal-5-phosphate; TMG, trimethylglycine; Trp, tryptophan