Mycotoxins & Chronic Infections Impacting Cognitive Function

Heather Sandison, N.D.

Oh, thanks. It’s so good to see you always, and a pleasure to be included on this summit. I created Marama after having pretty, a surprisingly good clinical experience with dementia residents. You and I both, we were told by very well-meaning instructors at Bastyr, that there was really nothing that we could do for a patient suffering with dementia. That we should tell them to get their affairs in order and never to give them false hope. And then when I was trained by Dr. Dale Bredesen, you know many years later, I saw very quickly in my practice that they were wrong. And that in fact, you could be reversing cognitive decline and pretty regularly. If patients had the right support then, and we did the right things, if we got rid of the toxins, we got rid of the chronic infections. 

Many of the things that you’re discussing here on this summit, if we could get rid of those things that were mucking up the system and put in the good support, the good nutritional support, everything that the cells, not only the human, the individual, but the individual cells needed to optimally perform. Then we could see a reversal of cognitive decline and improved cognitive function, independence, all of the things that we want, that we hope for. And we sort of hide from and assume that it’ll never happen to us, when we think about aging. All of those things that we can really have this optimal seventh and eighth and ninth decade. So what I sort of alluded to there was that in my clinical practice, the people who got better had support. 

They were able to implement a new diet, detox protocols, getting in for IVs. Doing all of the things that were necessary to get them to heal, they were able to do it. And as you might imagine, someone with dementia, I mean, it’s just hard to get your bills paid, and can’t say on top of life, let alone take on all of these new lifestyle practices. So I created Marama just in seeing that those who couldn’t implement didn’t get the benefits. And Marama, the basic idea there, is it’s a residential care facility, where patients can come and have an immersive full experience of the Bredesen Protocol. So we include an organic ketogenic diet, good high quality filtered spring water. 

So there’s not toxins in the water, in the food, but also not in the environment. So it’s a non-toxic environment, everything from the mattresses to the linens are organic cotton. We also have air filters running because, although we’re not close to a freeway or a highway, like many people are, we are in Southern California. And there are things like wildfires that happen, things that we just can’t control. And so we aim to keep that particulate out of the air, so that’s not accumulating in our residence. We also have really engaging and engaged staff. So we have our ratios are quite high. We have lots of staff per resident because anyone who’s been around somebody with dementia, knows it’s easy to get distracted. 

And it’s easy for things to feel hard. And that’s a little bit of what we want, right? Like every time you do Sudoku, every time you do a puzzle, it’s like bicep curls for your brain. We want that, but you don’t always feel like doing it in the moment. And so having that engaged staff that keeps people participating, keeps people like on the bike, going that extra minute, pushing a little bit harder. That’s where we really see the benefits. We also have a garden on site. The basic four pillars, the way that I typically describe it its a non-toxic environment, a ketogenic diet, an organic ketogenic diet, so the kitchen and we flex off keto sometimes, it’s not appropriate for everyone to stay there forever. But the kitchen, the environment, the activities. So we have a, we call it the Casida, or our routine or our circuit and the Casida. 

We have red light therapies, excuse me, contrast oxygen therapies, a rowing machine, a bike, the patients go on long walks, and accompanied by caregivers, keeping them going again, keeping them motivated. And then we have, what else is down there? There’s a BioMAT we just have, I think you guys also have like a room full of devices and a room full of devices is at Marama. All the residents use it. It’s five to six days a week. And then the fourth pillar of Marama is our staff just being really well trained to know how to redirect someone and also to expect them to get better.

Oftentimes, you know, as humans, we will rise to the occasion, right? So when, if someone expects us to do really well, if someone expects us to heal, then we do. And typically when someone moves into a residential care facility, they go downhill. And part of this is because, you know, there’s a change in environment and our residents when they, they move in, there’s usually about three, four weeks of adjustment where it’s a little rough, but when someone moves into conventional memory care or senior living, there’s often cake and cookies and pasta for dinner and cereal for breakfast and a sandwich for lunch. And this is the antithesis of a brain healthy diet, right? We want vegetables and good fats and good proteins. And that is really what our brain needs in order to heal. So when our staff, now they’ve seen many residents go through this process and they’ve watched them learn to remember names, learn to write again, you know, really phenomenal and miraculous things happen over there. And having the staff expect that is I think, a big part, a big key to the sort of what unlocks this potential.

Nafysa Parpia, N.D.

I love that you bring up so many important points. So first of all, about expectation when, human beings are like this, right? When somebody has that expectation of us, someone else believes in us, we begin to believe in ourselves. Even if the person doesn’t have the cognition to be able to think about that, there’s something, something in the spirit that recognizes that, and does rise to the occasion. I’ve seen that so many times. It’s so, so beautiful. Whether it’s regarding cognitive decline or, or anything really. I find when somebody, when somebody believes in us, we rise to that. The other thing is about diet. It’s so true, right? Even in hospitals, when people are trying to heal, they’re given mac and cheese and gluten and sugar and all kinds of inflammatory foods. And, of course, foods that affect brain inflammation. 

So I’m just so happy to know that Marama is doing the opposite. You’re bringing people nutrient dense food, anti-inflammatory foods, foods that are going to help set the foundation for everything else you’re gonna do for cognitive decline for the patients. Most people think that including, as you mentioned, our teachers from our past, so not only in, general naturopathic, general functional medicine, general primary care in general, you know, people think that if you have enough sleep, and diet and stress is, is managed, you know, there shouldn’t be cognitive decline. 

I’ve got my diet, right? I’m eating paleo or a Mediterranean diet. And I have all these techniques to manage my stress. I meditate, or I do acupuncture, or I have a therapist, or I have healers. I’ve done all the right things. Why am I still, why do I still have this brain fog? What’s going on? So what I wanna bring to light today with you is that, it’s not just about diet and lifestyle. There’s so much more. And I know that that clinically, we both work on this, and I know that you’re bringing this to your clients at Marama. Let’s talk, more about that beyond diet, lifestyle, stress.

Heather Sandison, N.D.

Yeah, so Marama was an answer to the lifestyle piece. So at Marama, we are by definition, residential, not medical. And then at Solcere, Solcere is the clinic that I founded. And this is where we do those deep dives into the why. And you mentioned it, it’s like, oh, wait, I’ve been doing the lifestyle right. I’ve been doing everything they told me, why do I still suffer? And so I do think there’s an 80-20 here though, and I, I will say, there’s lots of people that don’t need me. They can just get the Bredeson book and they can live the lifestyle at home. And, many people actually show up in the clinic after having done that and gotten benefit, but they want more, they want optimization. And so this is what we can do on the clinical side. This is really diving deep into, okay, what, and I like to get structured here, right? Because it can very quickly feel overwhelming.

Nafysa Parpia, N.D.

Right.

Heather Sandison, N.D.

So first I start with toxins, because if toxins are in the way, they are going to mess up cell function and mitochondrial function. They are going to deplete you of nutrients because you have to, you have to sort of like switch gears and focus on getting the mercury out, or the microtoxins out, or the chemicals out, instead of focusing on growing, right. If we are, the way Dr. Bredesen says it so well, he says like, if it’s your, my brain is done, right. Think of your brain as a country. If your brain is putting resources into fighting something off or cleaning something up, then it’s not able to put resources into growing and learning and thriving and building and creating. And so what we wanna do is shift the, the signaling. We wanna shift the whole pattern from that defensive, or threatened, or fighting kind of perspective to the growing and thriving. 

And so the way we do this again, it’s very sequential. So we start with toxins, we figure out what are the toxins there? And I think of them in three flavors. So mycotoxins, I know you’re talking a ton about, I have had the pleasure of working with Dr. Neil Nathan for a long time, and then also learning from Ritchie Shoemaker. And then of course, learning from all of my incredible, brave, inspiring patients for over many years and watching what works and what doesn’t for them. So mycotoxins are a really big deal. And I talk about them first with dementia, because I think that they, I would say from my perspective, they are one of the easiest to treat and the most like underdiagnosed issue that comes up with dementia, right? 

If you live in a moldy home and you’ve been exposed to mycotoxins and you have brain fog or cognitive decline, this is an easy, quick, simple place to start. And then I wanna know, is there heavy metals, are there heavy metals? So mercury is 10 times more neuro toxic than lead. Mercury is one of those really, really big ones. And in this day and age, you know, with the patients I’m seeing, they have significant mercury exposure, lead is mostly a thing of the past. I see this in my elderly patients, of course, and in people who lived overseas where leaded fuel was still a thing into the eighties. And even sometimes into the nineties, that was still an issue, leaded paint as well. But in the US most people who, you know, didn’t spend a ton of their time being exposed, they’re doing okay for lead. 

That’s not a hundred percent of the time, but for the most part, mercury on the other hand, there’s more of it in the fish and the, the metal amalgams people get such mixed information about that. I see it over and over again. If there are amalgams in your mouth, I recommend getting them out. Again, mercury is so directly toxic to the brain and Mad Hatter’s disease for anybody who hasn’t, isn’t familiar with that, right? The hatters used to use mercury with the felted hats, and it would drive them crazy, drive them to suicidality, depression, anxiety, which of course is rampant in our society. And if mercury is part of the issue we wanna know about it and get rid of it.

Nafysa Parpia, N.D.

Yeah. So I wanna talk a little bit about mycotoxins and metals.

Heather Sandison, N.D.

Oh yeah.

Nafysa Parpia, N.D.

I’m so glad you bring up these topics together because so often I’m seeing them together. So, we know that mycotoxins can affect the brain in so many ways, right. They induce mitochondrial dysfunction, which, you know, has been found to be connected with cognitive impairment. Mycotoxins interact with the neuro immune axis, which is the axis where there’s certain signaling molecules that link the immune system with the central nervous system. So now we’ve got, mycotoxins activating this axis, activating along this axis, triggering mass cell activation syndrome, causing cytokine flares. And then they impair neuronal plasticity. So now people have issues with learning, and with memory, and they compromise the integrity with the blood brain barrier. So we’ve got that. And then we have, very often mold, in the sinuses, creating mycotoxins as well. Again, they can cross a blood brain barrier and cause inflammation. So we’ve got mycotoxins and molds, which can directly affect the brain in all of these ways. And you’re so right, Heather, it’s one of the easiest things to treat. And one of the most overlooked that’s-

Heather Sandison, N.D.

Yeah.

Nafysa Parpia, N.D.

People aren’t thinking, most functional medicine doctors are not yet thinking, they’re going to be soon, I think about the sinuses.

Heather Sandison, N.D.

Right?

Nafysa Parpia, N.D.

Toxins.

Heather Sandison, N.D.

Yeah, let alone conventional doctors, which is where most people are being seen for brain fog and low energy and cognitive decline.

Nafysa Parpia, N.D.

Exactly, and then as far as metals go, I’m seeing a lot more mercury in people. Also, particularly since the fires in California, I’m talking about my, my patients from California, more mercury, but I’m also seeing more arsenic.

Heather Sandison, N.D.

Arsenic, yeah.

Nafysa Parpia, N.D.

And aluminum. As well, and so I’ll test their metals in their blood, in their urine, unprovoked first, just go to Lab Corps, get those tests done. And then in the past, I’d say, okay, do a fish fast now. And let’s retest. And then one month later, after a month long fish fast, they come and the mercury levels are lower. Nowadays, even after fish fast, I’m not-

Heather Sandison, N.D.

It’s not coming down.

Nafysa Parpia, N.D.

No, or just-

Heather Sandison, N.D.

Yeah, I really like the IMD product from Quicksilver. I see that work really, really well. And so that’s what I use. It’s quite accessible. We used to use IV chelation. I have just moved away from it a bit because I see the IMD powder working quite well for people. It’s easy to do at home. It’s risk free. It’s really affordable, especially compared to weekly IVs. And so, you know, I think that’s the other piece with looking at mercury one, the potential risk is so high and it’s relatively simple to get rid of. I do recommend also avoiding, especially tuna ahi, swordfish, shark, of course, any of those big pelagic predators are gonna concentrate that mercury up the food chain.

Nafysa Parpia, N.D.

I did some testing on patients with mercury and eating only salmon. So just testing in the clinic with about 10 patients. So not a real clinical trial, but just some, just some clinical pearls I was looking for. So I had people eat salmon twice a week for a month, test their mercury, and then stop eating salmon for a month. Test their mercury, this was, it was between fire seasons, actually. And I noticed that even with only salmon, mercury came down. Now salmon’s supposed to be a fish that’s not supposed to be very high in mercury. So I’m telling people, you know.

Heather Sandison, N.D.

Even salmon has a little bit in it. No, that’s so demoralizing.

Nafysa Parpia, N.D.

I know now, even though I also just said I’m not seeing the mercury levels come down so much after, after stopping fish at all. It’s because it’s everywhere now.

Heather Sandison, N.D.

Right? It’s so ubiquitous. Yeah and this is why I think a lot of these naturopathic ideas and tenants of, of just healthy everyday detox, right? Making sure you’re sweating. And this is why exercise is so critical, drinking enough clean, filtered, spring water, getting some vibration or some lymphatic movement, maybe a massage, something to just keep things moving is so important.

Nafysa Parpia, N.D.

One thing I notice is-

Heather Sandison, N.D.

That having a bowel movement every day.

Nafysa Parpia, N.D.

Exactly, that sometimes we try to detox people, but they’re just not ready in the ready at all. We have to do what I call a pre-tox, support the system, get them ready for detox. I like to begin with detox first as well, but with our patients, they’re not necessarily coming to us only for a cognitive decline, but they’re coming for complex chronic illness, meaning tickborne disease, mold, mycotoxins, autoimmune conditions, chronic fatigue syndrome, fibromyalgia, those illnesses is what they’re coming to us for. But there is cognitive decline along with it. Probably not, not as deep as in your patients, Heather, but our patients are having brain fog along with all these other illnesses that they come to us with you know? And-

Heather Sandison, N.D.

Yeah, well, you know, the lyme spirochetes. So like when we talk about infections, so I start with toxins and I again, I think of them in three flavors, mycotoxins, heavy metals, and then chemical toxins. Then we wanna understand nutrients and not just like, okay, do you, are you vitamin C deficient that you have scurvy, or do you have so much sugar you have diabetes. But what is your methyl B-12 level? What is your homocystine level? Do you have enough to functionally be able to metabolize the crap coming in the good stuff coming in and then get rid of the excess, Can you get rid of what doesn’t serve you efficiently so that you can keep optimal cell functions? So nutrients we wanna understand, but not from like an RDA, like a recommended daily allowance perspective, but from an functional, optimal kind of perspective.

Nafysa Parpia, N.D.

Exactly-

Heather Sandison, N.D.

So toxins and then nutrients. Structural issues can be an issue. So in terms of how I organize myself, right? I think a lot about cognitive function, but I like you, I think, you know, this is sort of the brain and you can’t separate, you can’t cut the head off, right? Like the brain is not separate from everything else. So we’re treating the whole body. And I would say that dementia is just one of these complex chronic conditions that we can use this same structure for, the same model for, in terms of figuring out what’s on. So toxins, nutrients, and then structure. You need enough blood going to the brain. You need enough blood coming out of it. And this includes all of the signaling hormones, right? 

So our, our hypothalamus and pituitary, they send signals to our thyroid, our adrenals, our ovaries, our testes, to our pancreas, to all of our glands. And then also the nervous conduction, right? We, we need to be able to get that signal from our, the tips of our toes, up to our brains. And so if those things aren’t happening because our neck is kinked or our posture is really off, then that is going to inhibit good information, getting both in and out. And then, so toxins, nutrients, structure, stress. We all know someone who has gotten sick from stress. We’ve all been stressed and known that that is probably been part of what made us sick. 

So in understanding our relationship with stress, we all have it. And we’ve probably, I’m sure you’ve seen heartbreaking situations happen to someone. They lose their parent, or God forbid, they lose a child, and watching two people go through relatively similar situations and one person makes it like their life’s purpose to make that the best thing that ever happened to ’em no matter how horrific it was, and the other person just crumbles under it. And we wanna be that resilient person that, our relationship with stress is something transformational. That it’s something that we see as a gift at some point versus something that just crushes us. And whether that manifests as a chronic illness, or something else. Then lastly, I put infections. So I know you’ve already mentioned lyme in the context of dementia, lyme spirochetes come when you dissect the brain of someone with dementia, lyme spirochetes are associated with beta amyloid plaques, as is herpes simplex as is the P. gingivalis. So the oral health is really critical in terms of dementia, but really, I mean, health starts in the gut and the gut starts in the mouth, right?

Nafysa Parpia, N.D.

That’s right.

Heather Sandison, N.D.

Cannot overlook oral health, but with dementia P. Gingivalis, one of the bacteria that gets into cavitations, into abscesses, into root canals, that, I think, because of the proximity anatomically, they’re neighbors, but also just because that happens to trigger more inflammation in the brain, this is a really important one as is Lyme. Like you’ve already mentioned. And the sinus infections, again, proximity allows for a lot of exchange between the brain and the sinuses. And we don’t have that same blood brain barrier when things are kind of crawling up the olfactory nerve. And so really, really important to be aggressively treating those things, not too aggressively to push anybody over the edge.

Nafysa Parpia, N.D.

Yeah.

Heather Sandison, N.D.

Working with a great doctor like yourself, who can say, okay, here are the steps. Let’s do this in a way that’s healthy and sustainable for you. And let’s get to a finish line.

Nafysa Parpia, N.D.

Absolutely. And the structural integrity piece is super important. I love that you bring that up. So a lot of our patients we notice are having CCI, Cranial Cervical Instability. They have ehlers danlos syndrome, or they’ve got some version of something like it, a lot of hyper flexibility. And so we include that as part of the structural integrity, in addition to, to anything else that’s out of alignment. But what we also know is that mass cell activation syndrome also worsens issues with, with lax ligaments. And so the mass cells send out histamine and a repertoire of a thousand other chemicals. Right now, those chemicals are they’re important when we’re under a stress. So there’s the initial stress reaction, our body’s response to it, it’s important. 

Inflammation is an important part of the healing response, but we get stuck in a pattern of inflammation or stuck in a pattern of our mass cells, sending out a thousand chemicals, not just histamine. And while those chemicals tenderize the ligaments, they tenderize the brain stem. And so that’s what makes our patients even sicker. We know mass cells exist in the brain as well. So I noticed that once I treat mass cells, in fact, that’s one of the things I treat first as well, while I’m doing detoxification, their pain changes, they do begin to have a better memory. The cotton wall that they feel is in their brain begins to calm down. So it’s important. And there’s so many ways to, to address a structural integrity by treating mass cells, by having body work done by having healing work done, and actually send people to, to a functional neurologic chiropractor as well, who I’m gonna be interviewing later on. That’s very helpful.

Heather Sandison, N.D.

Very helpful, yeah I would agree.

Nafysa Parpia, N.D.

And then, the infections, not just tickborne disease, not just mold, but like you’re saying viruses, parasites, are a big one I’m finding, so of course there’s a gut-brain connection that’s very, very important as it comes to, as it relates to parasites, fungus’s is in the gut, other infections in the gut and then the infections in the sinuses. So we’ve got this whole conglomeration of bugs and toxins that we’re looking for, in addition to, the structural integrity, and how it all manifests with respect to epigenetics and biochemical expression and just what the individual’s tendencies are. There’s certain things I tell my patients, you know, I can’t measure this in a lab like I can measure your genes. I can measure your biochemicals. I can measure your nutrient status, your toxins, but I can’t measure your will. Can’t measure your resilience. Most of my patients are, are resilient. They have so much will. They’re so inspiring. They go through these treatment plans that are hard. That can be like a full-time job because they’re so sick. And so to speak back to what you were talking about, having that resilience.

Heather Sandison, N.D.

So key. And that, that I feel like is part of my job, right. Is to help and guide that patient into having more resilience. That’s the sign we’re going in the right direction, It’s not, it’s not just that hemoglobin A1C number. It’s not just those lyme labs. It’s that ability to respond to the environment because that’s what’s lasting. And that could be even a definition for health is like, how adaptable are you? How flexible are you in the face of stressors from the environment? If it’s hot, if it’s cold, do you have tolerance to that? If you fast for a couple days, do you have tolerance to that? And so this really is ultimately the goal. And I think that’s also, again, that’s the path or the key towards a longer, healthier life.

Nafysa Parpia, N.D.

Absolutely. Let’s talk about a comprehensive approach, to cognitive decline. Tell us about your treatment plans.

Heather Sandison, N.D.

Yeah, so that was a little bit of what I was describing is like this model that what we do is we say, okay, let’s measure the degree of toxicity. Let’s measure where your nutrients are. Let’s measure, you mentioned guts. Like, let’s understand what’s going on with your gut, because you know, the sad part is like if we ever disconnected the gut in the brain. Right. I know we all, we all talk about the gut brain connection, but it’s like, wait a minute. Like our hip bone’s still connected to our leg bone. Like everything is still interconnected.

Nafysa Parpia, N.D.

I like the analogy, you know, once Eric, Dr. Gordon, was saying to a patient and I love it, I take it with me. We’re not a salad. Like here’s a tomato, here’s some lettuce, here’s some avocado and some cucumber, the body doesn’t see it like a salad, but it’s more a soup. And so that our whole body sees it as a soup. It’s connected, the inflammatory cytokines from here, come from there. I’m just pointing to my gut right now, or from lymphatic. clogging over here. So, it’s all connected, but we, humans need to put things into categories. So we say, okay, that’s the brain. And, and it functions on its own, and here’s the thyroid, it functions on its own. So it goes to the endocrinologist, or the thyroid, go see a cognitive expert who focuses only on the brain, only on the brain, right. Whereas the approach is whole body integral. And that’s where we see the changes.

Heather Sandison, N.D.

Yeah, definitely. And I think that part of the reason why conventional medicine has gotten it so wrong in the case of dementia is, of course, there’s lots of different paths that we can take to that same diagnosis, because the diagnosis really just describes the symptoms. It doesn’t tell us about the why. And so again, this just goes back to the model, and this is why I was so attracted to Dr. Bredesen’s work is that he says, he is like, unapologetic. You don’t need to just look at hormones. You need to look at toxins and nutrients and hormones and infections. Like if we’re gonna have a reasonable conversation, if we have a reasonable chance at fighting this impossible disease, this absolutely awful disease and the ones that you’ve listed as well, right? This is all part of that continuum of complex chronic conditions that are very much lifestyle mediated. But then like when things get outta balance, it starts to perpetuate, right? 

Like when, when there’s that toxic burden like CellCept, for example, you were talking about microtoxins and all of the impacts that they have, but mycophenolic acid is one that’s easy to test, right? We can get this on a Great Plains Lab. And that is actually a medication that they put into a pill called CellCept. And it’s used for autoimmune diseases to suppress, to aggressively suppress the immune system. So in small amounts, a lot of these toxins, as they build up, they start to suppress the immune system. And then you have infections that maybe in your twenties, you could have fought off. Maybe if you weren’t under so much stress, if you weren’t juggling two jobs and three kids and whatever, and a divorce or whatever it was, you know, if you didn’t have the toxic burden and you didn’t have the stress, then if you had been exposed to a couple parasites, you would’ve been okay, but here we are. And you know, you’re going through menopause and it’s not okay anymore. We’ve got to give you to give you a fighting chance. 

We need to look at the whole landscape and understand what are all the things you’re fighting. Let’s get rid of them and then support with all of the other great interventions, whether it’s craniosacral therapy, like you mentioned, like body work and calming the nervous system. Whether it’s suppressing mass cells for a little while, while we get that neural reprogramming done, and all of those things are just really critical. And it sounds like you guys do. I mean, obviously you guys do a phenomenal job putting these things in the right order, making sure that you’re not detoxifying too quickly at the beginning doing what a patient is capable of, and what’s gonna work for them and making sure that they’re supported the whole way through a process.

Nafysa Parpia, N.D.

Yeah. It’s very, very important. I tell my patients that I’m watching you like a hawk. I’m monitoring you. We’re on this journey together. I’m not just telling you here, do all these things, and then you go do them. No, we’re in this together because there are so many steps and timing is critical that if you do one thing before another, it can backfire. And so we have to understand the timing for each patient. Usually there’s a tempa. I wanna start to bring inflammation down first. I wanna start to work on immune modulation first. Usually I’m doing that with peptide therapies. If they’re really sick, I’m not even going to detoxification yet. I’m beginning to work on structural integrity, neuroplasticity, and then coming in and detoxifying, and we’re layering all these treatments together. 

Then I’m gonna come in and start to treat infections. A lot of times people are gonna wanna treat the infections right away. And I say, if we do that, I’ve seen from experience. You’re not quite ready for that. And the patient says, “Oh yeah, that’s true. “I’m not, I know I’m not ready to kill infections just yet.” ‘Cause we have to, we have to prepare you for that. Get you ready for that army, for that. It takes a lot of work on the patient’s part, on my part. But at the end of the day, when people are better, they’re so happy they did it. And then they have this, they see this, this silver lining, like, you know what, that was the best thing that ever happened to me. It was so horrible while I was sick. But now I’m a better human being and I’m more productive than when I first began.

Heather Sandison, N.D.

And a much better understanding of their bodies, how they work, what health really means.

Nafysa Parpia, N.D.

Absolutely. Tell us about the state of research on dementia.

Heather Sandison, N.D.

Yeah. Great question. So what has typically happened, right, so the there’s sort of this triangle, if you will and, the penultimate sort of best studies, what most people will point to, is a double-blinded placebo controlled trial of usually one intervention, a single molecule is really best because that can be patented. And then there’s a drug company that can make a bunch of money off of it. So obviously this approach is not conducive to a double-blinded placebo controlled trial of something that can be patented. This is very much a lifestyle approach. It’s very integrative, it’s very individualized. 

And so until about four years ago, the IRBs, these are the Internal Review Boards, who basically approve human research studies. This comes to out of a long history of people, basically prisoners and people of color being taken advantage of and used as human research subjects without their consent. And so this is very important. I’m really glad that IRBs do this, but they basically, their job is to make sure that any human subjects in a trial are treated fairly, that they’re fully consented. They’re fully informed when they decide to join a trial. And so the IRBs, until just a handful of years ago, they would not approve trials that had this many variables. And so it was just literally like four or five years ago, that Dr. Bredeson got a trial approved. And then I was very fortunate to get a grant to study another 25 participants. They studied 25 participants and they published last June. And then we’ll probably be about one year behind them. 

COVID slowed everything down, but we’ll get another 25 participants out there. And these are feasibility trials. So there was no control group. And of course, when you’re asking people to change their diet, to start exercising, to take a bunch of supplements, to, you know, manage their stressors, maybe see a therapist or get a health coach, all of these things, you can’t blind this, you can’t fully control this. But the feasibility studies showed us that, yes, in fact, people will do it. And Dr. Bredesen’s trial was published. Like I mentioned in June and 74% of participants in his trial doing what I’m describing here today, reversed their cognitive decline. 

So Dr. Bredesen took, and in their trial, Kat Toups, and they’re actually up in the bay area, very close to you. Ann Hathaway, Deb Gordon and Kat Toups, all working with Dr. Bredesen. The three docs were Ann Hathaway, Kat Toups, and Deb Gordon were the three clinicians who saw patients and then Dr. Bredesen was kinda overseeing the whole trial. So, they, again, feasibility trial, we see that it can work. And even in, they were also doing their trial during COVID, at the beginning of COVID. So people are interested, they are capable, they are willing to do the work that it takes to reverse dementia. And it can, we can get it to happen. 76, 74%, oh, it’s about 75% of the time.

Nafysa Parpia, N.D.

I love there’s a number to that. I love that. I love it. ‘Cause we see it happen. And there’s research now.

Heather Sandison, N.D.

Well that was the problem before, I would have patients come into my office, or the daughter, the son, or the spouse and say, “Hey, look, this is a lot of money. “And this is a lot of time and effort. “If I’m gonna do this, “how likely is it that my loved one’s gonna get better?” And I didn’t have an answer. So that was why I was so excited to do the trial in my office and we’ll publish the results this year. And that’ll be really fun and exciting. And then the next step, and Dr. Bredesen has already started this, is a controlled trial, as controlled as we can get, but essentially what it’ll- I believe that they’re doing a hundred participant trial, and I think they have five sites. They are taking a subset. They will just follow the natural history of the disease. So they won’t be doing all the testing that we’ve discussed. They won’t be looking for toxins. They’ll do some interventions, some education probably around, I don’t know exactly their trial design, but certainly as we are looking at our follow up trial, what we’ll wanna do is give people, at least education. I think ethically, I wouldn’t be able to enroll people and then say, just get on the conventional drugs and see a neurologist. Like we know there’s so much that you can do.

Nafysa Parpia, N.D.

Oh exactly.

Heather Sandison, N.D.

You would really wanna support people in at least the lifestyle pieces and maybe leave out the medical pieces as the control. So I’m sure Dr. Bredesen’s doing something like that. And then what it’ll be nice for all of the participants, is after they do about six or nine months, they’ll be on a crossover. So they’ll go into the active study group. So they won’t be in the control anymore. And they’ll get the benefit of all of the testing, all of the treatments, all of the interventions. So I’m really looking forward to seeing what that looks like. And I hope that this type of trial, you know, very much patient centered outcomes, we are looking for. We’re not looking for changes in the amount of beta amyloid plaque, because that has not been shown to help with cognitive function. 

So you can reduce beta amyloid plaques. And that typically if you have a drug, drugs, do that, they do that effectively. But typically when you do that, the cognitive function gets worse. There’s even a JAMA paper showing from, I think 2019 that shows that Aricept and Namenda, people who are on them actually have worse cognitive function. So the best drugs out there that you might get from a neurologist or primary care provider, actually, even though they’re prescribed for people with dementia, they make cognitive decline worse. So now caveat.

Nafysa Parpia, N.D.

I don’t think people know that so-

Heather Sandison, N.D.

Yeah people don’t know that. Caveat though, really fast. I wanna say, do not come off of yours if you’re on this, because what happens is it’s a precipitous decline. So when you have those SCO cholinesterase inhibitors in the system, you do not want, it’s like going cold turkey off of a benzo. You’re really gonna disrupt the neurotransmitter. So even though I don’t recommend that patients get on them, I also don’t recommend that they get off. So I just wanna be clear about that before anybody goes and stops taking theirs.

Nafysa Parpia, N.D.

Yeah, that’s really important. I just wanna reiterate that. And also that we’re not giving medical advice here at all. But we’re giving information for you to go and take back to your doctor. So if you do have cognitive decline, and you’re not yet on a medication, you wanna ask your doctor to consider other methods, such as what we’ve talked about here, you probably need to find us or someone like us to help you with that. And just to reiterate what, what Dr. Heather was saying, if you are on a medication for Alzheimer’s or on an SSRI, please, please do not yank yourself off of that. If you wanna come up.

Heather Sandison, N.D.

Right, no, it’s very important to work your doctor. Everybody’s a little bit different and, and it really, the literature’s out there. So what I would encourage more than anything is go in armed with the information and then have the conversation with your doctor.

Nafysa Parpia, N.D.

Exactly, exactly. Well, thank you. Thank you Heather.

Heather Sandison, N.D.

Of course. It’s always such a pleasure.

Nafysa Parpia, N.D.

Yeah always. I’m so happy you joined us.

Heather Sandison, N.D.

Thank you.

Nafysa Parpia, N.D.

Yeah.