Alzheimer's

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Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

The medical journal Neurology has reported that people who carry a gene that's associated with Alzheimer's disease may lose their sense of smell long before memory and thinking problems occur.

The specific gene reported in this paper is called APOE e4. 

You can order APOE Alzheimer's Risk from Labcorp. The code is: 504040

Testing a person's ability to detect odors may be a useful way to predict future problems with cognition.

The study from the Neurology journal surveyed more than 865 people about their ability to detect an odor and identify what they were smelling. Tests were given over five years. Those with memory or thinking problems were tested twice, five years apart. The investigators also took DNA samples.

People who carried the gene variant (APOE e4) for Alzheimer's were 37% less likely to have good odor detection than people without the gene, the researchers found.

Those with the gene (APOE e4) experienced reduced smell detection from age 65 to 69. 

People with the gene variant (APOE e4) did not show a difference in the ability to identify what they were smelling until ages 75 to 79. Once the ability to identify odors declined, it declined faster than in those who did not carry the gene.

At the start of the study, thinking and memory skills were similar among the two groups.

Unfortunately, the researchers concluded that thinking skills declined more rapidly among those carrying the gene variant than among those without the gene.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

References:

https://www.nia.nih.gov/news/loss-smell-linked-alzheimers-cognitive-impairment-and-biomarkers
https://practicalneurology.com/news/loss-of-smell-may-predict-alzheimer-disease-and-dementia
https://jnnp.bmj.com/content/70/6/739
https://news.uchicago.edu/story/rapid-loss-smell-predicts-dementia-and-smaller-brain-areas-linked-alzheimers

Compliments from Functional Medicine University www.FunctionalMedicineUniversity.com

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

Here is yet another reason to be super compliant in taking care of your teeth and that is for the prevention of dementia.

A study published in the Journal of Neuroinflammation has found that periodontal (gum) disease leads to changes in your brain's microglial cells.

What is the function of the microglial cells in the brain?

Microglia can be generated from white blood cells known as monocytes that circulate in the blood and are responsible for the elimination of microbes, dead cells, redundant synapses, protein aggregates, and other particulate and soluble antigens that may endanger the Central Nervous System

These are white blood cells that defend the brain from amyloid plaque that is associated with cognitive decline.

Unfortunately, when a person has gum disease microglial cells stop being able to digest amyloid plaque leading to neuro-inflammation in the brain.

Further studies convincingly revealed similar conclusions:

A study performed by the NIA Intramural Research Program team using publicly available data from the National Health and Nutrition Examination Survey (NHANES), a large population study performed by the CDC's National Center for Health Statistics examined whether gum disease and infections with oral bacteria were linked to dementia diagnoses and deaths.

The team compared different age groups at baseline, with up to 26 years of follow-up, for more than 6,000 participants.

The NHANES participants received a dental exam for signs of gum disease and a high percentage were found to have the bacteria, Porphyromonas gingivalis

This is the most common culprit of gum disease. In addition a study revealed that plaques of beta-amyloid protein, a major hallmark of Alzheimer's disease, may be produced as a response to Porphyromonas gingivalis.

The study further revealed that older adults with signs of gum disease and mouth infections at baseline were more likely to develop Alzheimer's during the study period. Among those 65 years or older, both Alzheimer's diagnoses and deaths were associated with antibodies against the oral bacterium  Porphyromonas gingivalis.

Almost half of Americans 30 and older have periodontal disease, according to the Centers for Disease and Prevention.

The number of Americans with Alzheimer's is predicted to more than double by 2050.

Could periodontal disease be an underlying contributing factor?

Maybe and to be quite honest emerging studies tend to lean toward this relationship and worth taken serious by all concerned about developing dementia

Steps to take to decrease the potential of developing dementia should include the following as it relates to dental care:

• Regularly brushing      your teeth
• Flossing
• Consider using a      waterpik water flosser (this is my dentist strongest recommendations to      clean out bacteria deep in the back molars.).This oral health appliance      provides a stream of pulsating water to floss between your teeth and below      the gumline.
• Don't forget the most      important step of ideal dental health and that is regular dental      cleanings.

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

References

https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-023-02821-x
https://www.nia.nih.gov/news/large-study-links-gum-disease-dementia
https://now.tufts.edu/2022/07/11/studying-link-between-gum-disease-and-alzheimers-disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488989/
https://www.nyu.edu/about/news-publications/news/2021/april/gum-bacteria-alzheimers.html
https://forsyth.org/gum-disease-linked-to-buildup-of-alzheimers-plaque-formation/
https://www.alzheimers.org.uk/research/care-and-cure-research-magazine/gum-disease-link-faster-decline-alzheimers
https://www.sciencedirect.com/science/article/pii/S277255962200027X
https://link.springer.com/article/10.1007/s40496-022-00319-8

Compliments of Functional Medicine University

Ronald Grisanti D.C., DABCO, DACBN, MS, CFMP

Mercury toxicity is the great mimicker of a host of health challenges.

Here is a sample of what one should know about mercury toxicity.

1: Mercury is known to denervate nerve fibers, similar to the pathology of multiple sclerosis. In other words it makes it so the nerves do not work.

2: Mercury can leak into the blood-brain barrier and reduce nerve conduction velocity and visual evoked responses, diagnostic tests used for multiple sclerosis.

3: Mercury can inhibit the action (binding) of happy hormones, like serotonin, at the synapse (nerve to nerve connection) leading to depression.

4: Mercury can cause hearing loss.

5: Mercury can decrease norepinephrine and dopamine activity at synapses, damaging our molecules of emotion. This can make a person lack zip, enthusiasm, joy, and creativity and make him anxious, insomniac, and terribly tense.

6: Mercury can create peripheral neuropathy, auto-immunity and interferes with synapse transmission, decreasing infection control so the unsuspecting victim gets recurrent sinusitis, prostate or gum infections, as examples.

7: Hidden mercury toxicity can be at the root of a resistant Candida infection. Sometimes you just cannot clear Candida symptoms until you get rid of the mercury.

8: Mercury is also a major undiagnosed cause of chronic fatigue and fibromyalgia.

9: Whenever we see someone resistant to all treatments, there is a high probability mercury toxicity is at the root of it.

10: Mercury toxicity can create any baffling neurologic disease as well as impair cure for any disease of other body systems.

One of the most common symptoms we see from mercury toxicity is that of terrible body burning and baffling pain that migrates.

But what neurologist looks for mercury toxicity?

And you certainly will never find it by doing an MRI.

Instead, folks get fictitious diagnoses like erythromelalgia, fibromyalgia, idiopathic neuropathy, neurosis, idiopathic pain syndrome, or hypochondriasis.

Reference:

Rogers SA, Detoxify or Die, Prestige Publishing, Syracuse NY, 2002

Compliments from Functional Medicine University www.FunctionalMedicineUniversity.com

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

Emerging evidence between depression, anxiety,  and exposure to mold has surfaced. It is thought to be associated with many complex health problems. Black mold species such as Aspergillus, Fusarium and Stachybotrys produce mycotoxins that are toxic to central parts of the body, including the brain.

Many mycotoxins are neurotoxins causing lesions in the brain in the grey matter and the white matter. This directly affects the frontal cortex, cause dopamine dysfunction which can create psychological disorders like anxiety or depression. These disorders occurs when the nerve cells in the brain that make dopamine are slowly destroyed. Without dopamine, the nerve cells in that part of the brain cannot properly send messages.

Mold is a biotoxin, and it releases toxic gas and spores into the air. When the toxins enter your body, via skin or air, the toxic gases cause a disturbance in many organs, including your brain.

Brown University conducted a series of cases linking mold, anxiety, and depression back in 2007. This was a large study, analyzing data from 5,882 adults in 2,982 households. Molds are toxins, and some research has indicated that these toxins can affect the nervous system or the immune system or impede the function of the frontal cortex.

Mold spores act as irritants, which can trigger the body to mount an immune response. This can lead to inflammation throughout the body. Inflammation in the brain can impair cognitive function, and in the case of chronic inflammation, this can lead to long-lasting cognitive impairment.

Mold is a sometimes silent and yet formidable trigger of symptoms. It is lurking in our homes, offices, cars, washing machines, and bathrooms without notice. It is quite literally a silent but deadly killer of our immune system and trigger of brain-related issues. If you have been exposed, you must detox mold from your body as soon as possible. 

One of the best test to detect mycotoxins is from Great Plains Laboratory (https://www.greatplainslaboratory.com/gpl-tox)

Here is a sample report from Great Plains Laboratory--https://www.functionalmedicineuniversity.com/GPLTOXReport.pdf

If you find you have mold (mycotoxin) exposure it is recommended to consult with your physician for the best treatment.

It is also imperative to do a deep dive into your home or work environment to identify where the mold is coming from. If mold is discovered the next step is to hire a professional company do a mold remediation.

References:

https://news.brown.edu/articles/2007/08/depression-and-household-mold

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179161

https://www.clinicaltherapeutics.com/article/S0149-2918

Compliments of www.functionalmedicineuniversity.com

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

A recent study in Nature Communications suggests that Parkinson's disease may actually start in the gut.

The microbiota-gut-brain axis has been suggested to play an important role in Parkinson's disease (PD)

Parkinson's is a brain disorder that can cause uncontrollable movements such as shaking, limb stiffness, and difficulty with balance and coordination.

The study published in Nature Communications involved recruiting 490 people with Parkinson's and 234 individuals who were neurologically healthy.

Each provided a stool sample and information about themselves.

When samples were analyzed, researchers found that bacteria, genes, and biological pathways differed by more than 30% in those with Parkinson's compared to those who were neurologically healthy.

Of special interest was the fact that a specific bacterial species called Bifidobacterium dentium commonly known to cause infections such as brain abscesses, was seven times higher in folks with Parkinson's

On the other hand another bacteria called Roseburia intestinalis commonly found in healthy colons, was 7.5 times lower. 

I recommend ordering the Gut Zoomer Stool Test from Vibrant Wellness. https://www.vibrant-wellness.com/test/GutZoomer

Here is a sample report which includes both the Bifidobacterium dentium and Roseburia intestinalis

//www.functionalmedicineuniversity.com/GutZoomerSampleReport.pdf

It is important to note that constipation is a common complication of Parkinson's disease. Many people who have Parkinson's disease notice difficulties with constipation before they notice motor symptoms such as tremor or stiffness

In addition to the above mentioned bacteria, elevated levels of Escherichia coli, Klebsiella pneumonia, and quasipneumoniae have also been found in those with Parkinson's.

Although the research is in the early stages of the relationship between Parkinson's disease and gut dysfunction, it is my suggestion to consider ordering a stool test to determine if in fact the above profile is apparent and take the appropriate action steps to improve the gut microbial environment.

You simply don't know the possible positive impact this can make in moving one more step closer to improving Parkinson's disease outcomes.

References:

https://www.nature.com/articles/s41467-022-34667-x
https://www.nature.com/articles/s41467-023-38248-4

Compliments of Functional Medicine University www.FunctionalMedicineUniversity.com 

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

Excitotoxins are chemical substances that overstimulate certain types of cells in the brain, all of the nervous system, and many other organs.

In high and excessive amounts these cells become damaged and may die.

The underlying mechanism of excitotoxins has been attributed to the following diseases: Alzheimer's, parkinson's, multiple sclerosis, strokes, autism, huntington's disease. 

Excitotoxins have also been found to be associated with the following diseases: migraines, diabetes, atherosclerosis, sudden death from heart disease, eye diseases, digestive disorders, autoimmune diseases, growth of tumors, spread of cancer and obesity.

The Most Common Excitotoxin is Glutamate

Glutamate is the main component of Monosodium glutamate (MSG)

As a general rule, the more a food is processed, the more likely it is to contain MSG. Foods that commonly use MSG include potato chips, flavored crackers, canned soups, dry soup mixes, canned meats, diet foods, soy sauces, salad dressings, cured meats and poultry injected with broth. But reading the labels won't always help you.

When a food product is 99 percent pure MSG it is called “monosodium glutamate” by the FDA and must be labeled as such. However, when a food product contains less than 99 percent MSG, the FDA doesn't require that the MSG be identified. So it often appears on labels in various disguised forms, such as “hydrolyzed vegetable protein,” “spices” and “natural flavoring.”

Here's a quick list of potentially suspect ingredients to watch for:

Ingredients that may contain 30 to 60 percent MSG:

hydrolyzed vegetable protein
hydrolyzed protein
hydrolyzed plant protein
plant protein extract
sodium caseinate
calcium caseinate
yeast extract
textured protein
autolyzed yeast
hydrolyzed oat flour

 Ingredients that may contain 12 to 40 percent MSG:

malt extract
malt flavoring
bouillon
broth
stock
natural flavoring
natural beef or chicken flavoring
seasoning
spices

 Ingredients that may contain some MSG:

carrageenan
enzymes
soy protein concentrate
soy protein isolate
whey protein concentrate
some soymilk

Although I have presented the downside of excessive glutamate it is important for me to let you know that glutamate does have positive health benefits.

These would include the following benefits:

• Acting      as an important neurotransmitter in the brain — it has excitatory effects,      meaning it makes neurons more likely to fire
• Serving      as a precursor for the neurotransmitter GABA (gamma-aminobutyric acid),      which is the main inhibitory neurotransmitter in the central nervous      system
• Supporting      growth and development of the brain
• Helping      cells survive and differentiate and supporting formation and elimination      of nerve contacts (synapses)
• Supporting      cognitive functions, including learning and memory.
• Stimulating      gut movement by increasing gut serotonin levels
• Producing      the antioxidant glutathione
• Regulating      inflammatory processes

So what is one to do when it comes to this special and sometimes detrimental neurotransmitter.

One answer is to get tested if you suspect glutamate toxicity. If your glutamate levels are high then you have an objective marker to carefully monitor as you taper and avoid foods high in glutamate.

Doctors Data Lab

If you don't want to invest in testing the next best step is to avoid foods in glutamate and see if you see an improvement in your symptoms.

Natural plant products and extracts that reduce glutamate and immunoexcitotoxicity

Curcumin, quercetin, green tea catechins, balcalein, and luteolin have been extensively studied to dampen the detrimental impact of excessive glutamate

My comments: If you suspect that your health issues are associated with glutamate toxicity I encourage you to talk with your functional medicine healthcare provider. They can best advise you on the best steps to take to improve your health.

References:

https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00561/full
https://pubmed.ncbi.nlm.nih.gov/8732541/
https://pubmed.ncbi.nlm.nih.gov/10613826/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098326/
https://link.springer.com/referenceworkentry/10.1007/978-1-4614-5836-4_148
https://www.frontiersin.org/articles/10.3389/fnins.2015.00469/full
https://pubmed.ncbi.nlm.nih.gov/29859974/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386414/
https://pubmed.ncbi.nlm.nih.gov/21288239/
https://www.nature.com/articles/srep44120
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307240/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478437/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8977545/
https://pubmed.ncbi.nlm.nih.gov/26788243/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260594/
https://europepmc.org/article/med/27185356

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Grisanti and his functional medicine community. Dr. Grisanti encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. Visit www.FunctionalMedicineUniversity.com for more information on our training in functional medicine. Look for practitioners who have successfully completed the Functional Medicine University's Certification Program (CFMP) www.functionalmedicinedoctors.com. This content may be copied in full, with copyright, contact, creation and information intact, without specific permission, when used only in a not-for-profit format. If any other use is desired, permission in writing from Dr. Grisanti is required

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

Growing research has linked diabetes, exposure to air pollution, and alcohol as the top three modifiable contributors to the development of dementia.

Diabetes and Dementia

People with diabetes have about 60% increased risk of developing dementia compared to those without diabetes.

There are reasons that diabetes may affect dementia risk:

Some of the changes that occur in Alzheimer's disease are similar to those in diabetes. In both, nerve cells in the brain may become resistant to the effect of insulin. This may lead to the build-up of amyloid and tau proteins in the brain.

This relationship is so strong that some have called Alzheimer's “diabetes of the brain” or “type 3 diabetes (T3D)

Air Pollution and Dementia

More than 57 million people worldwide are currently living with dementia, and estimates suggest that number will increase to 153 million by 2050. Up to 40% of these cases are thought to be linked to potentially modifiable risk factors, such as exposure to air pollutants.

Exposure to a type of air pollution called fine particulate matter, or PM, has been identified as a potential risk factor for dementia.

An NIH-funded study published on August 14, 2023, in JAMA Internal Medicine led by Drs. Boya Zhang and Sara Adar from the University of Michigan examined the links between different types of PM air pollution and dementia. They looked at data from more than 27,000 adults aged 50 and older between 1992 and 2016. 

As part of the study, participants underwent cognitive testing every two years or had caretakers report on their memory and cognitive function. The mean period of follow-up was 10.2 years. The average age of participants was 60.

The researchers estimated pollution exposures for the participants using models that included real-time pollution measurements and aspects of their homes like geography, land use, and local emissions sources. 

The team found that 4,105 of the people studied approximately 15% developed dementia during the follow-up period. 

Overall, higher PM exposure was linked to an increased risk of dementia. The team also examined nine specific sources of PM agriculture, road traffic, nonroad traffic, burning coal for energy, burning coal for industry, other energy production, other industry, wildfires, and windblown dust. After consideration of all sources from agriculture and wildfires were specifically associated with an increased risk of dementia.

The researchers estimated that, if PM exposure truly is a cause of cognitive decline and dementia, as many as 188,000 cases of dementia per year might be due to PM.

Alcohol and Dementia

Drinking alcohol is linked to reduced volume of the brain's white matter, which helps to transmit signals between different brain regions. This can lead to issues with the way the brain functions. Alcohol consumption above recommended limits (of 14 units per week) over a long period of time may shrink the parts of the brain involved in memory. Drinking more than 28 units per week can lead to a sharper decline in thinking skills as people get older.

Long-term heavy drinking can also result in a lack of vitamin B1 (thiamine) and Wernicke-Korsakoff syndrome which affects short-term memory.

Dr. Grisanti's Comments

When it comes to dementia, certain risk factors, such as aging and genetics, can't be changed. But other risk factors as discussed in this article (diabetes, air pollution and alcohol consumption) are modifiable, and knowing what they are can help you take steps to minimize their impact and protect your brain.

The results suggest that certain lifestyle changes could potentially help protect the brain from these risk factors. People can cut back on alcohol consumption, follow a plant-predominant diet/Mediterranean diet and exercise to prevent or reverse diabetes, and try to avoid situations where heavy air pollution is present.

I recommend the following three outstanding books on addressing and potentially reversing diabetes:

The End of Diabetes: The Eat to Live Plan to Prevent and Reverse Diabetes by Joel Fuhrman M.D. 

Dr. Neal Barnard's Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes Without Drugs by Neal Barnard

Mastering Diabetes: The Revolutionary Method to Reverse Insulin Resistance Permanently in Type 1, Type 1.5, Type 2, Prediabetes, and Gestational Diabetes by Cyrus Khambatta PhD Robby Barbaro MPH 

Here are my recommendations to improve indoor air quality and reduce PMs.

**I receive no compensation for recommending the following two air filter systems.

https://www.airoasis.com

https://austinair.com

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111529/
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2814924
https://www.sciencedirect.com/science/article/abs/pii/S1474442205702842
https://www.sciencedirect.com/science/article/abs/pii/S0014299904002110
https://www.nih.gov/news-events/nih-research-matters/air-pollution-linked-dementia-cases
https://pubmed.ncbi.nlm.nih.gov/30775976/
https://www.hsph.harvard.edu/news/press-releases/air-pollution-may-increase-risk-for-dementia/
https://www.bmj.com/content/381/bmj.p655
https://www.neurology.org/doi/10.1212/WNL.0000000000207656
https://pubmed.ncbi.nlm.nih.gov/15455646/
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800994
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6957093/
https://www.nia.nih.gov/news/mind-and-mediterranean-diets-linked-fewer-signs-alzheimers-brain-pathology
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02772-3
https://content.iospress.com/articles/journal-of-alzheimers-disease/jad230418
https://www.sciencedirect.com/science/article/pii/S0002916523036079
https://onlinelibrary.wiley.com/doi/10.1002/mnfr.202100606
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9738978/

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Grisanti and his functional medicine community. Dr. Grisanti encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. Visit www.FunctionalMedicineUniversity.com for more information on our training in functional medicine. Look for practitioners who have successfully completed the Functional Medicine University's Certification Program (CFMP) www.functionalmedicinedoctors.com. This content may be copied in full, with copyright, contact, creation and information intact, without specific permission, when used only in a not-for-profit format. If any other use is desired, permission in writing from Dr. Grisanti is required