EP 182 WTH?!?: Reversing Alzheimer's - Breakthroughs with Dr. Heather Sandison

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Hey, welcome back everybody. Dr. Greg Eckel. And today's topic is of doozy. Reversing Alzheimer's with The ever renowned Dr. Heather Sandison, naturopathic doctor specializing in neurocognitive medicine and the founder of Social Solary Health clinic in San Diego's premier brain optimization clinic in Marama which is a residential memory care facility. The first memory care facility to have the goal of returning cognitively declined residents to independent living. She has dedicated her career to supporting those suffering with dementia and is a primary author of the peer reviewed research observed improvement in cognitive on incognition during a. Oh, I totally butchered. Butchered that. Observed improvement in cognition during a personalized lifestyle intervention in people with cognitive decline. I mean it just rolls off the tongue. Dr.

It's a mouthful. Reversing Alzheimer's is a little easier.

It was published in the Journal of Alzheimer's Disease which is very a highly reputable journal. She hosts the annual online reverse Alzheimer's summit where she shares cutting edge and tried and TR insight into what is possible for those suffering with dementia. She's excited to shatter common misconceptions about Alzheimer's and share what she has learned about keeping your brain sharp at any age. Welcome aboard. Dr. Heather.

Thank you so much for having me.

Ah, we are so excited. You know, you really are trailblazing. You are ever present, educating people online. Your centers precede you. As I was sharing before we got on the line of hearing about your residential facilities and just the exciting work that you're up to. It is inspirational and this is a massive, massive topic because people don't hear reversing Alzheimer's very often.

No. And really that's my job. Like if I had to pull back and say there's all these projects we have going on, the research and the residential care facilities and the clinical practice and the online coaching programs and the book, we have an. I have a new book, Reversing Alzheimer's. It will be out June 11th. And really what is it all about? It's about changing the narrative. So many people have been told that there's nothing you can do for Alzheimer's or dementia and at this stage that's factually inaccurate. It's almost overwhelming how much you can do to optimize cognitive function at any stage of life, whether you have genetic predisposition, whether you're already noticing changes, whether mom is maybe even severely down that that dementia pathway. There are still ways to get beneficial optimization of cognition. Now not everybody is going to get back to perfect. Not Everybody's going to get back to work. But there are so many patients who have proven my false hopelessness wrong.

Right.

I had heard you and I both are naturopathic doctors. We're colleagues in that, in that way. And I heard, I'm sure you did, too, when I was in training. There's nothing you can do for Alzheimer's. Don't suggest that you can, because that's to give people false hope and it's actually doing harm. And so much has changed since I went through my training and I have learned over and over again from patients proving me wrong that there is always room for hope.

I so agree. And you know, you're giving me shivers with that statement because why is there such a misperception here? Why is there a disconnect? Because you're, you have published research. You see people improve. We see people improve. And you, you say this to the lay public on the street and they just look at you like you're crazy. What is going on with that?

Well, you know, I'm so excited because it's changing. Just in the past couple of weeks, Sanjay Gupta on, on CNN has done this dementia docu series where he is chronicling patients who have been seen by Dr. Dean Ornish and Dr. Rich Isaacson on the east coast where they have reversed their Alzheimer's symptoms. And so that was in, that was in on the front page news because people ask me all the time, if this is happening, how come it isn't front page news? And now it is.

Now it is. Yes. Awesome.

It's so exciting. It's happening. The narrative is changing. It's slow, however, right? Like medicine. What is the saying? Like, medicine changes one retirement, one funeral at a time, right? Because people are so stuck in their ways. But there's also a paradigm shift that has to happen. I have a houseplant here behind me, right? And if the house plant, we're struggling, which it was recently, I don't look at it and go, oh, are there misfolded proteins? Does it have beta amyloid plaques that I need to use an antibody therapy to get rid of? No. What we do is we say, especially us naturopaths, we say, is it getting enough light? Is it getting enough water? Is it getting enough nutrients? Is there something toxic in the soil? What does this complex system need in order to thrive? And that's the shift in the paradigm that Dr. Bredesen has really, he's really been the trailblazer and the one who's paved this path for me is to say, okay, when we think about the brain, this complex system, he has this great analogy, he calls it my brainistan. If you think of the brain as a country, if your brain is stuck in fighting and defending against microbes, against infections, against toxicity, you shouldn't be building the roads and schools, the infrastructure of our brain. You shouldn't be building the neurons and the connections between the neurons, the synapses. You really need to spend your resources and energy finishing up that fight. And so that's what we see. A lot of people are stuck in that inflammatory perpetuation caused by toxicity, nutrient imbalances, stressors, structural issues like sleep apnea or traumatic brain injuries. There's infections, they're not getting the signaling that says to regenerate, to grow, to heal. And so from a functional medicine perspective, we can start, or a naturopathic perspective, we start with the foundations, diet, exercise, stress management, sleep. And then we can test a lot of these precision based parameters that are going to increase or decrease our risk of developing dementia over time. We have so much control that we didn't realize we had because we'd been fed this story that there's a one cause of Alzheimer's, that it's beta amyloid plaques causing the Alzheimer's. But when you take that away, you don't get better cognition, you actually get worsening cognition, because that amyloid is antimicrobial. It's there to protect us. So what we want to do is we want to go one step above that, say what's causing the protective mechanisms of inflammation of amyloid plaques, of tau proteins, what is causing the degeneration? And address those things. And when you do that, this is common sense, right? It's just uncommon practice. When you do that, you get this improvement in cell function and then improvement in cognition.

I love it. And so what came first, was it the, your center or the residential facility?

Yeah. So I was trained by Dr. Bredesen in 2017, came back to my clinic and started seeing people. You know, I was a total skeptic still. I hadn't, I didn't think this was possible. But then I watched people get better. And then I started developing a bit of a reputation around this. And then I was in a very fortunate position. I had a philanthropist come in as a patient who had a good experience, and he said, how can I help you do more of the work you're doing? And, and he funded the clinical trial that we did in my office the same week that we got IRB approval. So we had the go ahead to do the internal Review board, thumbs up to go ahead and do the trial. We closed on the facility. So I had these sort of two potential projects going at the same time. And then of course, and I thought, oh, one of them probably won't work out. And then they both hit at the same time in December of 2019, which was interesting timing because then we were just getting up and running March of 2020, when the world shut down. But it was, it all worked out. It's all good. It's been a wild ride. But I got basically both of those opportunities to try in, in two different environments. The clinical trial we got to study and publish, we took 23 participants in a clinical setting. So this is outpatient, they live at home, they come in, see me or a colleague of mine as a doctor, we do all the testing, we give them the lifestyle advice, and then they go home and take their supplements and take their medications and get their exercise and get their sleep. And what we saw was that 74% of those participants with measurable cognitive impairment, to start, 74% of them improved in six months.

Wow. Yeah. 74%. Yeah. That is unheard of. Right. In that it's published data that people don't really quite know about it. So this is great. The word is it's growing.

The growing. And my, my study was the second one, not the first. So the other clinical trial was a nine month intervention. Doct Bredesen's team, headed up by Cat Tubes up in the Bay area, they took 25 participants through a nine month intervention. They didn't have as much impairment, so they weren't as progressed on the disease path, they had MOCA scores of 19 and above, which I can get into what exactly that means. But 84% of their participants got better.

Wow. Wow.

More often than not, given the resources, given the information, given the support, more often than not, people with moca scores above 15, 16, so if they're in that mild cognitive impairment state on the way, there's nothing mild about it. You still definitely feel and are impacted by the cognitive impairment. But if we catch it in that MCI state, more often than not, we can get improvements in cognitive function and sometimes full recovery.

That's awesome. So MCI is mild Cognitive impairment. So tell us about what the MOCA score means for folks that don't know that one.

Yeah. So the MOCA is the Montreal Cognitive Assessment, and it's one of several 30.1 page worksheets. So a perfect score is 30. So it's out of 30. 30 out of 30. Is perfect. 26 and above is normal. So this worksheet is where you are copying a box, drawing a clock, identifying zoo animals, where you are in time and space. And so many people have kind of heard of this or we've heard presidents refer to it. It's out there and you can find it online. It's just a PDF. If you look for M O C A, the moca, it's the Montreal Cognitive Assessment. And you need a trained, not necessarily a provider clinician, but some kind of tech who's been trained to administer it, to do it. So you wouldn't want just your, your daughter to do it. Right. There is a way to score it, but when we start getting into those lower levels. So I've seen patients with MOCA scores of zero, MOCA scores of two, where they're no longer even able to answer a single question on that worksheet. Even they have hope of improving now. It's much harder. But there's kind of this spot between 16, 17, 18 MOCA scores in that range where it's. So we have so much more confidence that we can get people better if they're in that earlier state of decline rather than further progress further down.

Yeah. Wow. And what are you seeing at your facilities then? It's called Marama.

Marama.

Marama. And one in San Diego, one in Wichita, Kansas.

That's right, yeah. So in wichita was our second facility, and we opened that in April of 2023. And so we've had our first set of residents be there for more than six months. And what we saw was at that six month mark, four of the five residents who've lived there have improved their MOCA scores.

Two, Four of the five. Yeah.

And what most people expect when you move into memory care is that you're just going to go downhill. It's like, all right, I'm putting mom or dad or uncles or aunts in memory care, and every time I see them, they'll probably be a little bit worse.

Yeah.

And the goal here is that people actually get better.

Yeah, that is, that's phenomenal. And I, I really, I'm looking forward to get this message out. So you all listening? If you know anybody, which the stats are such that you do know, people that have issues with their memory are on this continuum. You got to share this recording with them because this is not false hope. This is real hope. This is. These are real people getting better. Like, big numbers. Four out of five people living in the, in that residential facility. 74 in one study, 84 in another. With doing lifestyle changes. Right. Yeah.

Yeah. Really, what we see in my clinical practice is that the people who are able to implement these things, they get better. And they don't just get cognitively better. They get off their antidepressants, and they get off their antihypertensives, and they get off the diabetes medications, and they feel stronger. They're less at risk for falls. So life becomes more fulfilling, more meaningful, more enjoyable. There's less pain. It's. They're sleeping better. It's really incredible. And, I mean, the reason I get up in the morning, Craig, is because I have. I have patients and family members who are like, I got my mom back.

Yeah.

That's what life is about. When I talk to, you know, not that I'm the expert on this or anything, but I see so many elderly patients, and when I ask them, what. What's your happiest memory? Or what do you. What. What do you think back on most fondly? What was most important to you? It's the connections. It's the relationships.

Yeah.

And the ability to be present for them. Right. To. To remember, to reminisce, to look forward to things and to experience that fully. If that's not what life is about, like, what is it?

Yeah. That. That is so gratifying, and thank you for sharing that. And I would challenge you, Dr. Heather, that you are one of the top experts out there.

Well, I wouldn't say that I feel like my patients.

You wouldn't, But I'll tell you, you are.

But my patients have taught me so much. I mean, gosh, it's wild. I learn more and more every day from them about what works and what doesn't, and, you know, the little tweaks that they can make so that they get even better cognition or less. It's less hassle for them. It's easier to implement. And I. I just. I learn so much every day. I think that you kind of can probably relate. It's like, the more I learn, the more I realize I don't know. And so I just get more curious.

Yep. Yeah. Curiosity, it really is key. And just that effervescent feeling of service. That's why we got into medicine. And. And to get the results. Like, I. I can remember back to med school where they said, don't get attached to results, and it's like, well, that's downright depressing. And what are we doing? And, you know, I was gonna joke. It sounded like, well, you're. It sounds like you're a naturopathic Physician treating people, they're, they're getting better. All of their symptoms are going away. Let's talk about the evolution of dementia treatment because you've been in the trenches for a while as a clinician, as a researcher, now as an author, as an online summit producer. I mean, you're, you're in touch with a lot of folks out there, a lot of movers and shakers and people that are looking to make this change permanent for more and more people. What are you seeing what kind of give us the evolution of dementia treatment?

Yeah, so initially, you know, I, I was in the camp of there's not much we can do. And from a conventional perspective, there are a couple medications that have been around for a while. Donepezil or Aricept and then Namenda Memantine and then Arivistigmine is the combination of the two. And these medications, sometimes people will get a little bit of a bump in their cognition temporarily for a few months or so. But we saw in a jama, the Journal of the American Medical association published, think it was In December of 2019, maybe January 2020, there was an article where they showed that people who never started them actually fared better cognitively five years later. So that doesn't mean get off of them if you're on them, because I have seen people decline rapidly when they try to stop those medications. Really any of the medications that affect your neurotransmitters, you don't want to stop those rapidly. That's very stressful for the brain. And so if you're on them, stay on them, you keep it steady. However, if you're considering whether you or a loved one should get on them, the, the research is really not great for five years out. Now, the other pharmaceuticals that are now available, there's one called Leucane MAP or Leukenby, which is on the market, covered by Medicare. And this is an antibody treatment, and so a monoclonal antibody for amyloid plaque. And what this does is it's slows the rate of progression, so it doesn't improve cognition. And you need to use it in that mild cognitive impairment state. So you, once you're more progressed into Alzheimer's, it. You're not eligible for that medication. That's not what it's been studied on. And there's a risk of brain bleeding and brain swelling that comes with this medication. So you need to be in relatively close proximity to a major medical center so that you can be evaluated for all of these potential risks. And it, it's not just about going and getting an easy IV, right. You've got to show up for these MRIs and, and maintain really close contact with your providers. And it's also costly. So out of pocket, people end up spending about $8,000 per year. By, you know, contrast, we spend about $20,000 per year to do this approach. If you're paying cash out of pocket for everything, you can expect to spend about 20 to $25,000 over the course of, for every doctor's visit, every IV, every lab, every medication, every supplement. And what we see is that more often than not, people get better. And so when you compare these, my goal, we have these residential care facilities. It is so labor intensive to care for someone with dementia. It takes multiple people. It is not a one person job. For all the caregivers listening, this is not a one person job. You must get help before you think you need it. We see how costly it is to care for someone with later stage dementia. It can cost $15,000 a month to be in memory care. And so if we can invest upfront in our health and our brain health before we have symptoms, I think that the payoff, I mean, if you can delay this disease, you are saving money. If you can maintain the ability to work longer, you can make more money. We think about our 401k as how we prepare for retirement. Do we have enough money in the bank, but do we have enough cognitive reserve? Do we have enough cognitive, cognitive health reserve to maintain a fulfilling life after retirement?

It, you know, it's really interesting how that conversation even got skewed of. Wait a minute, you can't take any of this with you. What are we, what are we waiting for? And once you pass a line, it, you know, like you said earlier, it's never too late for hope, but, you know, maybe give us some scenarios or what have you been surprised on this healing journey for folks?

Yeah, you know, so we just, It's May of 2024 right now, and we just had our first resident at Marama move home with a perfect MOCA score. And she did exactly what I hope that we all start to do. She came for memory recovery, not memory care. So she found mold in her home environment. And on her birthday last year, she moved into Marama as a gift to herself, as an investment in her health. She's in her early 70s and so she moved in with a MOCA score of 24. So not normal. It was measurable cognitive impairment. But in six months she was back up at 30 and moving home into her House that had been remediated, so it was no longer moldy. Moving home with perfect cognition. And so she really is this case in. If we can invest a little earlier, if we can do more to recover our brain health, to invest in our optimal cognitive health long term, then I think that we can avoid so much of the suffering associated with dementia.

Yeah. Wow. That is powerful. That is so powerful. What. How about for the caregivers? Because this can. This is a very taxing disease process to live with if a loved one has anywhere on that continuum. It's a lot.

Dr. Gregg, I'm so grateful that you bring this up because I think it's. It's. Yes, it's a lot. Absolutely. And it gets missed. Right. So much of the focus is on the patient and the caring partner and how much is on their shoulders is often neglected. And this is emotionally taxing. Of course, it's the long goodbye every time your partner, especially when it's a spouse, that you've been used to them being your partner, not your dependent. And so every time you have to like rush them into the car or they. They forget to turn the sink off, there's bit of grief that they're not that person that you marry, that person that you depended on. And this is really emotionally just like awful. And then it's financially very stressful and very straining. It's physically very straining. And these things add up over time. And it. The impact is that people who serve as a caregiver are anywhere from two and a half to six times more likely to be diagnosed with dementia later in their life compared to people who never serve as a caregiver. So this is something that we want to take very seriously. As a provider, I feel like my job is to care for both people in the room and to make sure that they're both adopting a brain healthy diet, a brain healthy exercise routine. They're both prioritizing sleep, they're both prioritizing stress management. So a lot of our conversations are about how can we do this for both of you and reduce your modifiable risk factors of getting dementia and your loved ones modifiable risk factors dealing with dementia?

Yeah. Wow. Yeah, that. And what are some of the big. What are some big risks for, besides developing Alzheimer's or dementia later in life? Some caregiving risks around caring for their loved ones. Have you seen anything come up there?

Well, you know, caregivers, they're not getting the sleep right. They're not prioritizing their sleep, particularly if you're caring for someone who's suffering with dementia and their sleep has been disrupted. Right. This is a kind of a later stage symptom. But people have, their diurnal cycles will be very dysregulated and so they'll be up in the middle of the night and then just like having an infant. Right. But you don't know how long it's going to last. An infant ends up sleeping over time. Someone your mom or dad or spouse who has dementia, they stop sleeping through the night and you don't know if that's going to last five years or 10 years. It's very unpredictable.

Yeah.

And then people who struggle or who are caregivers, they often struggle with feelings of shame and guilt around asking for help. And so they take all of it on. They want to be. And I get this, right? When you love someone that much, you want to be the one taking care of them. You know that nobody else is going to take care of them as well as you can. But when you're sleep deprived and you're not eating well and you're not exercising, all of a sudden you're not actually providing the best care. And I've seen so many families backed into the corner of, you know, mom was caring for dad and then she fell and broke her hip and now there's no one available and we've got to just take the next warm body off the street who can just babysit. And now we're really not getting good care for dad. And so I really encourage families look for help before you need it. Go to church, your church community, your neighborhood, you know, anyone in your network, your family, of course friends and paid caregivers. Find people who can help support you. And every caregiver I think should have eight hours, eight hour block where you don't go take care of grandkids, you don't go do chores, but you take care of yourself, your own mental health and your own physical health.

Oh, that's great recommendation. How, what's the goal of the care facility and the book? How are these related and like where your book is coming out and we're going to put the links to it. I've already pre ordered and we're going to share as far and wide as we can. But where, what's the goal of these? How do they connect and what's the synergy that you see?

Well, so at Marama we have one location here in San Diego, as you said, and one in Kansas. And we have had people move from all over the world. We've had, we have somebody coming from the UK next week. And so we've had people come from Florida and, and New York and Hawaii to land in San Diego and get the benefit of this immersive experience. But no one wants move into a senior living facility. Like, no one raises their hand and goes, move me there sooner. Right? They want to stay home next to the people that they love and care about in the fabric of their communities. And so my hope with the book is that it's, you know, for under $30, you can get the how to manual, you can get the toolkit so that you can avoid the need for memory care or memory recovery. Now if you want to come and we can. It's like a spa experience. We'll take great care of you. There's a chef who's there and the food is amazing. So we can do all for you. Or, you know, if I would love for people to start earlier, I would love for people to avoid that need and to stay really, when I, you know, changing the narrative is. Is a big part of my why. But also we need. We need the experience and wisdom of our elders. We need that in our communities. We need them showing up at neighborhood board meetings and PTA meetings and picking up the grandkids and contributing in the ways that people have in previous generations not siloed away in some care facility. And so whatever I can do to help support that, that. That is why the book and the book is really influenced and informed by coaching our clients online and learning what works. There's a lot of reflection, questions. Every single family who's dealing with dementia has a unique and dynamic situation. And so understanding, like, what are the variables in my family? What are the things that are coming up in my situation and what is. What do I have limited financial resources, so I need to pick everything that's free. We have a whole list of all of the free things that you can do. Do I have limited mobility? Maybe the person I'm helping is in a wheelchair. Okay, what are all of the things that meet that constraint so we can kind of go in different directions based on what's going on. Am I in prevention mode versus helping someone with severe dementia? We ideas and brainstorm tools for all of those things so that it's easy to implement.

Oh, I love it. Easy to implement. There it is. Reversing Alzheimer's. Dr. Heather Sanderson, thank you so much. And we're really excited for your book to come out. Everybody, if you like today's show, give us a thumbs up. A like, go out give a five star review. And better yet, share this with your loved ones, because this one impacts us all. Let's get this information out to as many people as we can. Thank you all for tuning in. And thank you, Dr. Sanderson.

Such a privilege to be here. Thank you.