The Times' Strange Review Of Dr. Dale Bredesen's Dementia Reversal Program
- evacupuncturist
- May 24
- 15 min read
Updated: Jun 4
On Wednesday, some seven years after "The End Of Alzheimer's" was first published, a junior reporter (Lindsay Gellman) for the New York Times decided, inexplicably, to try to take down Dr. Bredesen's life work. (link to article, here) It didn't go well.
People wrote in about how the program had helped them. Or wrote about how they had done something similar. Or how it was all just common sense, really.
Many DIY-ers had simply purchased his 2017 book and followed its precepts, tuning in to the Bredesen team's periodical Facebook Live sessions and other videos. People noted Dr. Bredesen's distinguished career-- and the courage it took to break with his UCSF colleagues of decades. People noted the colossal 50-year, multi-billion dollar failure that is Alzheimer Inc's legacy. People noted the usurious expense, deaths and deception (not to mention inefficacy) of the latest, enthusiastically marketed "therapeutics."
Yes too, there were the obligatory cranks and trolls and pilers on. And those who still hold out for- and expect, as if owed to them-- a pill or a jab to treat even cure complex, chronic disease. Those who want only to be told what to take and have little interest in reflection or effort or outside-the-box thinking. Overall, though, I was legitimately touched at the level of thoughtfulness and gratitude. (Link to most thoughtful/helpful comments in the works.)
The impulse for Ms. Gellman's grade school attempt at a hatchet piece (in the initial version she or her editor had placed "Medical Establishment" in the headline, an apparent attempt to frame this as radicalism vs reason; it was later swapped out for "Experts") appears to have been the release of the new HHS secretary's report on how this country's unhealthy ecosystem of ultraprocessed & nutrient denuded food, industrial farming, over-diagnosing, over-medicating, over-stressing, and over-polluting combine to create an overall unhealthy populace. And while some of his specific complaints invite scrutiny & even push-back (and yes, he seems like a lunatic), no one with half a brain can argue with the over-arching critique.
But how did poor, unassuming Dale Bredesen get caught up here in the cross fire? I am still kind of scratching my head.
The Times' Well column has been a train wreck
since its very debut.
The Times' Well column has been a disaster ever since a decision at the ostensible paper of record decided, I am imagining, that they could get many more IG and TikTok shares were they to jump into (and publish way too frequently, with way too little reflection) the "hot topics" of health news. Well, not so much health as health trends & fads. I am calling out Well editor, Lori Leibovich, specifically. All the nonsense and lazy reporting and click bait headlines began with her.
But back to Dr. Bredesen.
The Times article follows one couple, John and Kerry Briggs (Kerry, at 61, in 2021 diagnosed after a spinal tap "showed evidence of Alzheimer's"), who had signed up for the ReCode program-- and stopped at eight months after struggling with it and not seeing any progress. Yes, that's right: the entire article was based on one couple's experience-- and equally important, one practitioner.
The general rule of thumb is that if after six months' time nothing is improving, we perform our own kind of self-assessment, "What am I missing? What am I missing? What am I missing?" (Or ideally, since there'd be a team (think West Wing Situation Room): "What are we missing? What have we missed? What have we not considered")
Noticeable improvement is not uncommon after only 2 or 3 months. Oftentimes this is the effect of the B vitamins, better sleep, digestive and/or hormone support. Sometimes hope itself. Not for everyone though.
The understandable instinct is to want to start taking things-- bacopa, huperazine, gotu kola, what have you--when what is often needed is to take things away: infections, insulin resistance, molds or metals.
Dr. Bredesen's Type 3, or "Toxic" subtypes are the most stubborn, and significant improvement is rare before 1 year on the program.
But practitioner variable is HUGE. If there is one glaring weakness in Dr. Bredesen's linkage with Apollo Health, it is the training/vetting/oversight. Almost anyone can pay $2,000 and become certified as a ReCODE specialist. The curriculum excellent as it is, is all canned & online. The mini exams you take at the end are easy to game. And can be taken over and over until you get a passing grade. Each "exam" typically consists of 5-10 MC questions.
You can actually fast-forward through the videos and go straight to the quizzes-- availing yourself of the Find feature on your browser to sift through the provided PowerPoint pdf's for the answers should the answer not be obvious. It's not impossible to complete the entire training/certification over a couple of weekends.
There is no internship or even clinical oversight. There is no competency testing. No probationary period. This should not be thus. (More on that in another post.)
And even the best clinicians have blind spots & biases: remembering & being subconsciously pulled back toward their great successes. Or haunted by their failure. That's why, imo, it's so helpful to create a team approach. More eyes! More noggins. More collective clinical experience.
Just looking at the Times' photos of Kerry Briggs,
one immediately thinks poisoning.
Just looking at the Times' photos of Kerry Briggs, though, you immediately think chronic, long-term poisoning. With also an element of hormone insufficiency-- but toxic exposures, depending on the type, can wreak havoc with hormone signaling & binding all by themselves.
(I also wonder now, also given the timing, if maybe this was a triple not just double whammy on her: sick house syndrome, menopause, and an infectious element, as in Covid.)
These so-called "Type 3" or "Toxic" cases are notoriously stubborn/tricky to treat. Where mycotoxins or Lyme co-infections are present, inexperienced practitioners are encouraged to refer out to a specialist. "Pure" Type 3 presentations are rare, making up only about 15-20% of dementia cases, but the toxicant element is present in up to fully one half of all dementia cases.
Type 3's generally are not expected to improve substantially until a full year on the program. If this was indeed even a piece of the official diagnosis the Briggs received from their Colorado practitioner, did he at least offer them this guidance for expectations management?
Over the long holiday weekend there was time to dig a bit deeper (admittedly with very little to go on) into the Briggs' case. The first breadcrumb, Kerry's sister, Jennifer Scheurer, was quoted in the Times' piece about how Kerry "had designed the kitchen herself." A even potentially more substantial clue came this morning after coming across minutes from a Barrington Hills community board hearing: major home renovation. Had Kerry unintentionally poisoned herself??
Had Kerry Briggs, owner of a high-end home design company, unwittingly instigated her own cognitive decline via a home renovation project?
Documents (warning, .doc file might auto download) retrieved from the hearing appear to indicate that the Briggs, owners of a high-end home design business, had run afoul of community board guidelines in what sounds like an ambitious expansion of the original structure.
(They also appear to live sandwiched between two golf courses: the Biltmore and Lake Barrington Shores. That certainly can't help. Sometimes what you're sold as the good life circles back to bite you.)
The onset of Kerry's cognitive decline ticked pretty much ALL THE BOXES for Type 3:
Relatively young onset (65 years old or younger)
More common in women than in men
Frequently co-incident with onset or recent menopause, peri-menopause, andropause (estradiol is, among other things, trophic, neuroprotective, and anti-inflammatory)
Generally ApoE4 negative/no family history of AD (Her ApoE status has not been publicly shared, but there was no mention of family history of dementia/"Alzheimer's," so we are assuming no "E4" alleles
First symptoms are often trouble with word finding, trouble calculating, trouble organizing
Often co-presents with depression or other HPA axis dysfunction
Precipitated or exacerbated by stress
In all fairness, the dissonance between my LinkedIn photo & present day face in the mirror regularly causes me to recoil in horror, but just look at how differently the two have aged: his biochemistry & genetics likely more forgiving of toxic exposures than hers. Or perhaps he merely spends less time at home?
Dr. B's "Toxic" type often presents in one's 60s, frequently around menopause, with initial symptoms being trouble with word finding, calculating, organizing.
Depression. Hormone disruptions. Weight loss.
Since I have been involved with Dr. Bredesen (during what seemed like two years of Covid lockdowns, we spent alot of time on Zoom and Facebook Live videocalls) since 2018 or so, I feel like I know him. He is the farthest thing from a "snake oil salesman" one can imagine. He is a brilliant academic. He has an extensive network of life-minded brilliant academicians. And he has nothing but the sincerest of intentions (and valid-est criticisms) in his desire to advance the therapeutic landscape for neurodegenerative diseases, including Alzheimer's and other types of dementia reversal.
I was so heartened to see so many people in the Comments section to the article rush to either put things into their proper perspective and/or rally to his (and the approach's) defense. I am curating the useful ones at this Google doc-- but as the Comments section remains open (and grew to 500+ over the weekend), I need a bit more time.
The Briggs might have had a better experience had they worked with a different practitioner.
And started at onset of first symptoms.
The Briggs might also have had a better experience had they worked with a different practitioner. This is the real heart-breaking (& super tricky) piece, and where Apollo Health has so far failed-- although I know that Dr. Bredesen has been trying to fix this: quality control of people certified to be in their network. While it's impossible (maybe even unfair) to try to deduce from a newspaper article & self-report, there appears to be things that were missed as well as costly bits that might have been unnecessary. Here are the 3-4 that immediately jump out:
The Briggs appear to have waited 3 years, after being turned down by various research studies, before deciding on a functional medicine/precision medicine approach. Having this be your "Plan B" rarely works, in no small part because it betrays the fact that you haven't yet figured out that the Alzheimer establishment approach to research & treatment lost its way decades ago. You need to be 100% on-board. Precious time was lost.
IT BEARS REPEATING: Amyloid does not equal Alzheimer's. There are brains full of amyloid (& even tau tangles) with zero cognitive decline-- even at 90 and 100. In the latest analysis of autopsies from the Nuns Study, so-called mini strokes were the only thing that correlated strongly with risk of dementia: extensive amyloid was present in both cognitively normal and cognitively impaired nuns. (Were you to look, you'd find that even (healthy) children have amyloid in their brains!) Conversely, there is "Alzheimer's" dementia with "clean" brain tissues. In both mice & men, adding amyloid to healthy brains does not cause pathology. And clearing amyloid from humans does not arrest the disease. Blocking the formation of amyloid, which has been achieved successfully with drugs & immunotherapies, not only does not prevent dementia but actually made both mice and humans sicker. (Turns out amyloid is actually an antimicrobial peptide.) Read Karl Herrup. Look up the Nuns Study. There is plenty more. Precious time was lost here with (arguably) pointless, extensive, and costly diagnostic testing.
Their choice of whom to work with seems odd (although now I see that she likely grew up in Colorado, and attended college in Boulder) and unfortunate. (All those five star reviews, all at about the same time, not to mention the laundry list of ailments treated, prick up my ears.) Julie Gregory, one of Dr. Bredesen's first star successes, lives just up the road from the Briggs, on the shores of Lake Michigan. It is unfortunate that the two did not connect. There was also a resident ReCode facility, Rolling Hills, not terribly far away (10 hour drive) in Wichita, KS, overseen by SoCal's dementia reversal superstar, Dr. Heather Sandison, of Marama and Solcere renown-- and at the time they were actively seeking new clients. Even now, although it sounds like she might not now qualify, that would be my personal "Plan B." John might even be able to move in with her for the first couple of months. And she, if the program is successful, come home after a year/year and a half.
Most people would not have initiated a ketogenic diet, even a "plants forward" one, with someone already so thin. If insulin resistance/brain fuel issues presented themselves as a high priority concern, KB might have experimented with ketone salts or esters, even straight MCT oil (if no "E4"), preferably first thing in the morning with coffee, to see if this helped. The ketogenic eating plan could come later once she had put on a few pounds. NoCal's Dr. Ann Hathaway, one of Dr. B's star performing clinicians, uses exogenous ketones (salts or esters), twice daily, to help with brain energy demands-- especially during the first few months (or when under-weight).
Finally, rapid decline is a red flag for toxic exposures. Sometimes also hormone insufficiency, especially in women during the first few postmenopausal years. If inflammation markers lit up as significant, rather than trying to "put out the fire" with fistfuls of curcumin & fish oil, the key here is to figure out where the inflammation is coming from. Many successful clinicians in Dr. Bredesen's network report that the use of SPMs, 1g a day for the first 2 months, are often the most effective way to "resolve" on-going chronic inflammation whilst buying the clinical team a little time to figure out where it's coming from-- and devising a plan to address it.
Rapid decline, especially at a relatively young age, is a red flag for toxic exposures.
Dr. Dale Bredesen's “Alzheimer” Dementia Subtypes & Features/Comments
Typical Age of Onset | ApoE4 Risk Factor? | Typical Presentation | Co-Incident Risk Factors | Shown To Be Helpful | |
(Predominantly) Inflammatory “Type 1” | 70s, 80s | Yes | Amnestic | Leaky gut, sleep apnea, oral health issues, pathogens, food choices | High-dose SPMs, IF, clean eating, pregnenolone (if sub-optimal), HIIT, meditation practice, HBOT (after resolution of inflammation, WCFE) |
(Predominantly) Insulin Resistant “Type 1.5” (Easiest to help) | 70s, 80s | Yes | Amnestic | Obesity, diabetes obviously, metabolic syndrome, leaky gut, intestinal fungal or bacterial overgrowths, SIBO | Restoration of IS, addressing any ongoing inflammation, tropic support |
(Predominantly) Atrophic “Type 2” | 70s, 80s | Yes | Amnestic (and/or retaining new information) | Oophorectomy, d/c HRT, acute stress causing chronically elevated cortisol | Optimization of hormones, both levels & function, restoration of insulin sensitivity, WCFE, citicoline, DHA |
(Predominantly) Toxic “Type 3” (Most difficult/longest time to change) | Younger (< 65), typically 47-55 | No (if ApoE4 here, there are more typical “forgetting” aspects) | Problems with word finding, facial recognition, calculating, organizing Depression or other HPA dysfunction also common | Menopause, Andropause, New-Onset Acute Stress, low TG and/or low zinc | Oddly enough, optimizing hormones/ hormone function, exercise If Cu:Zn > 1.3, Brewer protocol If mycotoxins, Shoemaker protocol If heavy metals, consider chelation |
(Predominantly) Vascular “Type 4” (treated same as Inflammatory) | 70s, 80s | Amnestic | DESS (Diet, Exercise, Sleep, Stress) Daily ingestion of NO production foods: beets, arugula, kale, organic spinach, walnuts, pomegranate seeds, green pumpkin seeds, garlic, watermelon | ||
(Predominantly) Traumatic (TBI) “Type 5” (treated same as Atrophic) | Amnestic |
Please note that as Dr. B and his collaborators have gained greater experience with this program, the following observations/modifications have evolved:
Just about EVERYONE with dementia/AD show some sign of insulin resistance in the brain, therefore just about EVERYONE will qualify for inclusion in the Type 1.5 group
Up to 80% of with with dementia/AD will have a vascular component, so again, nearly all comers will also need to address Vascular issues (Type 4).
And since the Vascular folks, according to the program structure, are treated the same as the Inflammatory folks, this put just about everyone also in the Inflammatory (Type 1) group
So now we have virtually ALL COMERS in the 1.0, 1.5 and 4 groups: inflammatory, insulin resistant, vascular. And 50% of these will also have a Toxic (Type 3) component.
Gellman wraps up her piece with the Briggs relishing in a French fry feast on a road trip home to celebrate their new-found freedom. Here she seems to have unwittingly tipped her teenage hand to reveal her what was her baseline bias all along: "Free at last from all those rules! That nutrient-dense, herbicide-free, fiber/polyphenol-rich, low GI menu malarky. Dig into those fries before they get cold. Life is good again."
Yet Dr. Bredesen and his ReCode program (as does Dr. Terry Wahls' self-healing program for MS) ask these things of participants because, more often than not, when followed conscientiously, they produce results.
In his introduction to the series of ReCode training modules, Dr. Bredesen recounts coming across a newspaper article on a plane back from London. One half of an elderly British couple had just received an Alzheimer's diagnosis, and after digesting the news made the heart-wrenching if arguably melodramatic decision to book a double euthanasia trip Switzerland rather than suffer the unpredictable ravages of this disease. Stories like this are common-- but also driven by a misplaced sense of impotence.
I can't seem to get out of my mind this image of Genevieve Lane, a 79-year old woman from The Villages, FL, in otherwise good health, who collapsed suddenly (8/26/23)-- at a Greek restaurant with her best friend-- in thrashing fits so violent the nurses, it was reported, had to restrain her-- after signing on (8/8/23) for the latest hot monoclonal antibody drug pitched for Alzheimer's, Leqembi (lecanamab). She worried that she had been growing increasingly forgetful and wanted to be proactive. How could she have known it would cost her rather than perk up her life?
And the lives of at least two others. No wait, twenty-two.
Here the Times (Walt Bogdanich and Carson Kessler) do Pulitzer grade reporting-- the predatory recruiting, the deception, the malpractice: "What Drugmakers Did Not Tell Volunteers In Alzheimer's Trials"
My parents lived for a time in The Villages, until the original developer (Harold Schwartz)'s son (Gary Morse) took over, massively expanding it until it was virtually inhabitable. My father, in 2015, was diagnosed with Alzheimer's, after only failing a MOCA. He very likely had instead SIFO, or a combination of SIFO and SIBO, and what one in-the-know physicians would label "metabolic endotoxemia." They put him in the Memory Ward all the same, where he died emaciated (the death certificate's cause of death: malnutrition), naked but for a plastic diaper. Not a day went by that he didn't query of the predictably steadily drying up stream of visitors, "When can I come home?"
It might be noted too here that Alois Alzheimer's most famous patient, Auguste Deter, 51, died of septicemia-- from untreated bed sores. His second patient, Johann F, 56, from pneumonia. What are we doing?
Still today, were you to take your life partner or family member to your family physician or neurologist, they would more than likely send you home with a prescription for Aricept (aka donepezil, a cholinesterase inhibitor developed in Japan in 1983 that increases acetylcholine levels-- which may or may not be what your body-brain is missing, and could easily be increased by with egg yolks, organ meat, even beans, mushrooms, coffee; or checking & supporting your vitamin B1-B5-B9 levels) and tell you to come back in 6 months to see how far you've advanced. Then you'd likely be offered one of these monoclonals. Except that, irony of irony, they have recently been shown ineffective (if they are truly effective at all) in people with one or two copies of the ApoE4-- the genetic variant shown to increase one's risk of developing ("sporadic," or late life) Alzheimer's by folds (2-3, 8-12) of magnitudes.
Dr. Bredesen walked away from all this madness because he saw it for what it was. That is one brave, good and selfless man.
Here, as briefly as possible, are my ReCode bottom lines:
Dr. Bredesen's approach is based on the absolute most current research & thinking, and continually tweaked by experience & new information.
People have unquestionably been helped by his program.
No one has been harmed by it.
Yes, it can be challenging, especially if this way of thinking or living deviates dramatically from what you are used to.
Yes, there are unscrupulous people who might use this program to charge you lots of money for things you don't need. (This is endemic in the functional medicine & "precision" medicine world generally, and embarrasses, saddens and angers me.)
Yes, there is an entire range of people certified as ReCode practitioners whose clinical (or detective) skills & competency vary tremendously.
Yes, there is a natural incentive to not want to turn away people who either might not be able to follow the program as strictly as it needs to be followed-- either because they don't have the necessary support at home or because they are not "fully in" with the approach-- and so some people who end up on the program probably should have been told 'no' up front.
Finally, yes, the 75% "stabilized or improved at 6 months" metric might be difficult to achieve in the general population.
And finally, finally, it is my view that Dr. Bredesen's initial Ayurveda-inspired classification of dementia types into Hot, Cold, Sweet, Toxic, is both unhelpful & unnecessary. Yes, it lends an air of special insight to the program, but with very few exceptions everyone generally ends up having aspects of each of these. And as one progresses with the program and regularly measures lab values in order get them into the desired ranges, they end up needing to address insulin sensitivity and toxic exposure and hormone balance and microflora balance. So in a ReCode "3.0," I would remove this and streamline the approach.
Last but not least, it is my experience that Dr. Bredesen has not fully appreciated the primacy of gut health and the gut-brain axis. If you recall, one of naturopathic physician Heather Sandison's star "patient" at Marama was a woman, although coming in with a MOCA of 19, whose only real dementia contributor was fungal overgrowth in her intestines. (I cannot say because I have not spoken with Dr. Sandison about this, whether it was in her large or small bowel, but I would bet that it was the latter and something we would today call SIFO. This is more and more common, not just in cases of cognitive decline but in all sorts of chronic health conditions. Dr. William Davis, whom I admire more each day, estimate that as much as 50% of the U.S. population could be suffering, to various degrees, from either SIBO or SIFO or a combination of the two. The bad news is that it is sometimes very stubborn to treat-- and can even require dramatic life changes (e.g., changing the way one responds to stress, eliminating the sources of chronic stress, or neuro-Vagal re-programming) in order to fully recover.
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