Using the New Alzheimer's Blood Biomarkers To Sense Danger And Progress
- Michael Barr
- Oct 29
- 5 min read
In his newest book, March 2025, Dr. Dale Bredesen writes of Susan, following her clinical history from her 30's to her 90's, and how she availed herself of the new Alzheimer's blood biomarkers as they became available (and affordable). Some might find it useful, so I repurpose it here.
Susan was full of life and loved to party, but when she turned 35, she did a BrainScan test* and found out that she was ApoE 3/4 and thus at increased risk for Alzheimer's. Her p-tau 217 was normal, and her GFAP was only slightly elevated, indicating some brain inflammation and repair activity. Her biological age, at 39, was a tiny bit high.
With the guidance of a ReCode trained practitioner, she decided to dig in a bit further:
She calculated her HOMA-IR, a measure of emerging insulin resistance, and it came in at 2.0: moderate insulin resistance. (Goal is <1.3)
She did her ApoB: 105 mg/dL
(Target range is 40-90)
A home blood pressure device clocked her BP at 139 over 90.
So all things considered, it looked like she was on a path to developing metabolic syndrome-- perhaps the commonest risk factor for the development of dementia.
So she developed a plan.
She bought a CGM device (Lingo) for $89. (You can now order one for yourself if you have an iPhone, and Android users can set up an alert for when the Android version is out.)
She started Dr. Bredesen's "Ketoflex 3/12" eating program and even purchased a ketone meter to track her progress.
Some do finger stick prick (Precision Xtra or Keto Mojo) for drop of blood.
Others use the breath test, but more and more practitioners are reporting breath results unreliable.
Dr. Bredesen no longer recommends breath testing for ketosis tracking.
Here is a list of vetted products.
She increased her exercise to 5x a week, including both resistance/strength training as well as cardio.
Within a couple of months:
Her BP was at 118/74 ✔
Her HOMA-IR was 1.2 ✔
Her ApoB was 82 ✔
When she re-checked her GFAP (one year later), it was normal.
Re-testing her Bio Age at 40, it came back at 35!
At 42, at 43 and again at 45, though, she contracted various intensities of Covid, and the last one kind of dealt her a real wallop.
Work was growing increasingly stressful too.
She added a wearable sleep monitor device just to sort of check in on sleep time and quality. Here's what she found:
Average sleep duration per night: 6 hours
Average time in deep sleep: 20 minutes
Average time in REM sleep: 60 minutes
The goals here are 7-8 hours, 60 minutes, 90 minutes, respectively. So she was missing all of them.
Her nighttime oxygen saturation (SpO2), though, was fantastic at 95%.
(Goal is 96-98%)
Checking in on the Alzheimer's blood biomarkers p-tau 217 and GFAP again, they were both straying away, if only slightly. When neurofilament light chain (NfL) testing became affordable, she added that in. And it was normal!
DIYers can order NfL testing (but not in NY, NJ, MD) for $278 via Rupa Health at this link
To address work stress, she took some time off. She also started shinrin-yoku (aka forest bathing) and began taking time each morning for some mindfulness meditation.
Low and behold, her energy came back, her deep sleep improved, her REM sleep improved, and she was now sleeping a full 7 hours.
When she re-tested her "straying away" p-tau 217 and GFAP the following year, they have both returned to normal.
And her biological age came back at 40!
At fifty she began BHRT-- but monitoring and adjusting it, not just taking something and never thinking about it again. Dr. Ann Hathaway in San Rafael, CA is the resident expert here, but she is very expensive ($600 an hour).
She did a CAC; it came back at 8!
She did a DEXA bone density scan. It too was excellent.
Around her 55th birthday though, upon upgrading her cell phone she struggled more than usual to figure out all the functions and features. This bothered her.
She decided to do a free online cognitive assessment and got back a result of SCI: Subjective Cognitive Impairment. That wasn't great news.
She re-checked her GFAP and p-tau again: 150 ng/L and 0.50 ng/L-- both elevated but only slightly.
[This is the part of the chronology that chafes just a little, but if I haven't lost you yet, we're almost finished!)]
Turns out that upon urine testing she had signs of mycotoxins: trichothecenes, from dreaded black mold, and gliotoxin, which is produced by Aspergillus.
Without going into all the details, let's just say that she identified the exposures, eliminated them, and cleared the mycotoxins from her body.
Over the ensuing 12 months she noted a return to normal. She was once again organizing and planning as she had always done, and she had no problems with her phone or other technology.
Her p-tau an GFAP were back to nearly normal, and two years later were completely normal again.
At the age of 60, her biological age was measured at 49, and more importantly, she felt great.
60-70 she continued with KetoFlex 3/12. She added EWOT to her workout sessions.
Continued with morning mindfulness meditations, monitored BHRT, some basic supplements (vitamin D+K2, ashwagandha (500 mg BID with meals), DHA/EPA 1 g QD, nicotinamide riboside 250 mg QD, ProButyrate 600 mg QD, urolithin A 500 mg QD, zinc picolinate 20 mg QD, magnesium citrate as needed, for bowels and sleep).
At one point she self-treated suspected SIBO with S boulardi and Atrantil
At 70 her cognition remained excellent, her Alzheimer's blood biomarkers p-tau and GFAP were in the normal range, and her bio age registered at 55.
At 80 her CAC started to drift up (to 15), suggesting some mild plaquing. So she added to her regimen the "vascular triad" of:
nattokinase 4,000 units
(beet-derived) nitric oxide supplement (no dose provided)
Arterosil HP (presumably 2 capsules daily with meal)
She also upped her EWOT training and soon noted that her vascular age (measured by elasticity) came down rapidly.
(Apparently a company called Withings lets you do this at home with your phone?)
A retinal exam showed not suggestion of age-related macular degeneration. (Having an ApoE4 alleles actually reduces this risk.) Nonetheless, she tried to avoid blue light as much as possible.
At 85 her CAC was back down to 7, and her biological age came back at 67.
At 99 she was still going strong. Her doctor and she discussed the fact that, even as an ApoE 3/4, she had avoided dementia. When a friend asked her how much longer she wanted to live, she replied, "As long as I have something to live for." Amen, Susan.
*BrainScan testing appears to be the latest addition to the Apollo Health suite of products. It tells you your p-tau 217, your GFAP, and your NfL. You need to either have an account or register for an account in order to do the testing. If you live in NY or NJ, they may refer you to a neighboring state for the phlebotomy.
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