Marc Joseph Nutrition - Blog

From a recent US News & World Report cover story:

[P]erhaps as many as 640,000–under the age of 65…have dementia, the vicious thief of minds that steals memories, personality, relationships, language, and ultimately the ability to function as a human being.

“In the last five years, more younger people have been showing up at support group meetings and in doctors’ offices, asking for help, and we realized this is something we need to start taking seriously,” says neurologist Ronald Petersen, an Alzheimer’s and memory disorders specialist at the Mayo Clinic. It afflicts people in their 50s, their 40s, and even in their 30s. “Alzheimer’s is not just a disease that hits 80-year-olds in nursing homes,” says Dallas Anderson, a specialist in the epidemiology of dementia at the National Institute on Aging…

…”Nationally,” says Pierre Tariot, director of the Memory Disorders Clinic at the Banner Alzheimer’s Institute in Phoenix, “there’s not enough help for younger people with dementia–or older people.”

This growth in cases is clearly a significant challenge and a potential crisis, both in human and financial terms, if steps aren’t taken to proactively address it.

The official name for the early development of AD is “early-onset dementia.” The national Alzheimer’s Association acknowledged in a report earlier this year that it’s becoming a widespread problem:

Early Onset Dementia: A National Challenge, a Future Crisis

Younger afflicted individuals face complicated issues that older people don’t necessarily encounter:

In the years before they are diagnosed with the disease, younger people may fail at and lose their jobs, leaving their families in financial hardship and having to wait years before qualifying for disability or Social Security. After diagnosis, Schneider says, “friends and employers sometimes turn away from us, like they’re afraid they might catch the disease.”

The key questions are:

1. What is causing this increase in dementia cases among younger people?
2. What can be done to prevent the condition and/or slow its progression into AD?

Potential Causes

Regarding the first question, the answer is very complex, as there are likely multiple potential causes, both genetic and environmental. As noted in the US News article, however, the condition is likely more than genetics:

Scientists studying the genes of younger patients have found three mutations that seem to make some susceptible to the disease. But these genes don’t explain most of the cases, says John Morris, director of the Alzheimer’s Disease Research Center at Washington University in St. Louis.

What’s disappointing about the US News article is that it doesn’t emphasize the potential environmental factors, such as diet and environmental toxin exposure, that likely account for the majority of the increase in dementia cases.

Instead, the article paints a dire picture of a “progressive and incurable brain disease” that can currently primarily be treated with drugs that act as ineffective patches:

No one is truly happy with the current crop of drugs approved in the United States for the treatment of Alzheimer’s. Their names–Aricept, Cognex, Exelon, Razadyne, and Namenda–are familiar to anyone who cares for a dementia patient. “What all these drugs have in common is they act on the symptoms, not the underlying disease,” says John Morris, director of the Alzheimer’s Disease Research Center at Washington University in St. Louis. They boost chemicals that help the brain form memories, but “they don’t help a lot.”

The article does mention that new drugs are in development that may more directly address the condition. However, the drugs mentioned are focused on halting the development of beta-amyloid plaques. For years this area has been the primary focus of pharmaco AD research.

Now, though, the AD community is publicly acknowledging that there is likely much more to the picture. Many researchers have emphasized the importance of looking at potential upstream causes of plaque development, but have not gotten their ideas published. That focus may be changing, as this recent Wall Street Journal article noted:

[The] “there is more to” [AD than beta-amyloid plaques] statement. It is the focus of a paper in the October issue of the journal Alzheimer’s & Dementia reporting on a “research roundtable” convened by the private, nonprofit Alzheimer’s Association…

…[W]hen you think about it, concluding that B-amyloid and plaques cause Alzheimer’s is like believing a scab on your knee causes pain. The scab is the body’s response to an earlier injury. Similarly, there is evidence that amyloid plaques don’t cause Alzheimer’s.

To be fair, the online version of the US News article does include links to more about AD and potential treatments, and these links do mention the importance of pursuing diet and lifestyle habits that are good for the heart, as they are also likely helpful for brain health. But, the focus of the hardcopy article is on the drugs mentioned above, as well as on other palliative care steps, like using Post-It notes and computers to keep track of things.

Familiar Symptoms

It was interesting to read the story of one of the people with early-onset AD profiled in the article:

[H]e got weak and bedridden, sick with what turned out to be a wheat, or gluten, allergy. The next year, he was diagnosed with diabetes and started taking pills and insulin shots. But this was different. “My coordination and balance were off,” he says. “I had trouble hitting a light switch when I reached out for it. I found that I really had to concentrate on all my movements.” Over the next two years, memory troubles became more apparent…His major complaint is a lack of focus.

Wheat & gluten allergies? Poor blood sugar regulation? Coordination and balance problems? Progressive memory decline? Lack of focus?

And other AD symptoms from the US News story’s online resources:

• Problems with language.
• Disorientation and confusion.
• Inability to follow directions.
• Poor or decreased judgment.
• Problems with abstract thinking.
• Changes in mood and behavior.
• Changes in personality.
• Social withdrawal.

Gee, is there another condition with similar symptoms?

Hmmm, say one like…autism?

Could heavy metals, which are implicated in autism, also be playing a role in the development of dementia and Alzheimer’s disease?

Researchers have taken a look at the role of heavy metals in AD in a recent issue of the Journal of AD. Unfortunately, the focus of this research summary is on aluminum, iron, and metals other than mercury.

Yet, mercury poisoning symptoms closely mirror those of autism, mercury exposure produces brain lesions similar to those observed in AD, and mercury induces the formation of beta-amyloid and tau tangles (both commonly observed in AD) in neuroblastoma cells.

The question is: Why hasn’t more research been done to look at mercury as a potential contributory factor in the development of dementia and AD?

Could it be because the primary exposures to mercury are from amalgam fillings, vaccines, seafood, and emissions from coal power, chlorine, and cement plants? What role have interests representing these groups played in slowing and/or suppressing further research in this area?

What to Do

While we wait for answers to these questions, I think that anyone who is experiencing early-onset dementia would be making a big mistake to not explore whether heavy metals may be playing a role.

Unfortunately, there is no laboratory test for measuring heavy metals in the brain (if only it were so easy). Most doctors will run a blood or urine test to check for heavy metal poisoning. But knowledgeable practitioners know such tests are relatively worthless for measuring long-term, chronic exposure to heavy metals and current levels in various tissues of the body.

A hair test is the best bet for identifying potential heavy metal toxicities. And even this test, when done, is often interpreted incorrectly. (Hint: Low mercury levels don’t necessarily mean no toxicity. In fact, they could mean high toxicity.)

It’s important to work with someone who is familiar with:

• What test/s to run & how to correctly interpret them
• What to do if the test/s suggest metal toxicity, e.g.:
  • Safely remove existing exposures (e.g., amalgams)
  • Provide nutritional support
  • Safely reduce existing heavy metal levels using low, frequent-dose chelation.
  • Address existing chronic infections (e.g., fungal, viral)
  • Support endocrine function (thyroid, adrenals)

In my nutrition consulting practice, I am very familiar with this approach. In fact, I used it myself to fully recover from mercury poisoning and symptoms that, coincidentally, closely mirrored those of both autism and Alzheimer’s disease.

I was in my mid-30s when that occurred. The word “incurable” never entered my mind. If dementia begins to affect you or people you know, I hope that you won’t accept such a label and will instead work with a knowledgeable practitioner to take a close look as to whether heavy metal toxicity may be playing a role.

(Photos: Jeffrey MacMillan for US News & World Report)

A new review study to be published in an upcoming issue of The Lancet notes that there are over 200 industrial chemicals that may damage the human brain, yet most are neither examined for potential effects on the developing brain nor tightly regulated. With one out of every six children now affected by a developmental disorder, the stakes are high.

As one of the study’s authors notes: “We must make protection of the young brain a paramount goal of public health protection. You have only one chance to develop a brain.”

This article does a good job of summarizing the study’s important points:

Few chemicals are assessed for neurotoxicity in the developing brain:

The authors then examined the published literature on the only five substances on the list–lead, methylmercury, arsenic, PCBs and toluene–that had sufficient documentation of toxicity to the developing human brain in order to analyze how that toxicity had been first recognized and how it led to control of exposure…the number of chemicals that can cause neurotoxicity in laboratory animal tests exceeds 1,000

The toxicity issue is most critical for children:

A developing brain is much more susceptible to the toxic effects of chemicals than an adult brain. During development, the brain undergoes a highly complex series of processes at different stages. An interference–for example, from toxic substances–that disrupts those processes, can have permanent consequences. That vulnerability lasts from fetal development through infancy and childhood to adolescence. Research has shown that environmental toxicants, such as lead or mercury, at low levels of exposure can have subclinical effects–not clinically visible, but still important adverse effects, such as decreases in intelligence or changes in behavior.

The impact is significant, both in terms of people and dollars:

[Researchers] conclude that industrial chemicals are responsible for what they call a silent pandemic that has caused impaired brain development in millions of children worldwide. It is silent because the subclinical effects of individual toxic chemicals are not apparent in available health statistics. To point out the subclinical risk to large populations, the authors note that virtually all children born in industrialized countries between 1960 and 1980 were exposed to lead from petrol, which may have reduced IQ scores above 130 (considered superior intelligence) by more than half and increased the number of scores less than 70. Today, it’s estimated that the economic costs of lead poisoning in U.S. children are $43 billion annually; for methylmercury toxicity, $8.7 billion each year.

What can be done?

The study’s authors have four recommendations:

1. Document chemicals that have caused toxic effects on the nervous system in humans to facilitate targeted preventive action against releases of these chemicals;
2. Document human exposures to neurotoxic chemicals and identification of subgroups at risk due to residence, occupation, diet, and other factors;
3. Research the consequences of developmental exposures to neurotoxic chemicals to expand our understanding of the long-term consequences of such exposures; and
4. Screen for neurotoxicity of commonly used chemicals to identify those that may present a hazard to brain development.

But they mention that these actions are expensive and will likely not be taken soon.

In the meantime, there are steps that individuals can take to protect themselves and their own children, including:

• Drinking filtered water
• Avoiding produce that is high in pesticides
• Reducing the use of harmful cleaning products in the home
• Selecting safer personal care products
• Having your residence tested for lead if it was built prior to 1978, and having lead paint professionally sealed and/or replaced
• Avoiding mercury in fish, amalgams, and vaccines

And for people who suspect toxin exposure may be an issue for either themselves, their own children, or future planned children, there are also other actions that can be taken.

It’s a true tragedy that better warnings and precautions weren’t provided by city and government agencies to the more than 40,000 police, firefighters, and other people who worked on cleaning up the debris at Ground Zero.

In fact, agencies assured people living and working in the surrounding area that there was nothing to worry about:

Literally before the dust had cleared, the administration of New York’s then-Mayor Rudolph Giuliani assured a terrified city that the air was safe. On September 16, the city’s health department issued a public statement declaring that “the general public’s risk for any short or long term adverse health [effects is] extremely low.” The same day, EPA Administrator Christie Todd Whitman volunteered her own bill of clean health: “There’s no need for the general public to be concerned.”

Of course, we now know that wasn’t true. Even a federal judge has concluded Whitman’s statements were “deliberate,” “misleading,” and even “conscience shocking.”

Now the effects of those decisions are being felt:

Today, increasing numbers of emergency service workers are reporting breathing and digestive problems and rashes, and their incidence of cancer is higher than normal. At least one death, that of Detective James Zadroga in January, from heart and lung complications, has been linked by a medical examiner to work at Ground Zero; six other responders in their 30’s and 40’s have died from causes like heart failure and lung cancer…

…A study of more than 12,000 firemen and emergency medical workers at the site, recently published in the American Journal of Respiratory and Critical Care Medicine, found that on average they had a reduction in lung function equivalent to what would be caused by 12 years of aging.

Fortunately, the health of some people is improving with the help of heavy metal detoxification:

Doctors and other health practitioners at the Olive Leaf Wholeness Center, in downtown New York…, have detected heavy-metal poisoning in many of the Ground Zero workers they have seen. They have given these workers detoxification treatments — including chelation for many patients. Chelation, a treatment often used on children exposed to lead paint, involves giving the patient a sulfur compound that draws heavy metals from the tissues.

These practitioners have found that after three to four months of detoxification therapy, the afflicted Ground Zero workers see most of their symptoms diminish or disappear.

You can learn more about heavy metal toxicity and treatment here.

Pretty amazing:

“The bottom line is it’s more hazardous than the Pentagon admits,” Fahey said, “but it’s not as hazardous as the hard-line activist groups say it is. And there’s a real dearth of information about how DU [depleted uranium] affects humans.”

There are several studies on how it affects animals, though their results are not, of course, directly applicable to humans. Military research on mice shows that depleted uranium can enter the bloodstream and come to rest in bones, the brain, kidneys and lymph nodes. Other research in rats shows that DU can result in cancerous tumors and genetic mutations, and pass from mother to unborn child, resulting in birth defects.

Iraqi doctors reported significant increases in birth defects and childhood cancers after the 1991 invasion.

Iraqi authorities “found that uranium, which affected the blood cells, had a serious impact on health: The number of cases of leukemia had increased considerably, as had the incidence of fetal deformities,” the U.N. reported.

Depleted uranium can also contaminate soil and water, and coat buildings with radioactive dust, which can by carried by wind and sandstorms.

In 2005, the U.N. Environmental Program identified 311 polluted sites in Iraq. Cleaning them will take at least $40 million and several years, the agency said. Nothing can start until the fighting stops.

Unfortunately, there aren’t really good treatments for quickly/safely removing uranium from the body. Supplementing with iron may help to reduce the body’s levels.

You can find more info on heavy metal detox here.