Here’s a list of the most impactful items for engaging the Bredesen Protocol™ to Reverse COgnitive DEcline, also known as ReCODE™. Please consult your doctor before utilizing any of the products and tools below.
Dr. Bredesen’s 2020 book “The End of Alzheimer’s Program: The First Protocol to Enhance Cognition and Reverse Decline at Any Age ” is a practical self-help guide for implementing the program (and an update to his previous 2017 book “The End of Alzheimer’s“). His latest 2021 book “The First Survivor’s of Alzheimer’s” portrays first-hand experiences of the Bredesen ReCODE Protocol™.
Recipe books can be found at on my recipes webpage.
Home Ketone Testing
Real-time feedback on how your food choices (predominantly in conjunction with exercise, sleep, etc) affect your individual metabolism is powerful. That’s why you may want to consider purchasing a ketone meter or continuous glucose monitor, see below.
Ketone testing provides an objective biomarker for achieving a mildly ketogenic metabolic state. Blood beta-hydroxybutyrate (measured in a blood droplet by the Precision Xtra/Keto Mojo) and breath acetone (measured by the Biosense meter) are both breakdown products of the parent ketone acetoacetate. All three compounds are energy sources generated when in a state of ketosis. Note that urine ketone testing for “peetones” is inaccurate after adaptation to ketosis and better for preventing ketoacidosis in diabetics (a different goal).
The Precision Xtra blood glucose and ketone meter kit includes a lancing device with 30 lancets and 10 ketone strips, costs about $65-75. The price has dropped significantly on a pack of 30 Precision Xtra ketone test strips to about $30 or around $1/ea. Use one ketone strip for each blood BHB ketone measurement. The meter with extra ketone strips is enough to get you started, but consider adding glucose test strips, additional lancets, and calibration solutions…or buying a kit (pictured).
I use the Keto Mojo, another FDA-approved dual ketone and glucose meter option that may allow a smaller droplet of blood than the Precision Xtra. The Keto Mojo glucose and ketone meter starter kit (newer version than my picture at the right) comes with a lancing device, 10 lancets, and 10 ketone test strips for about $45-50. An additional 60 Keto Mojo ketone test strips also cost about $60, also around $1/ea. Use bluetooth or a USB link to their app for online tracking of ketone readings and related health metrics. I appreciated Keto Mojo’s how-to videos to help me get over initial anxiety about pricking my finger.
For those averse to pricking their finger, new technology allows an accurate evaluation of ketosis by sampling exhaled breath. The Biosense breath ketone meter is a one-time expense of $269 using my $30 discount code “JenFelix” (type the code without any additional spaces in checkout either under the Show Order Summary tab or in the Discount Code box). Since the recurrent costs of test strips add up with long-term/repeated blood ketone testing, a breath analyzer could be easier and more cost-effective in the long run if you’d like the feedback from multiple ketone readings throughout the day over months. Clinical validation of the Biosense device shows about 80% correlation between breath acetone and blood beta-hydroxybutyrate levels.
Continuous Glucose Monitoring
A Continuous Glucose Monitor (CGM) is a tiny wearable device that shows you how your blood glucose level responds to food, stress, and sleep in real time. Continuously wearing a tiny CGM puts you on a faster track to blood glucose regulation than one-at-a-time finger pricks. Nutrisense offers the clinically validated Freestyle Libre CGM device directly to non-diabetic individuals. Nutrisense offers a 7-day trial, a two-week CGM device, and multi-month subscriptions at a variety of price points, including a phone app for tracking your glucose levels and access to chat with their nutritionists. Levels Health and January offer similar, slightly more expensive options–unfortunately the pricing is not readily transparent and there’s not less expensive option to receive only the CGM device and app readout alone. For diabetic individuals, a doctor can prescribe two-week-duration CGMs, available for around $120 each, sometimes covered by health insurance.
Brain training can come is many forms of activities that are cognitively challenging enough to stimulate new brain cell connections. Yes, persevering through a little (not too much), cognitive frustration can be a good thing. If you choose to use a brain training app, keep in mind that your score serves to monitor change over time. Celebrate improvement with practice and be mindful of negative self-talk about your percentile ranking.
To give clinically-validated brain training games a try, you can sign up for a free version at Posit Science BrainHQ. Over one hundred research papers show that exercising your brain with the BrainHQ exercises increases cognitive functioning and quality of life. Pay $14/month (or $96/year) to subscribe for the complete customizable range of BrainHQ activities. A paid ReCODE™ subscription (more details here) includes BrainHQ without an additional charge. Luminosity is a popular alternative brain training app.
While I’m partial to my Oura Ring (below), I haven’t comprehensively investigated and chosen among all the tracking devices available, including Dreem2. I recently tried the Garmin VivoSmart 4 watch with pulse oximetry (~$100) used to track sleep and activity in the clinical study I assisted with, but returned it because I prefer the Oura Ring.
I’ve happily using my pictured Oura Ring for over two years to track my sleep (duration, efficiency, and light/deep/REM stages), temperature, heart rate, heart rate variability, as well as step counts. The Oura app delivers user-friendly daily summaries of readiness, approximate physical activity, and sleep. In November 2021, I ordered the new Oura Ring generation 3 for the coming additional features, including sleep oximetry (I’ll update my experience with this soon). Ask around to hear most people’s high satisfaction with the $299 investment in this small, high-tech biomarker tracking device and app. I’m a genuine fan. For a limited time, feel free to use my link for $50 off with 6 months of free subscription to the app.
A complete Bredesen Protocol™ includes a sleep evaluation. If your doctor doesn’t order a sleep study for you, you can order a direct-to-consumer home sleep apnea test by iSleep yourself. For $199-$249, iSleep will ship you an FDA-cleared WatchPAT device that measures pulse oximetry along with actigraphy/movement, body position, heartrate, snoring intensity, chest motion, and peripheral arterial tone. Within days, you’ll receive the results along with discussion of your treatment options.
If your sleep study reveals low oxygen saturation during sleep, consider the $179 Wellue O2 ring for monitoring oxygen saturation to evaluate progress with mouth taping, myofunctional therapy, dental devices, and/or other treatments prescribed by your ReCODE doctor. The Wellue O2 ring is an FDA-registered pulse oximeter that records oxygen saturation levels over the complete duration of a night’s sleep, without falling off like fingertip oximeters. Though I don’t own this spefic ring, I keep the $38 Wellue fingertip pulse and oxygen monitor on hand to check for any sign of “silent hypoxia” potentially due to COVID and have heard excellent feedback about the Wellue O2 ring for longer-duration pulse oximetry. If the device records sustained oxygen saturation below 96% (for people not living at high altitude), report that to your doctor. Note that a normal/high oxygen saturation does not rule out disruptive apneas and hypopneas–you need a sleep apnea test for that (see above).
3M Micropore tape ($5, a postage-sized piece over lips), Breathe Right strips ($16), Air Max nasal dilator (~$15), and/or a neti pot can create conditions for greater nasal breathing. Breathing through your nose during sleep can come with the benefit of reduced snoring and even reductions in hypopneas/apneas.
The light from devices including computers, televisions, smart phones, and iPads can block melatonin production that would otherwise be generated under more darkness. Elevated melatonin is an important promoter of sleep. To dim light overall and block blue light from electronic screens in hours before bedtime: Install the F.lux app on your PC. Adjust your iPhone settings to “Night Shift” (under “Display and Brightness” on newer model iPhones). Wear amber glasses (I use TrueDark Twilight Glasses and there are a myriad of options from prescription Gunnar amber reading glasses to Zendustries clip-on amber glasses). Install dimmer switches to reduce light levels at night and/or use blue-filtered spectrum light bulbs, such as Lighting Science Good Night LED bulbs.
The App Store offers many excellent meditation app’s. I’ve benefited from Headspace, Ten Percent, and Waking Up. If you’d like to try a free month of the Waking Up app for yourself, go to wakingup.com/free-month and use the promo code: FREEMONTH.
Dr. Bredesen recommends Neural Agility by RevitaMind “meditation on steroids”, available for $97. Neural Agility can be passively listened to by individuals who might not be up for other types of meditation.
The successful Toups et al 2021 clinical study utilized the HeartMath Inner Balance app as a stress management tool. The phone app pairs with a wired iPhone accessory ($95-$130, depending on the sale) that gently clips on your earlobe to measure heart rate variability (HRV). Higher HRV is associated with increased stress resilience, better cognition, and better overall health. The app displays both your HRV and coherence–the synchronization between your heart and your brain. Coherence increases with more parasympathetic nervous system tone–with more relaxation that comes by using the app’s guided breathing exercises. Use HeartMath Inner Balance for a 3-5 minute session both when you need to reduce agitation and regularly for enhanced psychological, cognitive, and physiological wellness. The benefits of HeartMath are documented in over 300 studies. Similar benefits likely come with other mindfulness, meditation, and breathing practices. HeartMath is well-documented and gives the user a kind of biofeedback that may accelerate progress.
Kritan Kriya meditation audio file and instructions on CD or MP3 from the Alzheimer’s Research and Prevention Foundation, $20, is the type of meditation shown to help individuals with cognitive decline in a clinical study.
KetoFLEX™-Aligned Food Products
A high-quality 95% C8 Medium Chain Triglycerides (MCTs) supplement can boost nutritional ketosis. A trial size 3.0 oz Bulletproof Brain Octane costs under $7 on Amazon. Start with a half-teaspoon taken with food in case your gut doesn’t agree with MCTs. If MCTs help you, increase to up to a tablespoon up to three times per day. My coachees can refer to my “Tips for Nutritional Ketosis” for understanding when MCTs are beneficial and when not.
Some with cognitive symptoms may supplement with exogenous ketones. Nutricost exogenous ketone salts, KetoneAid KE1 exogenous ketone esters & salts, and LifeSeasons ReCODE morning balance can provide an exogenous source of ketones when you need a boost above the ketosis accomplished through the KetoFLEX diet and exercise.
Amphora Nueva is an excellent source for third-party-verified high polyphenolic extra-virgin olive oil [EVOO]. Contact Sharon firstname.lastname@example.org to request the ApoE4 discount or Apollo Health community discount when purchasing their premium large 750-ml EVOO at $16 -18 ea (rather than $21) plus shipping from Northern California. Experience the pleasant pepperiness, pungency, and healthfulness of varietals like their Spanish Hojiblanca, Chilean Coratina, and Tunisian Chetoui. FFA polyphenol ratings vary with each harvest, so ask for their recommended EVOO with the highest therapeutic polyphenol levels.
VitalChoice is a great option for buying sustainably harvested seafood tested to be low in hazardous contaminants, like heavy metals. I enjoy their canned wild Alaskan sockeye salmon (with small soft edible bones and skin for extra nutrition, larger 7.5 oz cans, product #CWR706) and tinned wild Portuguese sardines in organic extra virgin olive oil (product #CPS012). Both canned fish taste better than most competing products. Vital Choice has other seafood entrees like 5 oz herbed wild salmon burgers (product #FSB501) and spiced wild blue shrimp burgers (product #FBS404) that make it more convenient to eat safe seafood. VitalChoice seafood is delicious, nutritious, and a bit pricey…so look for their 10% and 15% off sales.
The Bredesen Protocol™ ideally involves reducing the total toxic burden as much as feasible and drinking clean water to enhance kidney clearance of toxins. When considering any water filtration purchase, check for independent lab measurements of the amount of common municipal water contaminants like heavy metals such as lead, chloramine, and fluoride (if added to your municipal water) actually removed by the filter–look beyond empty claims. Two excellent water filtration options are the Aqua Tru countertop reverse osmosis filter (removes 99% of lead, 94% of fluoride, 97% of chlorine) recommended by Dr. Mark Hyman
Eliminating constipation is a key to eliminating toxins out of your body each day. A Squatty Potty ($25 for the plastic one shown left; more for bamboo/teak/taller height) or similar stool can be a helpful aid for regular bowel movements.
My Fullscript supplement dispensary includes numerous premium supplements (including the full Cytoplan, Pure Encapsulations, and Quicksilver Scientific brand lines) and other products (i.e. Dentalcidin toothpaste for gingivitis) that Dr. Bredesen has identified as supporting brain health. Supplements selection is best guided by your ReCODE Report™ and doctor’s evaluation. For prevention, it may be wise to take the minimum effective dose of just the supplements for your individual needs, with awareness of financial incentives to push beyond that. If you are an individual already working personally with me, apply for a 25% discount on my entire dispensary and more using the form at the bottom of my Supplements webpage.
LifeSeasons ReCODE Protocol supplements come in blends that make it easier to take numerous supplements therapeutically for cognitive impairment. Use my discount code “nurture” at LifeSeasons.com to save 10%. You can also save 10% if you subscribe monthly. The maximum discount available is 15% from some practitioners who resell LifeSeasons supplements within their clinics.
Immersive Bredesen Protocol Assisted-Living Facility
Marama is a unique residential care facility in San Diego, CA with the goal of treating cognitive decline and returning residents to independent living with restored health. Participants experience a full, personalized Bredesen Protocol™ including medical care by Bredesen-trained providers in an environment that serves KetoFLEX™-aligned meals and fosters all the other healthy lifestyle practices. (I do not receive any kick-backs from Marama. Please let me know if any similar high-quality treatment centers emerge.)
Disclosure: Jen Felix of Nurture Brain Health participates in the Amazon Services Associates Program—an affiliate advertising program designed to provide a means for sites to earn fees by linking to amazon.com. Some, but less than half, of all the links above are affiliate links, such that I will earn a commission if you purchase through the links. I’m displaying these products because of the quality, value, and usefulness and not because of the commission I may receive from your individual decision to buy (or not).