Budgeting Lab Tests, Doctors, ReCODE Reports™

 

Spend your money wisely on the holistic Bredesen ReCODE Protocol™, whether your budget is $500 or $50,000.  Don’t lose sight of the massive importance of daily fundamental practices of good nutrition, physical activity, sleep, stress resilience, cognitive stimulation, and connection when deciding where to spend your time and money.  A “cognoscopy” of lab tests and assessments that generates a personalized ReCODE Report™ can help identify the probable underlying issues to be addressed with diet, lifestyle, and targeted medical treatments for your bioindividual case. 

I’ve seen the adage “an ounce of prevention is worth a pound of cure” prove literally true, having witnessed reversal of Alzheimer’s cost at least 16 times more than reversal of the early, subjective signs of memory not functioning as well as before.  To save money, implement the ReCODE™ lifestyle as early as possible, preferably at the stage of primary prevention by middle age. 

To replicate the successful reversal of mild cognitive impairment demonstrated in the 2021 clinical study would require a significant investment, including ReCODE™ doctor visits, qualified health coaching support, a ReCODE™ subscription, supplements, more expensive food choices, other modest lifestyle upgrades, and sometimes additional large expenses depending on each individual’s diagnosis and holistic prescriptions.  Much of the cognoscopy, healthcare, and subsequent medical treatments entail out-of-pocket expenses often not covered by health insurance. 

Ideally, for those able to make a considerable upfront financial investment, a comprehensive six-month (or longer) program to halt cognitive decline under the care of a an experienced Bredesen-trained physician, assisted by a health coach, is probably your best bet for efficacious progress. 

For those contending with a limited budget, I’ll share my perspective on navigating two cost-conscious paths forward—one for prevention and another for reversing cognitive impairment  My opinions are solely my own and do NOT represent the perspectives of any of the practitioners I collaborate with.  Also, note that I do NOT receive any kick-backs if you sign up for an Apollo Health program below.  Nothing on this page is medical advice.  Please use your own judgment. 

 

The therapeutic order for efficacious treatment

Your brain, mind, and body function in mindbogglingly complex and interconnected ways, well beyond recent leaps in scientific understanding.  No combination of cutting-edge medical interventions alone can reverse dementia.    Medical therapies can help battle infections, replete deficiencies, and assist detoxification in order to support healing and full functioning.  On a simple level, in order to prevent or reverse neurodegeneration, we must create the conditions that tip the balance from what Dr. Bredesen describes as “synaptoclastic” toward “synaptoblastic”.   We principally rely on fostering the conditions for the body to restore balance and deploy its marvelous capacity to heal.  In order to reclaim your capacity to rebalance and heal, you must become an active participant in the Bredesen Protocol™ diet and lifestyle

Shared with permission from the AANMC

Following the therapeutic order used by naturopathic doctors (see infographic) is both the most cost-effective as well as the most promising approach.   Your foundation rests on healthy food, adequate movement, restorative sleep, stress resilience, cognitive stimulation, toxin reduction, and connection.  These lifestyle aspects of the Bredesen Protocol™ are non-negotiable.  I know first-hand of people who have wasted tens of thousands of dollars on therapies done without any diet and lifestyle change.  Conversely, I have witnessed individuals reverse modest cognitive decline through diet and lifestyle before their planned initiation of costly treatments.  Most often, medical interventions will be more efficacious (and thereby more cost-effective) when deployed at the same time as optimizing diet and lifestyle.  Keep the therapeutic order in mind for judicious decisions on the course of your treatment. 

 

Prevention:

I am in dementia prevention mode, leveraging the most cost-effective lifestyle choices and therapies for optimizing my own health.  That means prioritizing the daily lifestyle habits that keep me healthy in combination with occasional medical evaluation and testing to bring to light issues I might otherwise miss.  I prioritize my limited budget to keep from regressing to the poorer health of my past.  I, too, wrestle with the expenditures of the Bredesen Protocol™, making countless cost considerations for lab testing, supplements, treatments, mold remediation, and more. 

nurturing brain health copyright Jen Felix 2018Whenever possible, to spare both money and suffering, implement the relatively inexpensive diet and lifestyle changes as fully as feasible and before cognition declines.  In addition, invest in as much of a cognoscopy (see below) as you can afford to identify and address underlying issues before they manifest in chronic degenerative disease.  Unfortunately, human nature and our conventional healthcare system make it hard for most people to fully embark on this excellent strategy at the ideal stage of prevention.  Be the exception!

Low-cost preventative health practices

For those struggling to make ends meet, you have steps to enhance brain health within your reach.  First off, doing whatever self-care you can to maintain sanity is essential stress management.  This could be taking a daily five minute break to watch the clouds, to bring your attention to your breath, to sing or play music.  Also, target single rather than multiple goals at a time so that you don’t feel so overwhelmed.  Climb the mountain one step at a time. 

Exercise has the most evidence of efficacy and it doesn’t need to be expensive, so prioritize physical activity.  Aerobics can take the form of increasing the pace of your chores (sweeping, vacuuming, squatting down/reaching up to clean, digging while doing these activities with good alignment) or a brisk walk.  For years, I have enjoyed utilizing the free and wide-ranging types of strength, mobility, and dance workouts on YouTube and in free app’s

Another high priority is nutrition.  Eating more seasonal produce (when it’s on sale) in place of processed food choices or resisting eating stuff with added sugar can make a dramatic difference over time.   If possible, consider growing some of your own herbs and vegetables from seed.  For encouragement with dietary and other choices, my San Diego support group is accessible to locals at any income as it is funded by voluntary donations.  (Note that it’s a socially distanced, outdoor, in-person group in San Diego for people at the stage of prevention.)  Free online brain health groups, like ApoE4.info, can boost motivation and education around healthy eating as well as the rest of the Protocol.  Another popular initial step is checking out Dr. Bredesen’s book from your local library and applying.   

Take advantage of free community services to stop smoking/alcohol if those are polluting your health trajectory.  Brain train with the free version of the BrainHQ app and/or take up a low-cost, cognitively challenging hobby or home project to keep your brain stimulated.   Prioritize time to connect with friends and to sleep.  Be creative about other holistic health practices that might suit you better that what I’ve mentioned.   Any part of the Bredesen Protocol™ you can do is a win for your long-term health. 

Those at higher risk for Alzheimer’s should seek professional help to optimize their Bredesen Protocol as much as financially feasible.  For some, progress alone is slow, the breadth of the Protocol feels overwhelming, and/or searching the internet only makes it more confusing.  If that resonates, then you may hugely benefit from the support of a Bredesen-trained health coach as the most cost-effective way to further implement the Bredesen Protocol™ and overcome obstacles. 

 

Budgeting PreCODE™ and the Preventative Health Lab Tests of a Cognoscopy

Test results from the basic lab tests of the cognoscopy will help uncover hidden drivers of disease before they manifest as larger problems.   The full suite of Bredesen Protocol™ lab tests may not be routinely ordered within standard healthcare.  If you can afford it, an exemplary way to begin your cognoscopy is investing in Apollo Health’s PreCODE™ subscription—a combination of  twelve months of access to Apollo Health’s PreCODE™ resources (for $39.95/month for 12+ months) and a smaller suite of lab tests for primary prevention for $259. The direct-to-consumer lab tests can be accomplished in a single blood draw at a local Quest Diagnostics phlebotomy facility and are used to generate your personalized ReCODE Report™ that interprets your results and recommends action steps.  In addition, the PreCODE™ subscription includes quarterly town halls with Dr. Bredesen, educational guides, a community forum, NeuroQ cognitive testing, access to the BrainHQ brain training app, and the ReCODE app.  An ideal cognoscopy for prevention also includes a cognitive assessment, a consultation with a ReCODE Qualified™ doctor, and a few sessions with a Bredesen-trained health coach to begin identifying and remediating potential risks for cognitive decline and other chronic disease.  This combination will help you quickly jump-start living in a way that increases your chance for a long, healthy life while diminishing your risk of dementia.

Many people, including retirees on a modest fixed income, may be keen on preventing cognitive decline, yet feel they cannot afford the aforementioned.  In November 2018, I reached out to two different people at AHNP (now Apollo Health) to request a lower-priced option with just the pivotal lab tests not commonly covered by Medicare or standard health insurance.  I was informed that people are working toward Medicare coverage and that this will “take time”, likely many years.  Since then, I’m thankful for how Apollo Health reduced the expense of lab testing by not adding any markup.  I will continue to advocate for people without ample financial resources.

If you cannot afford PreCODE™ with lab testing, another avenue is to ask your physician to run some of the lab tests listed in Dr. Bredesen’s book and this PDF.  The cognoscopy lab tests with the best chance to be covered under typical insurance, especially during your annual physical exam, include a lipid panel, a complete metabolic panel with fasting plasma glucose, a CBC, hemoglobin A1c, hs-CRP, TSH, vitamin D, vitamin B12, blood pressure, and body weight.

To make a reasonable request for lab testing, offer your doctor printouts of Dr. Bredesen’s research articles (at least print the clinical study the 2021 clinical study,  if not also the 100 patient case report, and ground-breaking 2016 paper) and refer to the list of tests on pages 21-24 in “The End of Alzheimer’s Program” book.   Make your case for additional relevant testing.  If you have a strong family history of Alzheimer’s disease, you may be able to justify the medical necessity for an ApoE genetic test along with genetic counseling.  If you have possibly cognitive symptoms, request a MoCA or other cognitive test.  If you’ve had an elevated HbA1c in the past or elevated fasting glucose, request a fasting insulin test to better understand your blood sugar dysregulation.   If you’ve had anemia, ask for a ferritin test to further investigate.  If you have reason to suspect heavy metal toxicity, you may be able to get initial blood mercury, lead, arsenic, zinc, and copper tests.  If you have an inflammatory issue, use Dr. Bredesen’s book to make your case for additional tests such as homocysteine.  Understand that a full cognoscopy includes more elaborate testing than most conventional doctors will provide, but it doesn’t hurt to ask.   Additional medical factors get analyzed, evaluated, and summarized in a ReCODE Report™  and by practitioners who’ve completed the ReCODE 2.0™ training.

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Affordable preventative care from a Bredesen-trained health coach

When you are both free of cognitive symptoms and at average risk of Alzheimer’s, chances are good that you have a longer prevention timeline ahead.  If you’re truly at the stage of primary prevention, you may opt to get started with the general KetoFLEX 12/3™ diet and lifestyle recommendations described in 2020 “The End of Alzheimer’s Program” book on your own along with free resources on my website.  Your lifestyle choices today dramatically influence your future risk of Alzheimer’s and other chronic diseases.  In order to objectively know that you are actually at the stage of primary prevention, don’t skip getting a simple cognitive assessment Also, consult your doctor to discuss your risk of Alzheimer’s dementia in light of co-morbidities, family history, and possible genetic testing (i.e. ApoE) to reveal additional reasons to take it up a notch from here. 

rainbowThat said, a holistic transition to brain-healthy food and lifestyle is often too much for most people to bootstrap on their own.  Crucially, most people will remain unaware of the aspects of the Bredesen Protocol™ they are missing without professional help.  For affordable expert support with KetoFLEX™ eating and the full spectrum of Bredesen ReCODE Protocol™ lifestyle modifications for brain healing and robust overall health, consider getting one-on-one health coaching supportGroup coaching is the most economical and can provide the most bang for your buck among ReCODE Protocol™ interventions.  I coach people at the stage of prevention either with or without a PreCODE™ account.

For people at the stage of prevention, nutrition and lifestyle provide the most bang for your buck.  I operate a lean, low-overhead practice to help you optimize brain health in a cost-effective way.  Here’s a two-minute video clip of Dr. Bredesen explaining the critical difference that coaching can make.

After implementing a brain-healthy diet and lifestyle for six months to a year, retest any previously out-of-range biomarkers to evaluate progress.  Celebrate your improvements.  If unsatisfied with your progress, it may be worth a consultation with a ReCODE Qualified™ doctor and investing in a personalized ReCODE Report™.

 

Consulting a ReCODE Qualified™ Doctor

A ReCODE 2.0™-trained doctor can examine your overall clinical picture, begin to assess underlying medical issues, provide expert feedback on how you’re doing thus far, and convey the relative urgency of additional therapies.

Apollo Health does not permit me to identify the ReCODE™ practitioners I work with, so please do not ask me to name Bredesen-trained doctors.  Full access to a directory of names, locations, and pricing of Bredesen-trained practitioners is only granted with a “PreCODE™” or “ReCODE™” subscription through Apollo Health.  If you are cost-constrained beyond the monthly subscription fees, then try searching the internet for a Bredesen Protocol™ practitioner either in your region or one who offers telemedicine.  Perhaps this is how you found my website!   You can also find several Bredesen Protocol™ doctors on the ApoE4 Wiki listing.  In addition, you can search among practitioners certified by the Institute for Functional Medicine [IFM] at this link, by inputting your area then using the advanced search option to select those who have completed the “Advanced Clinical Training: Reversing Cognitive Decline”.  Only those who have completed both “Advanced Clinical Training: Reversing Cognitive Decline” and IFM coursework will appear in the results.  (For instance, though I’ve completed the advanced training, my name “Jen Felix” doesn’t pop up because my functional medicine coaching training was through FMCA, an affiliate of IFM.)  If you have a PreCODE™ or ReCODE™ subscription, you may contact Apollo Health for a listing of  ReCODE Qualified™ practitioners’ programs and their pricing.

 

One portrait in prevention:

A 50-year-old San Diego resident on a limited budget invests in five sessions of one-on-one coaching.  As an added boost, she regularly attends my Brain Health Optimizers meetup for general support from a group of like-minds.  Her primary care physician runs as much lab testing as we can justify within in-network health insurance coverage.  One-on-one coaching gives her personalized KetoFLEX™-aligned products, recipes, and dining options that she hadn’t yet discovered and can immediately use to eat more deliciously, nutritiously, and conveniently.  With her budget in mind, she maximizes each coaching session by coming prepared and augments progress by scheduling to-do’s in between appointments.  Coaching helps her get creative about adding in more almost expense-free physical activities.  She seeks a home sleep study through her PCP and HMO insurance and begins coaching to resolve what’s been in the way of better sleep.  A coach is at her side to overcome challenges along the way so that she can keep moving forward.  After months of eating, sleeping, and moving better, it’s not surprising that she has more energy, calm, and strength.  Labs get retested at her next annual exam and show improvements such that almost all of her basic biomarker test results lie within Bredesen Protocol™ optimal ranges.  These new test results are associated with not only marked reductions in her risk for Alzheimer’s disease, but also lower risks of diabetes and cardiovascular disease.  Menopausal symptoms prompt her to consult a doctor within her health insurance network about the risks/costs vs. benefits of bioidentical hormone replacement therapy, as Dr. Bredesen proposes for extended trophic support.  She can hardly imagine a more rewarding return on less than $600 plus insurance co-pays and supplements.  

The positive experience thus far has her committed to sustaining her new brain healthy lifestyle.  Having completed the cognitive assessment baseline and many tests of the cognoscopy, she has the option to invest in the remaining cognoscopy tests, a ReCODE Report™, and/or ReCODE Qualified™ doctor visit(s) if/when her health or financial situation changes.  She also takes advantage of a 25% discount on a Fullscript supplements as needed going forward.


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Reversal:

If you are at high risk for Alzheimer’s or already experiencing cognitive symptoms, it’s time to financially invest in what’s important—your health.  Alzheimer’s disease is a terminal condition with only one treatment (as of early 2021) scientifically demonstrated to reverse cognitive decline: the precision medicine approach known as the Bredesen ReCODE Protocol™.  If you have the means, make the most of the one life you have by investing wisely.  Spend prudently on an evidence-based multi-modal approach and do not be lured by the many versions of snake oil in the marketplace, including marketing from doctors claiming to practice their version of the Bredesen Protocol™ not actually trained and vetted in ReCODE 2.0.

To give you an idea of the cost of a concierge full Bredesen Protocol™ program, I’m currently coaching participants in a six-month trial of cutting-edge holistic treatment to reverse dementia that is valued at about $25,000.   If you are at an earlier stage of cognitive decline than these study participants or if lifestyle is the biggest disease driver in your case, then (using the rough 80:20 rule) it is very possible that investing 20% in a targeted foundational program could allow you to reap 80% of the health and cognitive benefits.  At first glance, even a $5,000 price tag seems high until you compare it to the greater yearly cost of care for each person with advanced dementia.  Overall costs are borne collectively by individuals, their caregivers, insurance, Medicare, the insurance-premium-paying public, and the non-insured who cannot afford healthcare inflated by a market-driven push toward pricey treatment of largely preventable chronic diseases–including diabetes, heart disease, and Alzheimer’s, all sharing many common underlying causes, with treatments that become more expensive as disease progresses.

I have always felt the pinch of financial scarcity when seeking resolution of my own health issues.  I genuinely understand how several thousand dollars can seem like an enormous price tag.  Perhaps we have hope for future financial assistance: I’m aware of an Apollo Health employee advocating for free/sponsored ReCODE Reports™ to very low-income individuals at high risk of Alzheimer’s.  Unfortunately, until we have healthcare reform or universal basic income, personal financial investment is required to successfully reverse dementia. I acknowledge how tragic it is that many steps I’m about to describe can be out of reach.  On the other side, I also know of misplaced frugality that has heart-breaking consequences in continuing cognitive decline.  Once you come to terms with how much you can afford, review some of my ideas for spending prudently below.

When you or your loved one already experiences neurodegeneration, your best chance of stopping further decline or achieving reversal is comprehensive treatment with the full Bredesen Protocol™ as early as possible.  The brain damage often revealed on an MRI of someone with cognitive impairment requires comprehensive treatment, including proper diagnosis of underlying causes, time and energy of the patient and caregiver devoted to living the Protocol, along with plenty of guidance and support from ReCODE™-trained practitioners.  The sooner you begin, the more likely you are to realize a better outcome.  This means not only eating the KetoFLEX 12/3™ way and living a brain-healthy lifestyle, but also getting the cognoscopy lab tests plus quantitative MRI, a cognitive assessment, a ReCODE Report™, a Bredesen-trained doctor to treat underlying medical issues, a Bredesen-trained health coach to assist with implementation of the diet, lifestyle, and overall treatment plan.  That’s what the participants in the successful 2021 clinical trial received.  

 

Budgeting ReCODE™ and More Extensive Lab Testing to Restore Impaired Cognition

two person pushing yellow wall

Utilize your available funds wisely to live your best life.  That doesn’t mean getting caught up in innumerable brain supplements and speculative therapies out of fear or false hope from over-hyped marketing campaigns based on weak or non-existent evidence.  It also doesn’t mean throwing money at expensive medical interventions without putting in the effort to improve diet and lifestyle.   By the time cognitive impairment is diagnosed, effective treatment usually requires nutrition, lifestyle, toxic, infectious, and/or hormonal issues to be rigorously addressed by both an experienced, knowledgeable doctor as well as a health coach, often guided by a ReCODE Report™.  

Apollo Health’s ReCODE™ program is a $75/month subscription for unlimited ReCODE Reports™, monthly online town halls with Dr. Bredesen, a directory of Bredesen-trained healthcare practitioners, optional monthly CNS-VS cognitive testing, tons of resources, and BrainHQ brain exercises.  ReCODE™ requires a minimum of 12 months—a $900+ commitment.  To complete the needed blood tests and assessments to generate a ReCODE Report™, you may work with your physician and existing health insurance for some of the lab tests, then pay out-of-pocket for the ones remaining.  Or order the full suite of cognoscopy lab tests for an additional $780 (the fee in California) through Apollo Health.  Ordering labs through Apollo Health will make the most financial sense when paying out-of-pocket due to limited health insurance or a high deductible.  For comparison, the cash price for a similar, relatively well priced, direct-to-consumer Brain Health Panel is $1,350, yet this panel does NOT include an MMP-9 blood test NOR the valuable ReCODE Report™ as in the $780 add-on blood panel when subscribed to ReCODE™.  (Year-long ReCODE™ subscription with cognoscopy labs discounted to $1,590 in California when paid in a single payment.)

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How I help make the Bredesen ReCODE Protocol™ more affordable

Partnering with an experienced Bredesen-trained health coach, such as myself, will overhaul your diet and lifestyle more quickly, effectively, judiciously, and in a targeted brain-healthy way than you can manage alone.

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When a MoCA cognitive test is needed to document baseline/progress and/or for a ReCODE Report™, I am MoCA-certified and administer this within a coaching session or paid consultation.  A high performing person with modest cognitive symptoms may opt for an online CNS-VS cognitive test for more subtle measures of performance within twelve cognitive domains.   I charge $45, nearly at cost since CNS-VS charges $40 per test with accompanying full CNS-VS report.  Read more about cognitive testing here.  It’s valuable to have an initial measure of how cognitive functioning cognitively to inform your decision on a variety of treatment program options along with commitment of money, time, and energy.  A twelve-month subscription to ReCODE™ now includes CNS-VS testing and summarized results without the full CNS-VS report.

If you need data entry and ReCODE Report™ generation (only available with subscription to PreCODE™ or ReCODE™), I can perform this service at a lower fee than your ReCODE Qualified™ doctor.  I charge commensurate with the time it takes me, $15-$95 depending upon the volume of  test results and other data.

For Bredesen Protocol™ issues within my scope of practice, it’s less costly for my time than a privately paid doctor’s appointment.  A couple of my primary roles include assisting with dietary changes (such as smoothly transitioning people into mild ketosis) and reviewing each person’s ReCODE Report™ analysis with them.  The Report guides the most important personalized diet and lifestyle changes for their condition.  I elucidate cost-effective options every step of the way through diet, different aspects of lifestyle, and moreUtilizing both my advanced ReCODE training and extensive science background, I can provide education around lab testing, supplements, your ReCODE Report™ suggestions, and doctor’s recommendations.   I respect the unique paths of each person pursuing brain health and help them make the most progress with the Bredesen Protocol™ within their financial constraints.

I offer everyone I coach a 25% Fullscript discount off the retail prices of many recommended clinician-grade supplements of the Bredesen Protocol™.  Over years of supplement use, this discount can recoup the cost of my coaching fees.  (Note that this steep discount is not available to readers who I’m not coaching.)  For those who can afford to invest in Dr. Bredesen’s premium supplement formulations, use my discount code “nurture” for 10% discount off ReCODE supplements at LifeSeasons.com. My hope is that the money saved on supplements will be invested in advancing the diet and lifestyle changes likely to have a great positive impact on the course of your life.

There are no quick fixes to reverse cognitive impairment.  Implementing a personalized brain healthy diet and lifestyle generally reduces the need for supplements and medical interventions.  This is why Dr. Bredesen credits the health coach as the most important ReCODE™ practitioner because they assist with the essential diet and lifestyle changes (watch Dr. Bredesen explain this in the video clip above).  Nonetheless, diet and lifestyle alone is not enough to reverse moderate or more advanced cognitive impairment—targeted medical intervention is also required.

 

Navigating additional expenses

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The expense of doctor visits, medical therapies, and supplements can add up significantly, so do your best to navigate these waters thoughtfully.  I caution against selecting a physician based on their doctor’s visit fees alone.  Your overall medical bill will depend on the accumulation of therapies, supplements, additional testing, prescriptions, allied healthcare provider visits, and other treatments beyond the doctor appointments. 

Many times a functional/naturopathic/integrative physician with advanced training in the Bredesen Protocol™ (especially version 2.0) and years of experience successfully reversing cognitive impairment  will have high rates commensurate with their value delivering more effective healthcare.  And sometimes fees are merely inflated.  Some highly qualified doctors admirably keep their rates within reach of more people in need.  Others with less experience or licensure at the nurse practitioner level may offer lower rates and be a diamond in the rough.  You may want to meet with more than one ReCODE™ practitioner with your ReCODE Report™ in hand to find your best match.  

It’s important to have a doctor you can trust.  Dr. Bredesen has publicly stated, “There are doctors who are getting almost everybody better…and there are doctors who are getting almost no one to get better.”  I am currently only collaborating with ReCODE 2.0™ trained doctors and will no longer coach individuals whose doctors fall in the latter group.

Within your care plan, you may be recommended supplements and treatments with a good mechanistic argument for trying them, yet scant evidence of efficacy.  We are in the preliminary stages of research on a multi-modal treatment for a complex disease, so every treatment approach comes with some degree of uncertainty.  Nonetheless, some treatments are far more speculative and others have more of a proven clinical track record of positive health outcomes.  Another reality is that profits made off of supplements and treatments muddy the waters around their potential to be effective, or not.  This financial incentive permeates conventional medicine, integrative/functional/naturopathic medicine, and the internet.  I consistently strive for minimal conflicts of interest and independent thinking.

I must leave it entirely to your doctor to prescribe the best supplements and medical treatments for your case as this lies outside my scope of practice.  I cannot contradict and must also follow your doctor’s recommendations, so you might want to ask your doctor (not me) questions similar to the following:

  • Which of the prescribed supplements are the highest priority for my specific condition?
  • What are the risks of this intervention?
  • What are my other treatment options?
  • What do you think about first trying option A and waiting to take option B if A is ineffective?  (In the therapeutic order described at the top of this page, option A would be the least invasive treatment for addressing the root cause and restoring capacity to heal.)
  • How necessary is this?
  • How many treatments will I need, for how long, at approximately what cost?  How and when will we evaluate whether this works or not?

A few things to keep in mind: Allow 6 months of implementing as much of the Bredesen Protocol™ as feasible (without skipping any critical aspect) before judging progress via symptoms, lab tests, cognitive assessments, etc.  Having cognitive impairment not worsen is a win that defies what was considered inevitable “decline” in the course of cognitive decline.  When you’re really torn about a large commitment to treatment, remember that you have the option to get a second opinion/consultation.  The added appointment expense can be worthwhile if it helps you triangulate towards the most promising treatment that you’re comfortable with and the health outcome you seek. 

When necessary, I’m “patched in” as Dr. Bredesen says, via phone or videoconference during a doctor’s appointment.  That best equips me to work in concert with your doctor and help patients and caregivers fully understand what their doctor presented during a coaching session. 

In later stages of cognitive decline, neurodegeneration can accelerate.  The farther advanced the cognitive impairment, the more compelling it is to try numerous interventions at once, without being overly limited by the absence of clinical trials.  The increased risk, urgency, and lack of alternatives at this stage create different cost-benefit calculations.   Of all the subtypes, Type 3 (toxic) cognitive impairment often comes with extra treatment/remediation expenses and an indeterminate prognosis.  I’ve been at the side of families facing challenging financial and personal decisions.  I do my best to be a fiduciary to everyone I coach while helping them understand the course of treatment options presented by their doctor.  

Results of the Bredesen Protocol™ vary, especially with levels of adherence and degree of cognitive impairment.  That’s why I work very hard to support people to broadly and deeply fulfill all aspects of their personalized Bredesen Protocol™ as possible. Though there are no guarantees of cognitive recovery even when fully applying the Protocol, when it works, it’s priceless. 

Imitations of the Bredesen Protocol™

As an independent contractor, I have coached people who have chosen other doctors’ copycat versions rather than Dr. Bredesen’s protocol.  Sometimes these imitations are less expensive, sometimes more.  It’s satisfying for me to coach whatever is effective for brain health and whatever works best for a particular person.  Ultimately, I too want my coaching practice based on the strongest clinical trial evidence of efficacy, demonstrated clinical outcomes preventing/reversing cognitive decline, and financial accessibility.  I’m not dogmatic about the Bredesen Protocol™ and am willing to shift gears.  In fact, I’ve completed training in the more accessible Weill Cornell approach. 

The official Bredesen Protocol™ comes with advantages.  Unlike copycat versions, each individual’s ReCODE Report™ is generated by an algorithm based on accumulating results from ongoing clinical implementation of the Bredesen Protocol™.  As an example of another major advantage, I’ll briefly remark on my clinical experience with competing dietary approaches. The most robust multi-modal clinical publications on preventing/reversing cognitive decline include the Mediterranean diet of the Finnish FINGER study, the modified Mediterranean diet of the Weill Cornell study , and the KetoFLEX 12/3™ diet of the Bredesen studies.  In coaching practice, there’s no denying that a well-formulated ketogenic diet, like KetoFLEX™, will reverse insulin resistance/pre-diabetes/diabetes (drivers of cognitive decline) more reliably and rapidly than a Mediterranean diet.  For this and numerous additional wide-ranging reasons, I’m genuinely convinced that the Bredesen Protocol™ is clinically more powerful and worthwhile.

One portrait in reversal: 

A 65-year-old talks to his physician about senior moments.  A brief cognitive test reveals signs of cognitive impairment, so he gets referred to a neurologist (that accepts Medicare), a thorough neuropsychological exam, and an MRI.  Since one of his parents had Alzheimer’s, he’s seriously motivated to halt or reverse this decline.  He invests in both a ReCODE™ subscription and suite of lab tests.  Once subscribed, he can access a map of Bredesen-trained doctors, coaches, and their fees.  Since the neuropsychological results revealed cause for concern, but thankfully not advanced disease, he decides to proceed in a manner that judiciously conserves costs while aggressively engaging the full Protocol.  He starts with a single consultation to generate his personalized ReCODE Report™ and inform him of details like the MRI specifications that allow for software quantitation as recommended in the Bredesen Protocol™.  With his Report in hand showing his subtypes and high priorities for treatment, he shops around to find the local ReCODE 2.0™ doctor and health coach team best suited for his needs.  He commits to twelve months of the KetoFLEX 12/3™ diet, all aspects of the Bredesen Protocol™ lifestyle, a moderate supplement regimen, and the medical interventions most likely to help restore brain health for his unique condition.  The program is not easy, so he’s grateful to have the support of his wife, doctor, and coach.  Over months, his Bredesen-trained doctor and lifestyle changes treat the physiological imbalances, deficiencies, and toxicities driving his cognitive decline.  Health coaching accelerates his ability to implement the daily decisions to eat better, move more, promote intrinsic detoxification, relax, train his brain, and understand the doctor’s treatment plan.  All this gets routine and easier over time.  After six months, he feels renewed physically and a bit sharper mentally, with objective improvements in his lab results as updated in his ReCODE Report™.  He no longer needs three of his four prior medications.  He believes the $6000 spent so far has been a profoundly life-enriching investment and will continue to pay for the most salient aspects needed to maintain his improvements.  He looks forward to evidence that his cognitive improvements are indisputable by repeating his cognitive assessment after twelve months.