WHAT IS SLEDSSSS?
SLEDSSSS stands for Sleep, Learning and Laboratory, Exercise, Diet, Stress, Socialization, Spirituality, and Sex. These are specific areas of evaluation BBH targets for intervention to optimize cognitive health. These factors are based on research studies and the RE-Code Program developed by Dr. Dale Bredesen for preventing, reducing, and reversing cognitive impairment. See the Bredesen Program Resource page for more information.
There is no pill on the planet stronger than sleep, learning, exercise, diet, or stress reduction, nor one that can substitute for the importance of socialization, sexual health, or spirituality in life.
THE FIVE CAUSES OF COGNITIVE DECLINE
Insulin Resistance
Inflammation/Infections
Hormones, nutrient, and trophic factor optimization
Toxins (chemical, biological and physical)
Restoration and protection of lost (or dysfunctional) synapses
1) SLEEP TREATMENTS
Optimize Sleep by 7 - 8 hours
Ensure Nocturnal Oxygenation with a pulse-oximeter
Consider a Sleep study if signs of sleep apnea - snoring, overweight, or complaints by bed partner
Exercise daily (150-300 min of aerobic time/week)
Avoid pharmaceutical sleep medications
If need be use periodically: Melatonin 0.5 mg nightly; Tryptophan 500 mg 3x/wk if awakening. Night Rest 1-2 @ HS
Resource: Sleep Scientist Warns Against Walking Through Life
2) LEARNING and LABORATORY focused TREATMENTS
Monitor and learn about biomarkers - see specific laboratory tests and values below
Brain Training with BrainHQ APP: 30 minutes 3 times a week, or 10-20 minutes 5 to 6 times a week. Keep performance greater than 50% of people among your age
Cognitive Enhancement with supplements - see Supplyment Treatment section below
Learn a new language, musical instrument, and/or dance
Understand hormesis - the importance of the good kind of stress when learning
Resources: Bresden Program: The End of Alzheimer’s
3) EXERCISE TREATMENT
Aerobic 30-60 minutes, 5-6/wk for today of 150-300 min/week
Strength Training 2x/week with adequate protein intake
Make sure you are in your aerobic zone
Move more than sitting
Resources: Optimizing Exercise
4) DIET TREATMENT - THINK OF THIS AS A LIFESTYLE rather than diet
Understand the value of nutritional Ketosis Target Ketosis 0.5-4 mmo/L
Initiate healthy fat, moderate protein, low carb diet
A low-glycemic/low-inflammatory/low-grain diet enhances autophagy
Fast 12 hours each night, including 3 hours prior to bed
BMI (Body Mass Index) 18-22 - higher increases inflammation
Protein, Fat, and Fiber intake optimized
5) STRESS TREATMENT
Familiarize yourself with stress reduction techniques
Meditation, Mindfulness Practices, Yoga, Tai Chi, Tention/Trauma Releasing Exercises; Heart Math
Resources: Stress treatment, Our Polyvagal World Safety Trauma, Unshakeable: Trauma-Informed Mindfulness for Collective Awakening by Jo-Ann Rosen
6) SOCIALIZATION TREATMENT
Include daily stimulation with others
Attend groups, classes, volunteer, enter into healthy relationships
7) SPIRITUALITY
Resources: Meditation Mindfulness Spirituality
8) SEXUAL HEALTH
Learn more in the upcoming February 2024 Newsletter “Sexual Healing and Health”
9) SUPPLEMENT TREATMENT
Curcumin 1 g twice a day, empty stomach or with good fats
Ashwagandha 500 mg twice per day with meals
Bacopa Monnieri 250-500 mg twice per day with meals
Magnesium Threonate
H.- Erinaceus (Lion's Mane) 500 mg once or twice per day
ALCAR (alpha L-carnitine) 500 mg per day
Lithium Orotate 5 - 10 mg at night
Gotu kola 500 mg twice per day with meals
Citicoline 250 mg twice a day
Resveratrol 100 mg each day
Nicotinamide riboside 100 mg
Shankhpushpi (skullcap) 2 capsules per day
Resource: Supplement Treatment
10) LABORATORY TEST AND VALUES FOR RE-CODE PROGRAM - Biomarkers/ Vitamins/ Hormones/Toxins
What tests do I recommend following while on the Brain Body Health Program? Fasting blood sugar, Hgb A1C, Insulin fasting, HOMA IR or use calculator, Magnesium, APOE4, APOB (endothelial inflammation), LP(a), Mercury test, Herpes Simplex titer. CBC (complete blood count), CMP (comprehensive metabolic panel), B12, Vitamin D3, TSH, free T4, free T3 (Thyroid panel): Omega 3 index (fatty acid panel); PSA every year for men beginning age 40 if + prostate cancer family history or age 60 if no symptoms or history.
MOCA Montreal Cognitive Assessment
Other health screening tests: WOMEN DEXA Scan(bone health) every 2 years beginning post menopause, MEN- yes you need this too! every 2 years beginning at 70; Calcium Scoring Test every 5 years (dependent on radiation history); Vital signs (every year dependent on history): MRI of brain with NeuroQuant Analysis, dependent on history; Mammogram age 54-74 every 2 years for women, men if BRCA 1/2+ or if gynecomastia.
11) VITAMINS TREATMENT
Vitamin B12 Methylcobalamin 1000mcg - Level 500-1500 pg/ml; reduction of homocysteine/inflammation improves cognitive functioning
Vitamin B9 L-Methyl-folate 1000 mcg - Level 10-25 ng/ml Correction of MTHFR genetic variation: L-Methyl-folate, reduction of homocysteine
Vitamin B6 Pyridoxine - Level 60-100 mcg/l reduction inflammation/homocysteine,
Vitamin B1 50 mg - Important for memory function
Vitamin C 1000 mg - For those with suboptimal Vitamin C levels or copper: zinc ratios greater than 1:2
Vitamin D 2500 IU per day - Level to 50 - 80
Vitamin E 400 - 800 IU - When vitamin E levels are less than thirteen
Vitamin K2, as MK7 100 mcg - If taking vitamin D3
12) TOXINS TREATMENT
Measure: Heavy Metals or Biotoxins, such as mold
Resource: Mold and Mycotoxins, by Neil Nathan MD
13) HORMONE TREATMENT - Measure and Optimize
Optimize Estradiol with Bio-identical Cream or Patch - Increases Hippocampal volume; level 40-60 pg/ml
Optimize Progesterone - Prometrium 100-200 mg at bedtime, balance to Estradiol level ratio
Optimize Pregnenolone - Increases energy; level 50-100 ng/dL
Optimize Testosterone - Supports synaptic maintenance; level total testosterone: 24-45 ng/dL for women; 500-1000 ng/dL for men
Optimize DHEA - Regulates synapses; level 200 mcg/dL for women; 300-350 mcg/dL for men
Optimize Thyroid - Improves energy/memory; levels FT3 = 3.2-4.2(pg/ml), RT3 = 8-25, TT3 = <20, ratio FT3 to RT3:>20; FT4 1.3-1.8, TSH = <2.0
Optimize Vitamin D3 - Improves inflammation; level 50-60 ng/ml (always include Vitamin MK7)
14) BEHAVIORAL STRATEGIES
Do Not Focus on Numbers of Targeted End Results: Many times patients are discouraged by their current levels, keep in mind that the goal is never too far away no matter where you start. AD treatment is a long and continuous process.
Always be Aware of Where You Are in the Process: Keep track of when you are improving, where you stand, and when things need to be adjusted.
Be Open to Discuss: Now is the best time to get help on your symptoms. Take advantage of today's social networks, such as the Internet and health coaches. Be kind to your body.
“Stick With the Program:” The best results was the outcome of people who committed to the program. You have to maintain the protocol in order to achieve the intended goals because the protocol contains many elements only achievable over time.
Start at Your Own Pace: At first, the list may seem intimidating however it is a process, therefore adopt a number of easy elements that you will be able to maintain before adding in more aspects of the protocol.
Resource: Dopamine Fasting
The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline