WHAT IS SLEDSSSS?

Written By Clara Shook

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

  1. Insulin Resistance

  2. Inflammation/Infections

  3. Hormones, nutrient, and trophic factor optimization

  4. Toxins (chemical, biological and physical)

  5. 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

  • Resource: Optimizing Your Diet with Nutrition Therapy

5) STRESS TREATMENT

6) SOCIALIZATION TREATMENT 

  • Include daily stimulation with others

  • Attend groups, classes, volunteer, enter into healthy relationships

7) SPIRITUALITY 

8) SEXUAL 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

Clara Shook
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