February 2026 Newsletter: Worried About Your Brain? So Am I…
My mission is to be the first woman in 4 generations to not develop Alzheimer’s Disease (AD). On my journey of discovering ways to mitigate my risk, I pass this information on to you in this Brain-Body-Health (BBH) Newsletter.
Hello, Brain Body Health Citizen Scientists
Worried About Your Brain? So Am I…
Last month, we talked about your superpower of awareness. Many of your comments moved me to write more about how we can use that superpower to reduce cognitive impairment.
This month, I want to zero in on the Apolipoprotein E (APOE 4) gene, the reasons to consider testing and the conversation you can have with your family about genetic testing.
A Brief Review of APOE 4
The APOE gene is likely a very old gene. At one time, it may have helped us hyper-absorb cholesterol so we could survive periods of fasting and infections, because of its pro-inflammatory properties. About 20–25% of the population carries at least one copy of the APOE 4 allele. There are three forms (alleles): 2, 3, and 4. You inherit one copy from each of your parents.
APOE 4 is the highest genetic risk factor for Alzheimer’s disease (AD).
One copy confers about a 2–3x greater chance of developing AD.
Two copies increase that risk even higher
Newer staging models are beginning to consider two copies as preclinical AD.
My Story
Back in 2015, I had no idea about the APOE 4 gene. Even though I was a doctor, there was little accessible information about brain health and genetics. When I started Brain Body Health, I wasn’t just concerned about my brain, I was petrified. My great-grandmother, grandmother, and mother all died of complications associated with Alzheimer’s disease. It felt like a pattern. A destiny waiting for me.
Our family wanted genetic testing, but were discouraged by health care providers who feared it would push us into panic. What I’ve learned since is that uncertainty fuels far more fear than information ever could.
There are lots of reasons to test: My mother wanted to know for her children and grandchildren. Our family tested and discovered that most all of us carry one or 2 copies of the APOE 4 gene.
I went into research mode assessing our risk and something unexpected happened, the fear began to soften. I learned how this gene interacts throughout the body. I learned what lifestyle can do. I learned to care for myself, even while being a caregiver. And I learned what fear really is: False Evidence Appearing Real.
At some point, my question shifted from “How do I avoid AD at all costs?” to “If this happened, what would I do?” So I made a plan for living fully, for protecting my brain, and even for dying well if that ever became part of my path.
Then something deeper changed. I realized Alzheimer’s is not the worst thing that could happen, but living in constant worry might be. Watching friends lose their son after years of exhausting worry helped me see my own pattern. Worry doesn’t prevent disease. In fact, chronic stress may increase risk. When that truth landed, it felt like a new network formed in my brain, one rooted in purpose instead of panic. That’s when I began Brain Body Health back in 2016.
Today, my mission is to become the first woman in four generations not to develop Alzheimer’s and to do everything I can (most days) to reduce my risk and share what I learn with you. I know my risk, but I’m not throwing the dice every day. I see this disease now as a teacher. If it happens, it happens — I have a plan. The fear has quieted. What remains is purpose.
This is my journey. It may not be yours. But it is what I hold in my heart when I speak and when I share this work.
Resistance and Disinformation
Some of you are meeting resistance or disinformation about the APOE 4 gene and Alzheimer’s risk. Health care providers are often unaware of the importance of testing and what actionable ways to mitigate the APOE 4 gene.
But the research is clear: your health practices can offset the genetic risk. We’ve known since the landmark 2015 FINGER Study that lifestyle interventions can slow cognitive decline. More recently, the US POINTER STUDY showed that both APOE 4 carriers and non-carriers improved equally with structured lifestyle changes.
APOE 4 is not only associated with higher risk for Alzheimer’s, but also for other neurodegenerative and cardiovascular diseases. And this is where something important shifts.
The Big Picture
The Apolipoprotein E (APOE 4) gene is not just an Alzheimer’s gene. It is a metabolic gene. It influences:
How you absorb and transport cholesterol
How your body handles glucose and insulin
How efficiently your mitochondria produce energy
Your inflammatory response
Vascular integrity and blood–brain barrier function
Hormonal resilience — especially during midlife transitions
Brain health is never just about the brain. It is about metabolism, circulation, inflammation, and energy production. When those systems are supported, risk shifts.
Genes may load the gun. Lifestyle influences whether the trigger is pulled.
Metabolic Markers Worth Monitoring For Brain Health (Especially if you carry APOE 4)
Because APOE 4 affects lipid metabolism, insulin sensitivity, and inflammation, certain biomarkers become particularly important to track:
Advanced lipid panel (LDL-C, ApoB, LDL particle number, triglycerides)
Fasting glucose
Hemoglobin A1c
Fasting insulin
hs-CRP (high-sensitivity C-reactive protein)
Homocysteine
Triglyceride/HDL ratio
Blood pressure
These markers give you a window into the metabolic environment influencing both cardiovascular and cognitive risk. And the empowering truth is that these numbers are modifiable.
Which means your risk is modifiable.
You can see with all these interactions, the APOE 4 gene is not only worthy of monitoring, but also a major influencer of our health and longevity.
Talking About APOE 4 With Family
Lead with Care
“Because of our family history, I’ve been learning about brain health. I’ve recently found out some of our family carry genes that increase risk of AD.”
Normalize Fear, Emphasize Empowerment
“This isn’t about predicting AD. It’s about knowing if we act earlier we can protect our brain and heart health.”
Reframe Destiny
“Genes are tendencies, not guarantees. Knowledge helps us make smarter choices.”
Share Your Why
“I wanted to reduce the uncertainty. It feels better now that I have a plan to work towards improving my brain and heart health.”
Honor Autonomy
“This is your choice, and I’ll support you either way.”
Gentle Close
“We can’t change our genes, but we can change how we respond. Awareness is our superpower.”
Consider Timing
Set up a time to talk that is calm and relaxed.
If They Say No
“That’s okay. If you ever want to revisit it, I’m here.”
How to Get Tested:
At-Home Kits: Companies like empowerDX, RxHomeTest, and 23andMe offer direct-to-consumer saliva or cheek swab tests that analyze the APOE gene.
Healthcare Provider: A doctor can order the test, which may be recommended if you have a family history of Alzheimer's or are considering specific treatments.
Genetic Counseling: recommended to understand the implications.
Limitations: The test does not predict with certainty who will get Alzheimer's, and it is not a routine test for everyone.
Cost: At-home tests often cost around $99. Medicare and some insurances will pay for the test.
Awareness Is Still Your Superpower
If you carry APOE 4, or suspect you might, remember:
Awareness is your superpower:
You can move your body.
You can nourish your brain.
You can improve sleep.
You can manage stress.
You can build connection.
You can monitor your metabolic health.
You can advocate for yourself.
I accept my risk. But I do not live in fear of it. Instead, I live with purpose.
And I share this with you because you, too, can move from fear to informed action — from worry to awareness — from panic to plan.
We are not powerless. And you are certainly not alone.
Save the date: I'm giving a Brain Body Health talk at the Ukiah Senior Center on March 6th, from 10:00 to 11:30 AM.
Attention: Brain Body Health is now on Substack. You can download it on your mobile device or computer.
Creating each newsletter takes dedication and passion. Supporting this work ensures it can continue to inspire and educate.
Venmo: @bettyglacy
PayPal: @BettyLacy932
To optimal health and peace for all!
Subscribe to the email list for news and updates on Body-Brain Health
“If you want to go FAST, go alone. If you want to go FAR, go together."
- African proverb
To our optimized health!