Can You Reverse Alzheimer's? A New Hope With Dr. Heather Sandison

Reversing Alzheimer’s is not just a hopeful phrase; for many, it is a clinical reality. Dr. Heather Sandison, a naturopathic doctor and founder of the care model Solcere, is challenging the traditional paradigm that cognitive decline is irreversible. In this episode, we explore the root causes of Alzheimer’s disease, including toxins, nutrient imbalances, and chronic infections, and discuss how personalized lifestyle interventions can foster an environment for brain healing. Whether you are seeking prevention strategies or looking for ways to support a loved one, Dr. Sandison offers deep expertise and actionable steps to help optimize cognitive health at any age.

The information presented in Fully Alive is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before making changes to your health regimen. Guests’ opinions are their own and do not necessarily reflect those of the podcast host, production team, or sponsors.

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Can You Reverse Alzheimer’s? A New Hope With Dr. Heather Sandison

Challenging The Alzheimer’s Paradigm: A New Vision For Brain Health

This episode tackles one of the most feared diagnoses in modern medicine, Alzheimer’s disease. For decades, the narrative has been largely the same. That cognitive decline is progressive, irreversible, and something we can only try to slow down. What if that story is incomplete? What if, in many cases, it’s possible to improve brain function and even reverse aspects of cognitive decline?

My guest is Dr. Heather Sandison. She’s on the front lines of challenging that paradigm. She’s a naturopathic doctor, founder of a care model that’s focused on reversing cognitive decline, and the author of the book Reversing Alzheimer’s. Her work builds on the research of her mentor, Dr. Dale Bredesen, taking it into real-world clinical practice, where she’s seeing measurable improvements in patients, sometimes in a matter of a few weeks.

In this conversation, we’re going to explore what’s driving Alzheimer’s, why traditional approaches may be missing the mark, and what it looks like to create an environment where the brain can begin to heal. We also dig into what this means for the future of our society, prevention, and how all of us, no matter our age, can start protecting and optimizing our cognitive health. Dr. Sandison brings both deep expertise and real hope to a topic that impacts so many families. Let’s dive into this episode with Dr. Heather Sandison.

Dr. Sandison, thank you so much for being with us. It’s been a joy to get to know you over these last few months and the time that we’ve shared together. I’m excited to dive into all things Alzheimer’s and brain health. It’s so fun to have an expert like you on the show to learn from and for our audience to get to learn from you and your expertise. Thank you so much for being with us.

It’s a privilege to be with you. Thanks for having me.

You’re someone who’s unique in your field. You have this amazing book and these protocols. You’ve done the work and are helping people significantly improve things that are associated with Alzheimer’s and cognitive impairment. I’m always curious. How did you end up in this work? What drove you into this field? What drove you to do the work and the research that you’ve done to get to the point that you’re at?

I stand on the shoulders of giants. There are so many incredible people who have come before me and done the hard work of proving that you can benefit someone with dementia and Alzheimer’s. I ended up in naturopathic school because I was much more interested in health than in disease, and my own medical issues that came up in undergrad.

I went to undergrad in San Francisco, hoping to go to UCSF, the best medical school on the West Coast. I was very much interested in medicine and health, but then became disenchanted with the conventional medical approach as I navigated some of my own health issues during my undergraduate career. I stumbled across naturopathic medicine while I was in San Francisco.

The moment I heard about it, this idea that we think of the doctor as the teacher, that we want to treat the root causes, and that we want to understand everything that it takes to create a healthy human, and want to understand and dig into that. Versus having surgery and medications in your tool belt. That immediately was attractive to me. It was what I wanted to spend my life doing. Fast forward to being in naturopathic school, one, it was an incredible experience. I feel so lucky I got to do it. There are amazing people who are attracted to that program and that approach.

Still, I was taught the way most providers are. In my neurology class, I remember very distinctly being told there was nothing we could do to support someone with Alzheimer’s. That to suggest that we could would be to do harm and create false hope. That whole premise has been turned on its head. There’s a woman who works with my mentor, Dr. Bredesen. She calls the suggestion that there’s nothing that can be done creating false hopelessness, and that is doing harm. There is so much that we can do to protect brain health.

There is so much that we can do to protect brain health.

My mentor, Dr. Bredesen, I didn’t meet him in person until many years later. In 2017, I was at a conference, the Integrative Medicine for Mental Health Conference, where he was speaking. He described this stacking of everything I had learned in naturopathic medicine around getting toxins out, treating chronic infections, optimizing hormones, and optimizing nutrient balance. He described stacking all of these things I learned in naturopathic medicine so that you could get improved neuronal health.

I didn’t believe it at first. I didn’t think that this was possible because I had been told by well-meaning, well-educated instructors, everybody in the media, and everything out there up-to-date, all of our resources said there was nothing that you could do for dementia. I didn’t believe Dr. Bredesen at first, but when he described how they did it, I was like, “This conceptually makes sense.” The brain is not separate from the rest of the body. If you create a container that supports health, if you get the junk out and put the good stuff in, how could you not get better functioning cells? It was common sense.

After hearing him speak, I went ahead and went to his training. He had a weekend-long training. It was reassuring for me when I showed up for the training. He essentially had packaged all of functional naturopathic medicine into the weekend and then made it applicable to brain health. It was all things that I already knew, but there was an orientation towards supporting some with dementia, like thinking through the medications that come up and the imaging that comes up there more specifically.

There are risks, and also, the population is older. There are certain things that we need to think about. It’s not just generic functional medicine. Applied to dementia and Alzheimer’s, it can be very effective. What we see in the literature over and over again is that it’s the most effective approach. It has taken us ten years to get there. If someone tells me, “My neurologist said there’s nothing I can do about this. I can come back in a year, and we’ll measure the decline,” I get this pit in my stomach. That’s factually inaccurate. There’s so much we can do to protect and preserve brain health as we age at this stage.

You’ve been at this for ten years. You mentioned you had your own health issues. I always find that it’s interesting. For many people in the healthcare industry or in the field that you’re in, it often stems from something that was either personal or someone that they loved, and they’re trying to solve a problem. I’m assuming that you solved your problems through your naturopathic root-cause foundational approach.

I had a pretty severe TMJ. I was very cold. I was living in San Francisco. I’d come from the tropics, from Hawaii, where I’d grown up. I was having trouble eating. I could barely brush my teeth. It was challenging. There was a lot of emotion. I was homesick. There were lots of things related to it. I ended up seeing an osteopathic provider. I went to the dentist. I got mouth guards. I went to many medical providers. I remember being at the student health center, and he was Googling TMJ, and then he gave me a muscle relaxant. It made my jaw a little bit better, but I was groggy. It was a disaster.

The brain is not separate from the rest of the body. If you create a container that supports health, get the junk out, and put the good stuff in, how could you not get better functioning cells?

I went and saw this osteopath, and I was 80% better in an hour. She’s the one who encouraged me to go to naturopathic school. Runa Basu was her name. She’s up in the Bay Area. She’s fantastic. I feel so grateful for her. I saw her twelve times, and then I didn’t have any issues with my jaw until I had my baby. I flew back up to the Bay Area to see her. I saw her once or twice, and it was fine.

That’s amazing. Thanks for sharing that part of your story, too. When someone does get the bad news, “You’ve been diagnosed now with Alzheimer’s or dementia or you’re having some MCI.” It does seem like a hopeless journey from that point on. At Shell Point, that’s something that’s a concern for a lot of people. It’s probably the biggest fear for most of us as we’re aging. We’re like, “What if I lose my cognition and have cognitive impairments or dementia or Alzheimer’s?” That seems to be one of the scariest things that’s out there for people.

I love that you’re bringing this message of hope. I love what you said. I want to underline that. It was creating false hopelessness to say, “There’s nothing you can do.” You’re turning that on its head by saying, “There is a lot that you can do.” Explain the difference and what’s been discovered. Is it true that there’s this traditional belief that’s all about the amyloid plaque that most people hear about, that it’s a metabolic lifestyle-driven condition? Is that the differentiator that you’ve studied and focused on? Can you break that down for us a bit?

Reframing Alzheimer’s: Moving Beyond The Amyloid Hypothesis

It is a terrifying time. I want to agree with you and echo that to have a diagnosis of Alzheimer’s or a diagnosis of MCI, or to feel yourself like you’re walking into a room and you can’t figure out why you’re there. You can’t remember the neighbor’s name, or you’re misplacing your keys and wallet more than you used to. These things start to make us wonder, “Am I going down that path?”

Particularly when you’ve seen family members go down the path of Alzheimer’s over the past generations or two, there was nothing we could do. There was no cure. Still, to this day, there’s no cure, but there’s a lot of hope. It triggers in us this terror to think, “I might be dependent on others. I might lose my dignity. I might lose my mind.” No one would choose that. Usually, when you ask people, “Would you rather lose your legs or your brain?” They’re going to pick legs every time because it’s such a terrifying thing to imagine.

Exactly to your point, how have we gotten here? What happened with all of the resources that have been thrown at this awful disease? With so many people aging and approaching this time in their lives when they are at the highest risk for developing dementia, why don’t we have a solution? There are a couple of explanations. There are entire books written about this. One is called How Not to Study a Disease: The Story of Alzheimer’s. The other is called Doctored by Charles Piller. The first is by Karl Herrup. These are essentially descriptions of the history. How did we get here? What happened?

We’ve been focused on this amyloid hypothesis. At one point, if you were studying dementia and you weren’t studying amyloid, you weren’t studying Alzheimer’s. The issue is the paradigm. There’s this perverse incentive in the pharmaceutical industry. To cover the extremely expensive costs of researching a medical intervention or drug, you have to be able to patent it and sell a certain amount of it to recover those costs. It has to be a unique single molecule in order to patent it. It encourages a very simplistic approach to finding a solution to a complex disease.

That complex disease deserves a complex intervention, but it’s not one that you can patent. Unfortunately, we’re stuck in this spot where we have all this money going towards this amyloid hypothesis. These monoclonal antibodies are available. Kisunla and Leqembi or Lecanemab are on the market. Aduhelm or Aducanumab has been taken off the market. It was riskier and less effective than the other two that are available.

The issue is that on April 16th, I believe, of 2026, there was a Cochrane Review article. This is a meta-analysis and a large review of all of the data on the monoclonal antibodies. The authors’ conclusions were blunt. Essentially, these don’t work. They’re very expensive with a high risk of brain bleeding and brain swelling. We need to pursue a different mechanism of action. This doesn’t work to go after amyloid. We’re quite good at getting rid of amyloid, but that does not equate to a meaningful benefit cognitively.

Alternatively, the hopeful side of this is that much of this is within our control. We don’t have to wait for the next medication to be approved by the FDA. We don’t have to wait for science to catch up. We know, based on multiple studies that include multimodal interventions that focus on lifestyle, such as diet, exercise, sleep, and stress management, that we consistently get improvements in cognition.

With the monoclonal antibodies, at best, what we got was a reduction in the rate of decline. With lifestyle interventions, we see an improvement in cognition. This is up to us. What it comes down to is day-to-day what we decide to eat, what time we go to bed, who we surround ourselves with socially, and how much movement we get day-to-day. These are the things that have an impact on our cognitive health over time.

If we know we’re at high risk, if we have genetic risk that we’ve identified or even elevated p-tau-217, or if we’ve identified some risk factor. There’s a bunch more that we can layer onto those lifestyle factors, like getting toxins down, getting infectious agents out, and getting hormones optimized. There’s so much else we can dig into with the medical provider.

The amyloid hypothesis is that it’s the root cause of the cognitive impairment of dementia or Alzheimer’s. While we’re on that topic, can you clear that up for us? For Alzheimer’s, dementia, and MCI, explain how they are all interrelated.

This is confusing. Dementia is the umbrella term. Underneath dementia, Alzheimer’s is the most common form of dementia. Dementia is an age-related memory loss that affects your life. You can have Alzheimer’s disease. This is the early stage where there are changes in your brain, but your cognition is fine. Maybe you’re still working. You’re still doing your thing. You may never progress to Alzheimer’s dementia.

Other types of dementias include frontotemporal dementia and Lewy body dementia. There’s Parkinsonian dementia. There are multiple types of Alzheimer’s, including posterior cortical atrophy. There’s a type of dementia called LATE. There are a bunch of different types of dementias. As our diagnostics are getting better, we’re getting better at differentiating between them.

However, it’s important to know that someone who has Lewy body dementia might also have some amyloid and vascular dementia. They are not mutually exclusive pathological processes. There’s a nuance to it. We always want to grip that ICD-10 diagnosis code. We want a diagnosis that can be helpful for people. The interesting thing, in my opinion, is not what we call it, but why it’s happening. It’s playing in the field of what the drivers are.

To your point, we think of beta amyloid as the cause of Alzheimer’s. Certainly, amyloid is related. These are correlated. If you have high amyloid, you’re at a much higher risk of having Alzheimer’s dementia. However, you can have amyloid and perfect cognition. You can have dementia and not have any amyloid. Usually, then, it’s different. It’s not an Alzheimer’s process. It’s a different type of dementia if the p-tau is negative or the amyloid PET is negative.

With the amyloid, what is going on there? Amyloid and phosphorylated tau are misfolded proteins in the brain. I have this beautiful house plant behind me. I’m very proud of how well I take care of it. It thrives on hate and neglect. If my house plant starts to struggle, I don’t look at it and go, “It must be misfolded proteins. Let me get them out.” We think about, “What is going to help this complex organism thrive? Does it have enough water? Is it getting enough sunlight? Does it need more fertilizer? Does it need more nutrients? Is something poisoning it?”

We think about what are all the inputs and outputs that a complex organism needs to thrive. Amyloid is there to protect us. Amyloid and phosphorylated tau are both antimicrobial. They get upregulated in response to gum disease, cold sores, and toxins. We see on autopsy that there are microorganisms that are encased in the amyloid. It’s there to protect us. If we take it away, but we don’t take away the triggers, then what we end up with is an unprotected brain.

Amyloid is there to protect us. If we take it away, but not the triggers, then we end up with an unprotected brain.

The Six Primary Triggers: Identifying Root Causes Of Cognitive Decline

We hear about p-tau a lot. It’s phosphorylated tau proteins. That’s a misfolded protein. That happens all the time in our bodies, that proteins misfold because of oxidative stress. If we remove the reactive oxidative species and remove inflammation, we’re limiting the misfolding of proteins. If we’re talking about the root causes of what leads to these things, is that one of the things that’s at the root, then?

Absolutely. Even in the functional medicine space, some people say amyloid isn’t the cause of Alzheimer’s. It’s inflammation. Those are both interesting, but what caused the inflammation? We want to think about what caused the amyloid cascade to start. Microglia is another way that we think about it. One of my mentors, Dr. David Perlmutter, is coming out with a book called Brain Defenders. It’s all about microglial activation, like what turns it on, what activates it, and then what makes it calm down.

We’re thinking through that systematically. What will calm the microglia? We don’t want to have a medication that goes in and turns them off. There are things that are triggering them. What are those triggers? I would argue that there are six of them. We can dial this in and systematically go through the six primary level or causal level factors or imbalances that will drive a neurodegenerative process.

They’re imbalances. It’s too much or too little in the wrong place at the wrong time. Whenever we have an imbalance in a complex system, it’s going to lead to dysregulation in education systems, financial systems, and ecosystems in the brain. Imbalance is going to cause dysregulation. In this case, it’s Alzheimer’s.

The six causal level things are imbalances and toxins, imbalances in nutrients, imbalances in the structure, imbalances in signaling, imbalances in stressors, and imbalances in infectious organisms or in the immune function. I’m happy to go into those in further detail. My book, Reversing Alzheimer’s, goes into those in great detail, but I’m happy to dive into them.

Give us a minute on each overview, if you can. If people want more, they can order your book and dive into it.

There’s lots more. If something pops out to you as you’re reading, take that one and run with it. A lot of people already know these things. There’s a gut feeling or a knowledge of, “That one’s the one that I need to focus on.” If that’s the case, don’t wait. Dive into these things. When it comes to toxins, I think of them like ice cream. There are three flavors.

Toxins include heavy metals. Mercury in particular is very neurotoxic. Heavy metals can be toxic. Aluminum is another one that people associate with Alzheimer’s. Mycotoxins or biotoxins come from water-damaged buildings and are associated with mold growth. They can grow in drywall, if you’re in Florida, after there’s a hurricane or a flood.

Third are the chemical toxins. These are forever chemicals, such as plastics, pesticides, herbicides, and petrochemicals. These can also accumulate and become neurotoxic. We want to look for those three types of toxins. Sometimes, we can identify exposures. Not always. In other cases, we can get specific about how we bind and get those toxins out.

Second, we talked about nutrients. For nutrients, we think of micro and macro. We can have imbalances in both. We can have too much sugar, like our carbohydrates. If we’re thinking of our macronutrients, which are our carbs, fats, and proteins, too many carbohydrates lead to diabetes. Sometimes, you’ll hear Alzheimer’s called type 3 diabetes. Certainly, having insulin resistance or diabetes will put you at higher risk for dementia. Optimizing metabolism is important. We recommend an organic ketogenic diet.

Often getting into ketosis will have a huge impact on energy and cognition. From the micronutrient side, we think about minerals. Lithium orotate at 5 milligrams a day has been shown to support our cognition. Creatine, an amino acid, has been shown to support cognition anywhere from 5 to 20 grams per day. Talk to your doctor before you start that. Those are things that can be safe, efficient, and effective for supporting brain health and memory.

We had a creatine expert on, so that’s perfect.

Go back to that episode and learn even more. Also, B vitamins. We want to look at the micronutrient side. Do we have too much or too little? Do we have enough to support our brain metabolism? Stress-wise, we want to be thinking about too much and too little. Being a caregiver for someone with dementia increases our stress and burden, significantly for most people. It increases our risk of being diagnosed with dementia from anywhere from 2 and a half to 6X. Being a caregiver is directly impactful on the brain. It is making sure that you don’t have too much stress. High cortisol levels, over time, are toxic to the hippocampus, so we have to mitigate that.

On the flip side of the stressor, certainly, you’re going to have too much, but you can also have too little. We need to have purpose and meaning throughout our day. We’ve got to have a reason to get up and go. A lot of people derive that as they get older from mentoring, hanging out with grandkids, volunteering, or being involved at church and other social organizations. It is thinking about, “Where am I going to derive purpose and meaning after I retire, so that I’m not just kicking my feet up, waiting for 5:00 to have happy hour?”

We’ve talked about toxins, nutrients, and stressors. Structure also comes in micro and macro. We talked about microstructure. The APOE, our genetic risk. That’s something that we can look into and understand our risk. For the macrostructure level, I think of it as plumbing. Can we get air through our airway at night? Do we have obstructive sleep apnea that’s going to make us hypoxic, have low oxygen, and prevent our brain from getting enough oxygen at night? It’ll also prevent us from getting the deep sleep that we need to rinse the toxins out of our brain.

It is important that we protect and optimize our sleep as we age, but throughout our lives, particularly if we have a genetic risk for dementia. Looking for sleep apnea and aggressively treating even mild sleep apnea is very important. Also, understanding our cardiovascular risk. If we don’t get blood to the brain because of high cardiac calcium score plaques or atherosclerotic plaques because we have a stroke. Vascular issues can cause dementia. We need to optimize not just for brain health, but for cardiovascular health.

Deep Dive: Signaling, Infections, And Vascular Health

Chronic pain is another piece of that microstructure. In the way that a chiropractor or an orthopedist might think of it. If your hip bone isn’t connected to your leg bone, and that keeps you from sleeping because you’re in pain or keeps you from exercising. That’s going to have downstream effects. Making sure that our physical structure is optimized is important. We’ve talked about toxins, nutrients, stressors, and structure.

Signaling is the microglial activation that I alluded to. Microglia are the immune system of our brain. If they are in attack and defend mode, we’re using all of our resources. If you think of a country at war, that country is not building roads and schools. The only thing it’s doing is attacking and defending. What we want to do is resolve that. We want to get up over toxins and the infections and resolve that war so that we can shift the signaling into that rebuilding or that repair.

Things that do that that signal rebuild, repair, and grow our hormones, like our testosterone, estrogen, progesterone, DHEA, pregnenolone, enough thyroid hormone, enough vitamin D, and vitamin K2. We call them vitamins, but they are more hormones. There’s Brain-Derived Neurotrophic Factor or BDNF, that comes from muscle and goes to the brain to signal neurotropic behavior of the cells and signal more connections. It is that synaptogenic connection between neurons that helps us remember where we put our keys.

We’ve got to have enough. It’s that balance. Too much testosterone is too much testosterone. It can create a risk of cancer. It can do damage. Not enough is going to reduce the signaling to our brain that tells us to grow, connect, repair, and regenerate. There are stem cells and peptides that we can go into in terms of signaling as well, but I don’t want to miss infections because this is one that’s highly actionable for people.

I mentioned that HSV-1, the herpes virus that causes cold sores, plays a big role. P. gingivalis also increases the risk of dementia. The oral microbiome, gum health, and dental health play a big role in the brain. Additionally, Borrelia, the Lyme spirochete. There’s a neuro-Lyme. That has also been found on the autopsy of people who have suffered from Alzheimer’s. COVID is another one. We’ll probably predispose more people to the dementia called LATE. That happens more to people in their 80s and 90s.

It’s a slower-progressing form of dementia. It seems to be triggered by viruses like COVID. COVID itself can cause clotting in the microvasculature that can lead to ischemic changes, more related to vascular dementia. Certainly, this is something that’s important to address. I’m sure many people out there who had COVID go, “My brain was not working the same after that.” For some people, that lasts quite a while. Helping with vascular health and helping with blood flow perfusion is an important piece of that post-COVID cognitive change scenario.

Those six triggers are imbalances. I love how you said they’re imbalances. There can be too much or too little. With stress, we don’t want to sit around and do nothing all day. We want to have some healthy stress. It’s like, “I’m volunteering. I have meaning and purpose.” You mentioned the Brain-Derived Neurotrophic Factor comes from lifting weights.

We want to put a little bit of stress on our bodies to trigger that sort of thing. This is helpful to understand those six triggers and imbalances. What is so great about that is that there are actions you can take for each one. I’m assuming that’s what you lay out in your book and in the protocols that you’ve developed that have helped people reverse some of their cognitive impairments, right?

Exactly. That’s what we do. I feel like it’s about starting where it feels good for you. My hope is that somebody out there reading is like, “I’m going to make that appointment for the sleep study or I’m going to start wearing my CPAP tonight.” That is amazing. They’re like, “I’m going to start exercising.” To your point, it’s that hormetic effect when it comes to stress. What we want is enough stress to get the system to learn more resilience.

What we want is enough good stress to get the system to learn more resilience.

That’s exercise. That might be fasting three hours before we go to bed so that we get better sleep. That is stressing the system a little bit so that we get even more resilient. We’re a stronger, healthier organism. That’s good stress. It’s when we have too much of it. Sleep deprivation is always bad stress. There are nuances to this. My hope is that everyone reading saw themselves in one of those pieces and can do something to start optimizing.

Those are all things that we can do that would prevent cognitive impairment in the long-term. If you’re reading this or you’re like me in your 40s, all of those lifestyle factors can go together to help me maintain brain health long into the future, right?

Yeah. Even more generally, these are considerations for health and longevity in general. We’re talking about them in the context of brain health. However, these are all things that are going to reduce cancer risk and cardiovascular risk that are going to help us maintain our youthful vigor well into our 80s and 90s. That’s the goal.

I love that you’re bringing hope to people who have maybe what’s a scary diagnosis. You’ve run a residential center that people have come to. They live there for 6 to 12 months at a time, and then are able to move out and go live life on their own. I’ve heard other stories. One of our mutual friends’ mothers-in-law went through your protocol and was having some severe cognitive impairments. A year later, she’s traveling the world on her own, driving, and doing everything else. It works. Could you share a few anecdotal stories or other stories of success and things that you’ve seen happen to give people some hope?

Evidence Of Recovery: Clinical Trials And Success Stories

We had the good fortune of being able to run a clinical trial in our office, where we took 23 participants through a 6-month intervention. Seventeen of the 23 improved their cognition. They all started with Measurable Cognitive Impairment or MCI. It was both mild cognitive and measurable cognitive. We did not exclude people who had a diagnosis of Alzheimer’s. It’s not anecdotal. We see this consistently, both in the study that we published that came out of our office and also in the other literature where other providers are doing this as well.

The first patient who opened my eyes to this, I saw her in late 2017 or early 2018. She came in with a MoCA of two. The MoCA is the Montreal Cognitive Assessment. This is a blunt tool. We use it to establish where someone is on that spectrum of mild cognitive impairment versus more measurable cognitive impairment versus dementia, going down that path towards debilitation.

She was a 2 out of 30. Normal is 26 and above. Perfect is 30. The closer you get to zero, the more severe the impairment you have. She was a two, so she had an extremely severe impairment. She was barely verbal. Her handwriting was cramped. She could barely write. She was completely dependent on her husband for everything. It was scary.

I had been trained by Dr. Bredesen. His book had come out. I was the only provider in San Diego, so people were coming to me with a lot of enthusiasm that I did not have. I did not have confidence in this at all. Here she was, very severely impaired. I was like, “I’ll go through the motions, but I don’t expect anything from this.”

Six weeks later, she came back, and her MoCa score was a seven. She had dramatically improved. She wasn’t perfect, but her handwriting was better. She was speaking in complete sentences. She was bickering with her husband because of something that had happened before they got there. It was funny. She had this bright, beautiful smile. You could tell her soul was in there even the first time I met her. She was this incredible human, and she was still in there.

They did it. They got her dental work done. They started ballroom dancing three times a week. They got on the ketogenic diet. They moved from their moldy bedroom into their living room and started living in their living room. They got all the supplements for bioidentical hormone replacement. She did phenomenally well.

I remember thinking that day when I saw her, “We must have done something wrong. We must have measured this incorrectly.” When her husband confirmed, “It’s different. We are going in a different direction.” I was so delighted, but also, I was like, “So many people don’t have to get this far. If we start intervening earlier, people don’t have to have severe dementia.”

We’ve had a case where we had a patient go from a MoCA of 3 to a MoCA of 7. We’ve had patients go from MoCAs of 8 to 16. Those are severe cases. What they do is they give us that inspiration. They give us certainty that this is working. If we see someone that far progressed and consistently improved, then we know that prevention is working. We know from these earlier stages that it’s not just happenstance or chance that people are improving.

What I love is working with those people who are in MoCa scores of the low 20s, like 22 or 23. Maybe they’re even trying to work a little bit still or stay engaged as much as possible, and they get back to 30. That is so fun. They get back to driving. They’re doing things independently. They’re no longer afraid they’re going to become that burden on their family.

They have time to travel and experience life. Those relationships stay strong. My favorite thing in my work is when I show up. There’s a patient supported by their family, and six to eight weeks in, they’re like, “My mom’s back. She’s buying the age-appropriate presents for the kids at their birthdays again. She’s baking. She’s doing all those things that we love about her.” That’s fun.

That’s great. I hear a lot that Alzheimer’s or other dementia-related issues often start with, “This has been going on for twenty years. You don’t notice it until much later.” I’m assuming that a lot of people who are still working or have a little bit of, “I forgot where my keys are.” Some of those things are indicative of the beginning stages, but to have the hope that you can get back to a full, healthy 26 and up on the MoCA score, and living and thriving still. That’s very hopeful.

The number one way to know if your brain is having those changes early, before you have symptoms, is the p-tau 217. That’s that marker. That’s what they’re talking about. When someone says Alzheimer’s changes are happening decades before you have symptoms, the way to know is that p-tau.

That’s a test that people can ask for when they’re getting their blood panel drawn.

Function Health offers it on the Advanced Brain Health panel.

It’s interesting. We’re talking about brain health, but brain health is just health. All these things that you’re talking about are lifestyle things that are going to help keep us healthy for longer.

We see that. Don’t come off your blood pressure medications without talking to your doctor, but people who are working with us get off their diabetes medications, blood pressure medications, and antidepressants. The side effect of this is that you’re healthier.

That’s exciting. I imagine a lot of our readers are in that boat, like, “How can I implement some of these things so that I don’t end up there?” Others may have a loved one or relative who is having some of those symptoms. What percentage of the population is being impacted by dementia or dementia-related things at this point?

The Future Of Brain Health: Demographic Shifts And Treatment Horizons

My personal experience is that everyone I talk to knows someone. In First World countries, there’s a reduction in the incidence of dementias, but not all of them. Parkinson’s isn’t going up. There’s nuance to that, but generally speaking, there’s a reduction in the incidence of dementias. It’s increasing in the Third World. The issue is the demographic shifts.

Every day in the US, 10,000 people turn 65. The Baby Boomers are approaching this time in their lives when they are at the highest risk. That is what’s so scary. How many people in our population are going to be approaching this? There are not enough people to care for them. Caring for someone with dementia is not a one-person job. It’s not up to the spouse or one adult daughter. It takes a village. Often, they need 24-hour care. Sometimes, there are combative behaviors. It is awful. It is an awful disease, so it takes a huge amount of resources.

It’s emotionally trying and financially bankrupting. It is physically very demanding to care for someone with dementia, but not every story is the same. There are some people who have the best dementia. I have one patient who says, “It’s the best day. This is the best soup. This is the best everything.” He keeps repeating that phrase. They call it the best dementia. You have those people who are blissed out in their dementias, but that’s not typical. Typically, it’s quite torturous. If we can get anyone to avoid the suffering, then we’ve done our jobs.

I love that. When you think about the future, we have the age wave or the silver tsunami. Ten thousand people a day are turning 65, so we have this massive demographic shift. More people are going to be faced with the potential reality of some of these things happening in their lives. In the future of treating, curing, or reversing Alzheimer’s and other dementias, what do you see on the horizon? What are you excited about as you look into the future?

I’m not anti-medication. I do hope that with the research, the taxpayer dollars, and all of the effort that’s gone into looking at medications, we find something. I will be the first one to scream it from the rooftops. If there is an IV or a pill that you can take to reverse this disease, I will be the first one to tell everyone. Even with the monoclonal antibody therapies, I am of the opinion that if you take a male who’s APOE 3-3, who tends to do the best with the monoclonal antibody therapies, and does all this Bredesen work, where you get the toxins out, get rid of the triggers, and then use the monoclonal antibody therapy, you do end up in a better place.

There’s utility in combining these things. Let’s take the best of all of it. Let’s set people up for success, and then let’s get them the medications that augment that or support that. There was a GLP-1 study for dementia that did not pan out, but in the right person who is overweight, has insulin issues, and maybe is drinking too much and eating too much, the GLP-1s reduce the risk of Alzheimer’s.

We can use medications in a way that supports and complements the functional medicine piece. That’s my hope. I want to see a world where dementia and Alzheimer’s are optional. The Lancet is an international journal. They suggest that 45% of worldwide dementias are preventable. Based on my work, that number is much higher. I hope that for our generation, we have the choice.

Some people are going to want to indulge and have that life. They’re like, “I’ve earned this. I want to have ice cream, drink my cocktail, and sleep when I die.” That’s fine. No judgment. For other people who are looking for something different, people in their 30s, 40s, and 50s, we can choose a different path. We can choose to reduce that risk.

On that note, what do you personally do? What does a day in the life of Dr. Sandison look like? How do you practice what you preach in terms of implementing these things in your own lifestyle and staying healthy, both for your brain and overall?

Living The Protocol: Dr. Sandison’s Daily Routine For Brain Health

My morning routine is a big part of that. I aim to get up between 5:30 and 6:00. I go downstairs, and I make myself a matcha. I get an organic Japanese matcha that I love. I put in it a product called Keto Brainz. I don’t make any money off these products. These are what I buy personally. I probably should get a discount, but I haven’t yet.

I use this Keto Brainz product that has MCT, theanine, lion’s mane, and Alpha-GPC in it. That gets me some of those ketone precursors. I also put about twenty grams of creatine in there. Sometimes, it’s ten. I put 10 to 20 grams. I put in a lot of creatine. I also put collagen powder in there to get some protein. That’s my breakfast. I have that in the morning. I usually use a little almond milk or coconut milk to make sure I don’t raise my blood sugar. I then meditate for twenty minutes, and then I start my day.

I usually go to Pilates. Depending on my parenting schedule, I’ll go to Pilates from 7:00 to 8:00, and then start at my desk by 9:00. I have that chunk of time from 6:00 to 8:30. That is my chunk that I’m taking care of myself. I do that before I take care of other people, plus my daughter. I’m at that phase in parenting.

Prioritizing sleep is a big one for me as well. There are always other things to do. At the end of the day, there are always more emails, and there’s always more to do, but I aim to get into bed by 8:30 or 9:00 and have enough time so that I can get good, high-quality sleep and make up for the nights when it doesn’t always happen. I’m trying to keep that sleep deficit low, optimal sleep high, and activity wherever I can get it throughout the day.

Do you monitor your sleep with an Oura ring, Garmin, or anything like that?

I do. I’m wearing an Oura. It keeps me honest.

If someone has sleep apnea, in your opinion, would an Oura ring show their lack of deep sleep or lack of REM sleep?

It may, but I wouldn’t rely on it. I used to order a sleep study for someone to tell me that they snore, for someone to say that they wake up tired, and for all these things. If somebody has any cognitive change or is at risk for cognitive impairment, I want them to get a sleep study. I might prioritize it differently if they say yes to some of these trigger questions. However, if someone’s working with me within a year, I want to have a sleep study. I cannot miss that. It is my job not to miss that.

I can’t tell you how many older women don’t have a partner, or their partner takes their hearing aids out at night. Nobody’s hearing them snore. They’ve had these patients go in, and they see sleep medicine. I’ve literally had this happen more than once, where they are told, “I can tell by looking at you that you don’t have sleep apnea.” Forty-eight hours later, I have a report that says severe obstructive sleep apnea.

Estrogen is responsible for tissue integrity and laxity. You get more laxity. That’s why we have wrinkles and the skin sags. Estrogen is responsible for some of that integrity. The same thing is happening inside as it’s happening outside. That’s happening in the airway and the soft tissues that keep the airway in place.

You can have more tissue laxity, which leads to that obstruction. You don’t have to be an overweight male to have OSA or Obstructive Sleep Apnea. That’s something to keep in mind. You don’t have to snore to have Obstructive Sleep Apnea. You don’t have to be gasping. A lot of people have this misinterpretation that there will be overt signs when there aren’t.

It doesn’t hurt to get a sleep study.

No. In fact, I highly recommend advocating for one. Get one. The other thing with them is that a lot of people will say to me, “I know I’m never going to wear a CPAP, so why should I even get the study done?” There are these tongue stimulators. There are mouth guards that are for keeping the jaw forward and keeping the airway open.

A sleep study is another thing. People are like, “If I go to that overnight sleep study, it’s four hours away. I can’t drive. How am I going to get home?” They have these watches. We use WatchPAT, which is a watch plus a ring. They’ll ship it to you. You use it at your home. It beams the information up to some sleep doctor somewhere, and then they can interpret the data.

It’s not perfect. The overnight sleep studies in a clinic are the gold standard. Don’t get me wrong. If that is too much of a chore, get the WatchPAT-style at-home sleep study, because we discover a lot of sleep apnea that way. I’d rather you get that done as a preliminary. If it’s negative, and you’re waking up tired, figure out a way to get that overnight sleep study. The overnight at-home watches don’t rule everything out, but they will rule a lot in. It will pick up apnea, but we won’t always pick it up when it’s there. That has been very helpful in our practice in terms of being able to get people more access to that.

It gets the ball rolling. This is so informative and helpful. You’ve given a lot of people hope, and you continue to do that. People can connect with you. You have your own podcast, right? ThinkWell AgeWell. That’s one place. I know you have a newsletter as well. Can they find that by going to your website, DrHeatherSandison.com?

You are exactly right. You can sign up for our newsletter. If you’re on Instagram, I’m @Dr.HeatherSandison. Solcere is the name of our clinic. Solcere means Solutions for the Cerebrum. My book is Reversing Alzheimer’s, which is available wherever books are sold.

That website is ReversingAlzheimersBook.com.

It’s on Amazon also. It’s everywhere.

That’s a great place to start, too, of digging into these six triggers, imbalances, and then the protocols around reversing or preventing those.

We’re happy to support in whatever way serves people.

Thank you so much for the amazing work that you’re doing, bringing help to people. Thanks for being with us. I wish you well. I hope that many people reading this will choose to take some action and make a difference in this, or to share this with people that they love and care about. Thank you so much.

Thanks for having me.

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Final Thoughts: Taking Action For Long-Term Brain Health

Thank you so much for tuning in to that episode. I hope that was a helpful conversation for those of you who may be lacking hope at this stage of your journey or wanting to prevent these things from happening in the future. Maybe it’s one that you need to share with a friend or family member who’s going through something like this. It can maybe be helpful and bring some hope in a place where it seems a little hopeless.

Heather dove into those triggers or imbalances in six different areas and lifestyle factors that can lead to significant cognitive decline, and then what we can do about those. I would encourage you to check out her book, Reversing Alzheimer’s. The website we mentioned was ReversingAlzheimersBook.com. You can connect with her and receive her newsletter at DrHeatherSandison.com.

Sign up for her newsletter there. Also, tune into her show, ThinkWell AgeWell. There are many tips and other therapies that she mentions there. Check her out and do a little deeper dive into all of these topics we explored. Thank you so much for tuning in. We’ll see you back here next time. Have a great day.