Facebook Live: ReCODE Analysis — 74% Stabilize or Improve

Apollo Health’s Chief Science Officer, Dr. Dale Bredesen; Chief Health Liaison, Julie Gregory; and Principal Research Scientist, Dr. Ram Rao, discuss the successful data analysis of Apollo Health’s members who adopted the ReCODE Protocol™ — 74% of whom experienced either stabilization or improvement of their cognition.

In addition to discussing the recent data analysis of 255 members practicing the protocol, they also discussed Dr. Bredesen’s recent Alzheimer’s clinical trial, both offering proof that Alzheimer’s can be prevented and its symptoms reversed.

Julie Gregory offered a free 30 day trial subscription to either the Apollo Health ReCODE Program for the reversal of cognitive decline or the PreCODE Program designed for prevention. She invited listeners take the Cognitive Quotient (Cq) Assessment test to help determine which program is right for you and to access your free trial.

We’ve included a complete recording of the session and a full transcript below for your convenience. 

Watch here:

Transcript:

Dr. Dale Bredesen: Hey, everybody. I hope everyone is doing well, staying safe and well. It’s great today to welcome Julie G. and Dr. Rammohan Rao. Welcome, and we thought it would be really interesting to go over some of the data. This is a first, which I think should be very interesting, and it’s the beginning, hopefully,
of more and more.

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Dr. Dale Bredesen: So the idea here is, we’ve, back in May, posted the first trial in which, as we’ve talked about it before, the idea was instead of predetermining how you’re actually going to treat someone with cognitive decline, the idea was, okay, can we now look at all the different features, all the different potential contributors, and then address those contributors?

Very exciting with 84% of the people showing improvement on their CNS Vital Sign scores and even improvements on their MRI hippocampal volume and gray matter volume, so I’m very excited with that. Now, what that brings up, though, is the question of, okay, that was just three doctors with a very intensive nine-month trial. What about in real-world usage?

We now have over 2000 physicians from 10 different countries and all over the U.S. who have been trained to use the same approach, the so-called ReCODE protocol, based on reversal of cognitive decline looking at these various parameters, but, of course, they have their own ways they’re practicing.

They have certain things that they may be looking at. They may be doing other things that are slightly different. They may have their own areas of specialty. Some may be specialists, for example, in tick-borne illnesses. Some are specialists in toxins, mycotoxins, for example. Some are specialists in metabolomics or bioidentical hormone replacement, for example.

So, the question that comes up is what if we start looking at the data that are coming into Apollo Health that are looking at real-world data from the various physicians? So, Dr. Rammohan Rao did a fantastic job of looking at the data coming in and analyzing how many people are actually getting better in these real-world settings. Does it work as well as the trial? If not, why not? How can we close the gap? How can we improve things there? If it’s not working, what are we doing wrong?

So, this is, I think, a critical area because, as I say, this is the first [inaudible 00:02:23], and this should be scalable now to millions of people all over the world, and hopefully, ultimately help us to impact the global burden of dementia.

So, Ram, let’s talk a little bit about your paper, which you’ve just published in the last couple of weeks. A fantastic job. Thank you once again. Can you talk a little bit about how you gathered the data and analyzed the data.

Dr. Rammohan Rao: Yeah. Thank you, Dale. Good afternoon, Julie. Good afternoon, Dale. So, as you mentioned, Dale, what was the object of our work? Well, just to give a little bit of background for the audience here, we now know that, in the case of Alzheimer’s, there’s not a single therapy today that can exert anything beyond a marginal, unsustained symptomatic effect.

Dr. Dale Bredesen: Right.

Dr. Rammohan Rao: Now, this suggests that a monotherapeutic approach of drug development for Alzheimer’s may not be an optimal one, at least when it is used alone, and thanks to your similar work on hundreds of subjects and with several publications to that, we now have the record, which we now know as a novel comprehensive personalized therapeutic system, which proved very successful in the clinical trial that you published.

So, what we did is we set out to determine whether this program could be scaled to improve cognitive and metabolic function in individuals who are diagnosed with SCS, subjective cognitive impairment, MCI, mild cognitive impairment, and early-stage Alzheimer’s.

Dr. Dale Bredesen: Mm-hmm affirmative.

Dr. Rammohan Rao: So, what happened is, in our setting, we collected data from 255 individuals who enrolled in this program, who had prior consultations with their clinical practitioners. Now, these people, they submitted their blood samples prior to enrollment, and the also took the Montreal Cognitive Assessment test, the MoCA test, and then these participants were followed for about 12 months.

Then, during this follow-up period, they had to repeat blood sample analysis and they also had the MoCA testing. So, what we did is we collected the data. Even though we had thousands of patients, we had good data from over 250 people, and then we compared their pre and post treatment measures. We compared them in order to understand whether the ones that were in the program, if they had any improvements or not.

Dr. Dale Bredesen: Mm-hmm, affirmative.

Dr. Rammohan Rao: So, when we compared the baseline results to follow-up results, we observed that the MoCA scores were either significantly improved or stabilized. It improved about 51% of the patient population that had enrolled, and about 25% had stabilized.

Dr. Dale Bredesen: Okay.

Dr. Rammohan Rao: Now, these results were not as successful as the ones that you had in your clinical trial, but the reason why we are very happy is because we were more successful compared to the anti-amyloid therapies-

Dr. Dale Bredesen: All right.

Dr. Rammohan Rao: … and in relation to the MoCA testing we also noticed that there were other risk factors that also significantly improved in the participant pool.

Dr. Dale Bredesen: Right. Yeah, so-

Dr. Rammohan Rao: I can talk about the highlights later, but that was our objective.

Dr. Dale Bredesen: … Right. So, let’s talk for a minute about some of the critical points that came out. I think there were some really important points that came out of your study. One of the points, for example, was that in the trial, we looked at people who had MoCA scores of 19 to 30, so these were people who had MCI, many of them relatively late-stage MCI or early-stage Alzheimer’s or early dementia, but not people who were later on, nobody with MoCA scores zero to 18.

However, in your study, you included all comers, so one of the things it allowed you to do is to see where do you actually see a difference? As you pointed out in your paper, in the people zero to 10, there was no statistically significant difference, although am I right to remember that there was a trend toward improvement, as I recall?

Dr. Rammohan Rao: Yes, yes.

Dr. Dale Bredesen: But then, in the ones that were in the 10 to 19 group, a group not included in the trial, you actually did see a statistically significant improvement.

Dr. Rammohan Rao: Yes.

Dr. Dale Bredesen: As you pointed out, the 74% includes both those who improved, that was 51%, but then you’ve got another about 24% or so that were stabilized, and, of course, with the drug trials, they haven’t seen stabilization. It was simply a slowing of decline-

Dr. Rammohan Rao: Right.

Dr. Dale Bredesen: … very slightly.

Dr. Rammohan Rao: Right.

Dr. Dale Bredesen: So, you have people in the 10 to 19 range that you actually saw improvement-

Dr. Rammohan Rao: Right.

Dr. Dale Bredesen: … which is new information and actually very exciting information.

Dr. Rammohan Rao: Yeah, Dale, that was very interesting because when we… So, initially, when we analyzed the data, we took everybody from zero to 30, and when we included the entire participant pool, what happens is, especially if you’re to publish a paper, we have to show statistics.

So, the minute you talk about statistics, the minute you have the entire pool, what happens? Because of the people who did not either improve at all, because they pull the scores down, we could not see the statistical significance there, but as you rightly pointed out, there were quite a good number of people in the nine to 19 bracket who had actually improved a lot, but the only problem is, the minute you pool them up with those that didn’t improve, they couldn’t report it because they were not [inaudible 00:07:46] significant, but if we follow that pool, I’m sure, if they have proper guidance and they have proper coaching, and if you followed them for quite some time, my gut feeling is that they are definitely going to improve, given the fact that their MoCA scores read definitely on the improvement trend.

If you look at our data, Dale, a majority of the participants if they showed improvement in cognition if you take the 19 to 30 bracket-

Dr. Dale Bredesen: Yeah.

Dr. Rammohan Rao: … their memory scores are significantly improved, in this case, 51%, and then about 24% of them, it was stabilized, all right?

Now, if you compare the clinical data, of course, in the clinical trial that you published, we can definitely say that they were at a higher rate of adherence. The results are more impressive, but in our case, what it tells is that, even though the adherence may not be that good, at least the fact was that most of these people did experience an improvement, and along with that improvement, there was a significant improvement in other risk factors.

Now, this, if you compare it with other anti-amyloid therapies that have been sold so far where there’s absolutely no improvement or stability, what this showed is that they merely show there the rate of decline is probably slowed down, and they considered that a success.

So, if you consider that a success, then ours is even more successful. That’s what I feel, especially concerning the recent trial on the drug aducanumab, where it didn’t prevent or modify or stop dementia.

I mean, our ReCODE program actually is must better to all these people, and the thing is, all the risk factors, Dale, whether it is blood glucose, whether it’s heightened C-reactive protein, whether it’s vitamin D, or whether it’s HOMA-IR, which quantifies your insulin resistance levels, all these had significant improvement in these people. So it’s just not MoCA score, but it is the metabolic factor that improved as well.

Dr. Dale Bredesen: Yeah. I think that’s a really important point because, as you’re pointing out, these other metabolic factors that improved were factors that are also risk factors for cardiovascular disease, other inflammatory conditions, even things like glaucoma, and things like that. So, the good news is you’re lowering these risk factors as well.

Now, in the trial, everybody was followed up for nine months. In your work, what was the range of follow-ups that you had?

Dr. Rammohan Rao: Yeah, the problem was, even though the initial data was very impressive in the sense that we had data from nearly 1,200 people, but we couldn’t take everybody, mainly because some of them had very good follow-ups, some of them had absolutely no follow-ups, but if you consider the ones that had a follow-up, then, yes, they were people who followed up for three months post-program, six months post-program, and 12 months post-program.

So, what we did is we actually took the mean of all these, and so our studies were actually comparing pre-treatment and then post ReCODE one year of treatment. That [inaudible 00:10:46], so, now, the question is what do we do going forward?

Well, the thing is, we would like to narrow down this entire work in such a manner that we can optimize the program much better. We would like to see the participants doing a diligent job of collecting their data for three months, six months, nine months, and 12 months so we can actually see the trends. Where is the greatest trend? Is it the first three months, or is it the later three months, or is it after six or nine months? Where do we see the maximum trend? That could be a good follow-up study that we would like to see.

Dr. Dale Bredesen: Got it. Okay, and then, Julie, maybe we could come to you for a moment. You’ve obviously founded ApoE4.Info, the website, and so you’re exposed to thousands of people who are talking about their own approaches, and many of them, as you’ve pointed out, are on some variation of ReCODE.

Do Ram’s data comport with what you’ve seen with people discussing how they’ve done with their approach with the protocol and using their own variations of it?

Julie Gregory: Yes, absolutely. In the ApoE4.Info community, when people essentially do the right things and stick with the protocol, they experience improved cognition, and when people go off the protocol for various reasons, whether they’re on vacation or they just decide to take a break because it’s too much, then they notice that their cognition takes a hit.

So, what Ram has found and what you found with the clinical trial definitely echoes the experience of real live people practicing this on their own.

Dr. Dale Bredesen: Yeah, yeah, interesting. So, of course, with the trial, we were really fortunate to have three fantastic physicians: Dr. Kat Toups, Dr. Ann Hathaway, and Dr. Deborah Gordon. With this, there are now many physicians who are involved, and, of course, some of them are more experienced and some of them less experienced. And as we discussed, this is really more comparable in many ways to learning a surgical procedure than it is to simply writing a prescription because you really have a set of things that you have to do correctly.

One of the things that’s been very helpful for many people is to have a health coach. Ram, did you have any sense from this work about how many of these people … Did most of these people have health coaches? Did most of them not have health coaches, or wasn’t that clear from the data that you evaluated?

Dr. Rammohan Rao: Yeah. So, Dale, that information we are still trying to obtain as to why … because what happened is there was definitely a more positive trend for a majority of the participants, but, at the same time, let me also confess that there were others also who, there, the trend was in the downward slope, and we are not yet sure why that happened.

It’s possible that maybe they didn’t follow up on the program, maybe they didn’t have proper coaching, and so, if you consider the study as a whole, Dale, and then if I’m to point out what were the main salient features, and what do we do going forward, here is where I like to break them apart.

Number one is we like to focus on more intensive training for the practitioners and for the health coaches in order to further optimize delivery of the program, number one.

Number two: There were some that did remarkably well; whereas there were some that did not do very well, so what we got from that is that we have to emphasize to both the participants and the practitioners that the metabolic parameters, they have to be optimized, not normalized. Normal is good, but we need them to be optimized.

The other point that came from the study is that combination is much greater than doing it individually in the sense that we have the seven steps, the salient features of the program, and if all seven steps are judiciously followed, whether it’s with the help of a coach, or on their own, then you see the benefits. Not only that, but there is a certain threshold effect, so as long as all the steps are being followed to reach that threshold, then the benefits are sustained.

Then, it’s just not that. It’s possible that some of the ones who actually went on to do very well, it’s probably because they stayed in the program, but we also noticed that some of them may not have stayed in the program, so there’s no falling back.

Dr. Dale Bredesen: Right.

Dr. Rammohan Rao: In the clinical trial, if you noticed, there was a higher rate of adherence. 84% of participants actually experienced cognitive improvement, so that tells me that adherence to the program, and then constant guidance from the coaches, as well as keeping the program, these are three important steps that are necessary.

Then, of course, any human study, Dale, needs to have a proper subject population to be accepted, and in our study, of course, we didn’t segregate our population into the six different types, the subtypes of AD that you said.

Dr. Dale Bredesen: Okay.

Dr. Rammohan Rao: We just pooled the entire participants, but now, because the results are so encouraging, Dale, one of the things that I’d like to focus on with the data that we have, especially if you have a good amount of data, is to actually segregate this population into the different subtypes, and then see which of the subtypes do much better or do far better with the ReCODE program.

So, I mean, remember, we have a nice paper, and it’s been there in the press and all that, but we have got a lot of work to do in order to know whether this program is efficacious enough and whether we can put this in a manner such that the people are really happy and embrace it, and then keep on sustaining those changes that they see.

Dr. Dale Bredesen: Yeah, and did you notice differences in terms of response? Certainly, with the trial, we got good responses from both people who were ApoE4 positive and those who were ApoE4 negative. Did you notice significant differences between those two groups?

Dr. Rammohan Rao: We didn’t actually, so that’s one thing that I’m currently now analyzing because what we did was, we just pooled everybody, Dale, and we didn’t have… I think there was like 40% of people in the group that were ApoE4 plus-plus, and there were those who were ApoE4 plus-minus, and then there were some ApoE3 as well, but I didn’t closely look at the data. This is another thing that I want to do.

I mean, is it just the ApoE4 that’s most susceptible, or is it that ApoE3’s are less susceptible, and among those that improved, how many of them actually have ApoE4, and how many of them are actually ApoE3? That will be a fair bit of analysis, and it will be very interesting actually to know that.

Dr. Dale Bredesen: Yeah. I think the good news is you’ve got a lot of data you have to analyze, a lot of data mining that can happen-

Dr. Rammohan Rao: Right.

Dr. Dale Bredesen: More and more will be forthcoming, and I think that some of those questions can be answered.

Dr. Rammohan Rao: Yes.

Dr. Dale Bredesen: Here’s an interesting one. We’ve had anecdotes of people with MoCA scores of zero improving, but it’s not the rule. Most of the people who have MoCA scores of zero don’t do well, and, as I say, some do. As you pointed out in your paper, the zero to nine group, overall, did not show statistically significant improvement, but were there examples of people with single-digit MoCA scores who did show improvement?

Dr. Rammohan Rao: Yes, Dale. I mean, that’s very good news, and I was really, really happy when I saw that. So, there were three participants, Dale, in that group. One had a MoCA score of one, one had a MoCA score of seven, and the other one had a MoCA score of nine, and guess what? All three of them, post ReCODE, had their values in the range of 13 to 15. It was less than 19, but that was significant.

I mean, if you were to present the data to anybody in the Alzheimer’s field, they’d say, “Oh, no. This is not good,” but they should be considering the trend from zero to one or from one to two, they jumped all the way to 13 to 14 in a matter of six to eight months. That in itself tells us that the program is very good.

It’s just that, for these people, they may have to sustain it for a longer period of time, maybe another six months post ReCODE, that 13 or 14 may jump up to 20 or 21, so that’s the reason why I feel very confident about this program.

Dr. Dale Bredesen: Yeah. It’s a good point. I mean, certainly, subjectively, we’ve had people begin to talk and people getting on the computer again, and people doing things that they hadn’t done in a while, so, certainly, there are subjective improvements, but it’s certainly helpful. Now, obviously, it’s a very small number so far compared to the ones with the single digits, but obviously, going forward, we can look at more and more. So, let’s-

Dr. Rammohan Rao: That’s true, Dale. One more thing-

Dr. Dale Bredesen: … Yeah.

Dr. Rammohan Rao: … In these people, the reason I was happy was because the ones where their MoCA scores were a little lagging behind, what was interesting was their metabolic factors, they all came back to normalcy. I mean, it almost reached optimal levels, so it’s as if the metabolic factors were much more amenable to treatment compared to MoCA scores.

That gave me a level of confidence in that, definitely, these people are going to come back to normalcy. I don’t have the subjective assessment. Probably, I’m sure, these people would have said, “We are a little more clear in our perception. We are able to recognize…” Things like that. I’m sure they would have said that, but what was important was the metabolic factors actually improved much better compared to their MoCA scores.

Dr. Dale Bredesen: Yeah, and, of course, the concern is always, well, are these just unrelated? Is it just that, yeah, you can improve the metabolic scores, but that doesn’t correlate with the cognition. In general, though, what we’re finding is that they do run together. If you don’t improve your metabolic status, you don’t improve your cognitive scores, and if you have good improvements in your metabolic status, you have good improvements.

Julie Gregory: Let’s come back to you again. Have you seen situations where someone improved dramatically, but had no metabolic improvement or vice versa, or who had lots of one without the other, or are these usually coupled in your experience?

Julie Gregory: I think that they’re usually coupled, and the metabolic improvement seemed to precede the cognitive improvement-

Dr. Dale Bredesen: Okay.

Julie G.: … and I would say that was my experience certainly. Once I healed my insulin resistance, and I got a steady supply of fuel to my brain, it’s like I’m back, and so I think what Ram was capturing was the fact that we saw some people that had the metabolic improvement, but the cognitive improvements were lacking, at least that’s what I’m certainly hoping.

Dr. Dale Bredesen: Yeah, yeah. So, the hope is you just have to continue, and I think we often talk about the fact that you go from about 20 years from the beginning of the biochemical changes to an actual diagnosis of Alzheimer’s disease, so you really are trying to change something that’s been there for many, many years, and often a decade or two. Therefore, it’s going to take more than a couple of months of metabolic changes to make a difference.

Dr. Rammohan Rao: Right.

Julie Gregory: Mm-hmm (affirmative).

Dr. Dale Bredesen: All right. So, before we go on to the questions, Julie, I know that there are going to be people who will say, “Well, okay, this looks interesting. We’ve now got the anecdotes, we’ve got a trial, and we’ve got real-world usage with many of these physicians,” so many people will say, “What’s the best way to access this?”

I often point people toward either ReCODE or toward MyCognoscopy.com to get evaluated. We’ve talked about Cq, so, Julie, maybe if you could talk a little bit about what’s the best way for people to get access?

Julie Gregory: Right. I actually want to take a step back because we’re throwing around terms people may not be familiar with.

Dr. Dale Bredesen: Yeah.

Julie Gregory: ReCODE stands for reversal of cognitive decline, and it’s a program created by you, Dale, and it’s offered through Apollo Health. It’s one of two programs. They offer the ReCODE program and the PreCODE (for prevention) program, and lots of people aren’t sure which program is correct for them, so Dale has created this terrific cognitive assessment. It takes 10-15 minutes. It’s called the Cq, and we’re going to share a link to that in the chat window right on Dale’s Facebook page.

We invite everyone to learn their Cq sore, which will provide you a snapshot of your current cognitive abilities. It’s basically going to let you know which program is most appropriate for you, if you should be working on prevention, or if you should be working on reversal.

We also warmly want to invite everyone who’s listening today to take advantage of a free 30-day subscription to whichever program is appropriate for you because we talk about these Apollo Health programs all the time, but I kind of want to give you an idea of what’s behind the paywall, what’s behind the scenes, and how we offer support. So, if we have a few minutes, I want to share my screen-

Dr. Dale Bredesen: Sure.

Julie Gregory: (23:26): … and just show you a guide about how to make the most of your free trial. Essentially, this goes through all of the educational tools and support resources that we’ve created for you.

Everything is based upon Dale’s amazing science. Now, we have his clinical trial. We have Ram’s analysis of ReCODE. This is a proven program. We know it works. It personally worked for me.

We invite everyone to begin with a more robust cognitive health checkup. We ask you, in addition to the Cq, to take some additional cognitive testing. You can either use the SLUMS, the Saint Louis University Mental Status evaluation, or the MoCA, the Montreal Cognitive Assessment, and we ask everyone to take every six months. We also invite ReCODE folks to take the CNS Vital Signs cognitive assessment every month, and this is a more detailed assessment that you take right on your computer.

Additionally, we ask that your loved one, someone that knows you very well, complete the Alzheimer’s questionnaire, the AQ-21, so we can get an independent assessment of your progress, and once you’ve got cognitive testing done, we invite you to begin your program.

We’ve created dozens and dozens of wonderful educational guides, and the guides use very simple language, and the information is layered, so when you’re ready for more information, you hit a hyperlink that takes you deeper into any new topic that you’re interested in.

We want everyone to begin with the guide entitled the Fight of Your Life-We’re Here to Help You Win It. This gives you an overview of the program, what you can expect when you’re on ReCODE, all of the resources that are available, and what your responsibilities are.

We then invite everyone to check their brain oxygenation, both during the day and at night. This is vital for improving cognition. If we don’t have adequate oxygenation to the brain, nothing’s going to work.

We then invite participants to move on to a guide that teaches them how to monitor their metabolic health. We want you to learn how to test your glucose and your ketones because optimizing metabolic health, as Ram’s analysis showed, leads to a steady supply of fuel to the brain and cognitive improvements.

After those three guides, we invite everyone to look at the seven main guides for the Bredesen Seven, and I saw on one of the questions Rick was asking, “What are these seven steps?” Well, Rick, here’s the answer.

These seven strategies are foundational to addressing all of the drivers of cognitive decline, so we have main guides and auxiliary guides focused on nutrition, exercise, sleep, stress, brain stimulation, detox, and supplements. So, you will get a copy of this guide if you decide to take advantage of the 30-day free subscription, and you’ll have links to all of these amazing guides.

We have dozens of guides on nutrition alone. We’ve created a grocery guide that you can take with you when you’re at the grocery store. It tells you KetoFLEX 12/3 approved foods. And we’ve got a library of amazing KetoFLEX 12/3 recipes that we’ve put together.

We’ve got guides on exercise. We want you to learn what type of exercise yields the best benefit for brain health, how often you should be exercising, and how to keep it fresh and fun. We also invite you to join our Friday yoga class with our very own Dr. Ram Rao, who, in addition to being a neuroscientist, is also a registered yoga teacher. It’s so fun to take a yoga class focused on brain health, and it’s something a lot of our participants are enjoying.

We have lots of guides on sleep. Learn how much sleep you should be getting each night. Many people struggle with getting restorative sleep. We have lots of tips for sleep hygiene. We also teach you how to rule out anything that interferes with getting enough oxygen at night, sleep apnea or other conditions. We have step-by-step instructions for that in our guides.

We have a stress guide. Chronic, severe, and unresolved stress dramatically affects cognition, and while we can’t control the stress that we’re exposed to, we can control our response to it, and we teach you those skills in our stress guide.

We also have a guide on brain stimulation. Lots of people in our audience know we can continue to grow new neurons throughout our lifespan, but we help you facilitate that process. We’re going to offer you a complimentary subscription to Brain HQ. It offers you brain training, which is an important part of keeping the brain stimulated.

We’ve got guides on detox. Lots of people aren’t aware that the air they breathe, the water they drink, and even the homes they live in could be contributing to the risk of Alzheimer’s, so let me see if I can stay right there… We will walk you through that process.

We also have a terrific guide on supplements. We want you to know how to insert the biochemical changes necessary to support cognition.

Additionally, our software team has put together lots of tools that help you put it all together. If you decide to take advantage of this free subscription, your participant home page will have a task manager that basically has a list of personalized tasks that you need to complete each day, and you can basically check the tasks off as you go. It gives you a good idea of when you should be exercising, meditating, when it’s time for brain training, and so on. This is fully customizable, so you can make it work with your schedule.

In addition, if you have an Apple iPhone, we have a ReCODE mobile app that has these same features and many more. The ReCODE mobile app, which you can download from the app store, allows you to take a snapshot of the food that you’re eating, so you can really track how well you’re doing. This also links with all of your wearables, so anything that links with the Apple Health Kit, whether it’s the Apple watch or it’s the Fitbit, or the BioSense Breath Ketone device (no longer available), all of that data is collected on the ReCODE mobile app, so you have all of your information in one place, which is really handy. You’ve got the guides, the grocery list, and everything there.

In addition to all of this educational material, and I’m just giving you sort of the tip of the iceberg, we have lots and lots of support resources for you. We have a team of physicians, practitioners, and health coaches that are trained in the protocol, so you simply enter your zip code, and you can create the team you need to help you best optimize your cognition.

If you’re working on reversal, we definitely encourage you to work with a physician who has been well trained, and as Ram said, we want our physicians and our health coaches to have the best training. Look for somebody who’s completed the ReCODE 2.0 training. It’s the most current training.

We also have town hall meetings, so, every month, we have question and answer opportunities with Dr. Bredesen and his colleague, Dr. Ann Hathaway, who has a wealth of clinical experience working with ReCODE participants.

You’re also welcome to look at past town halls because you can learn a lot of good information from looking at past question-and-answer opportunities. We have a community forum where people can find support with other like-minded participants. Practicing the protocol can sometimes feel lonely, and it’s wonderful to have a forum where you can ask questions and seek support. Dr. Bredesen pops in to answer questions. Dr. Rao pops in to answer questions. I’m always there to answer questions. We also have nationally certified health coaches who are trained in the protocol and answer questions.

Additionally, we have support group opportunities. I think these are available for an extra fee. We currently have groups for care partners of folks who are practicing ReCODE, and we also have a KetoFLEX 12/3 support group that I’m currently taking part in, and it’s been a wonderful opportunity. These are people that need more help with the diet; they want to take a deeper dive. We’re having a really good time with that. Support group opportunities are constantly changing.

We have a wonderful coaching staff. They offer monthly webinars, such as the Coaching Connection webinars, and you’re welcome to pop in and look at any of the past webinars; these are offered once a month. We know behavior change is difficult, and our coaching team, whether you’re working with a coach one-on-one or just popping into these webinars, can offer amazing help. We have so many other supports. You guys know we do the Facebook Live every couple of weeks; sometimes we do it weekly, lots of other insider strategies, where various members of our team write blogs to help you practice the protocol more effectively.

We have a news page. We’ve also  created participant resources, so we’ve identified industry leaders that have products and services that we think are helpful for folks on ReCODE, and we’ve worked out discounts for these various services. So, by clicking on this link, you can get ahold of all of these wonderful resources and these discounts.

We have a dedicated customer support team that’s available 24/7 through email from Monday through Friday, available from 9 to 5 Pacific Time.

Finally, all of these things I’m talking about are auxiliary to actually creating a ReCODE report. A ReCODE report kind of drives the whole process, and the ReCODE report is created after you do your cognitive testing, after you fill out the medical questionnaire, and after you do your laboratory testing. You’re going to get a 50-plus page report that’s all about you, and it’s going to show your cognitive risk factors.

Right here on this page, we can see these thermometers, we call them, for all of Dr. Bredesen’s Alzheimer’s subtypes, so you can see how well you’re doing with inflammation, with trophic loss, with glycotoxicity, with vascular factors, trauma, and more.

A lot of us start in the red or the yellow, but our goal is to move every single one of these thermometers towards the green, and we give you step-by-step instructions on how to do that. So, I warmly invite everyone to take advantage of this free subscription opportunity. I know the program works because I’ve been doing it for ten years, and it’s not as hard as some people want to make it out to be. We have so many resources that can help you with it.

Dr. Dale Bredesen: Yeah. I think just about everybody knows their cardiovascular risk. Most of us know our blood pressure, most of us know our cholesterol, for example, but most people don’t know their risks for cognitive decline, so I think having that is so, so important. So, thank you for showing us that. Julie and I hope everyone will take a look.

Meanwhile, there’s some excellent questions here. Let’s go through some of the questions. Valerie says, “I’m so glad this has come on. ReCODE has given me my life back.” Always great to hear. Said, “I’m the healthiest I’ve been in a decade even despite a dementia diagnosis in 2015. Kidneys improved. Toxin levels normalized.”

Yeah, again, most people don’t realize this is the sort of thing that sneaks up on people over time. She says she’s working, and her own best champion is herself, right? A lot of people like to work with health coaches, but sometimes it is a spouse, and sometimes it’s the person themselves, no question.

“Also got a dramatic response to Aricept.” That’s important to point out. Aricept has been helpful for a number of people. Be careful. What it does is it bumps you up, and then you go right back down to declining, so the hope is if you get a bump up, but you’re doing all the right things, that, just as Julie pointed out, you sustain your improvement for many, many years.

She says her improvements “all included, on neuropsych testing, over 50% improvements.”

Julie Gregory: Wow.

Dr. Dale Bredesen: Always great to hear. She mentions here about the homocysteine actually starting to bump up again, but getting some B12 actually has brought it back down, so, yeah, typically, it’s B12, active B6, and methylfolate are typical. Fantastic news.

Valerie says, “It takes ongoing discipline.” Yes, and this is again where the health coaches can be so helpful, and she says, “Not letting stuff beat me.” Yeah, and I think, just as Julie as pointed out before, going from something that has been hopeless in the past to something that has been hopeful, and don’t let people tell you what they told Julie years ago, which was, “Good luck with that,” when she asked about just even staying stable or improving.

So much to be done. The arsenal is large, and it’s growing, and, again, we always say please keep optimizing because you get to a point sometimes where you hit a plateau. Find out if there are things are continuing to be an issue.

Rick has asked, “What are the seven steps,” and, Julie, you just talked about those a minute ago, the diet, exercise, sleep, stress, brain training, detox, and then targeted supplements.

Then, Gigi says, “Optimizing numbers.” Yes, absolutely, so, as I say, we often give examples. A simple example is homocysteine, in which normal homocysteine can go up to 12, and old numbers go up to 13. They still go up to 12. The same such thing with insulin resistance, so these can be “within normal limits,” but we know from studies on long-term MRIs that anything over six, as you get up into the eight, nine, 10, 11, and especially, up above 13, is associated with more rapid reduction in hippocampal volume and in gray matter volume.

So, things that are within normal limits are not necessarily the best for you, unfortunately, so optimizing is the way to go for sure, and then, Valerie’s saying, “Yay for the coaching team … GP function,” so she has her own team, Team Val, fantastic, and that’s, again, getting a team. This is a huge issue.

It’s something that, if you don’t continue to optimize, can have dramatic impacts on your life, and, of course, in a negative way. Many people… Time in a nursing home. I mean, this is a huge problem, so we want to keep everybody out of that. We want to keep everybody optimized, and, as you pointed out, Julie, ten years, and you’re still doing exceedingly well, and, hopefully, you’ll be sharp till 100. I have every reason to believe that you shall.

Then, Valerie’s asking, “What about a quality of life measure?” It’s a good point. We included the AQ change on the trial to look at whether the partners could notice clear changes because there have been examples where there were minimal changes objectively, and, subjectively, people couldn’t tell anything. So, Ram, did you have a way that you looked at quality of life measures in the study?

Dr. Rammohan Rao: No, Dale. Unfortunately, I don’t have that, and that was one of the most important aspects of our study that was not included because we didn’t have it, but I mean, it’s very important.

Even if it’s not the person or subjectively themselves, but if their caregivers can tell us an idea about how exactly they’re doing, there’s a few questions that they can answer, and based on that, we can … Because that subjective assessment actually goes very well with the metabolic changes and with the MoCA assessment.

It’s a very important part of our investigation, and the part two of the study program definitely will likely involve or include the study assessment as well, quality of life.

Dr. Dale Bredesen: Great point. The next one is from Huma, who says, “What are the resources for physicians certifying in the program?” Great point, and there is ReCODE 2.0 training. Hundreds of people have already done this, so please check that out on Apollo Health as well and-

Julie Gregory: Yeah. I also want to mention we have a dedicated forum for our ReCODE practitioners at Apollo Health, so you can definitely ask questions and get support from one another, help with business practices, and lots of these practitioners are also posting questions at our monthly town halls as well.

Dr. Dale Bredesen: … Yes, and then the next question from, I believe it’s Gigi, and depending on how it’s spelled here, so, it says, “I would sign up with the program. I have a question. I’m a ReCODE client. I have Hashimoto’s, ApoE4, 116 pounds,” but nothing on the height here.

The bottom line is, and, again, we’ve talked about this a number of times, when you do the right things metabolically, physiologically, you end up with improving your health overall, and so we have people who go off their antihypertensives because they’re no longer hypertensive, people who go off their statin drugs because in fact they’re vascular system is doing better, their lipids are better.

I know, Julie, you followed your own lipids and have a spectacular lipid profile yourself. Then, people who are on antidiabetic drugs or things like Metformin for type-two diabetes, who no longer need those as well, so I would encourage you, yes, please do the right things and, actually, it may turn out that you heal your Hashimoto’s-

Dr. Rammohan Rao: Right.

Dr. Dale Bredesen: … This is an autoimmune disease, and having appropriate immunity is part of getting the best outcomes. She also asked about Keto without lowering weight. Great point, and Julie, I know you’ve written about this in the book. Maybe you could just say a few sentences about what’s the best way to go? Absolutely, Keto is helpful, and absolutely you don’t want to drop your weight too far. There are all sorts of ways to do that, however.

Julie Gregory: Right. KetoFLEX 12/3 is not a weight loss diet. You can lose weight with it if you need to, and you can gain weight with it if you need to, and we’ve created guides that will basically help you do either of those things. We have a terrific guide focused on gaining and maintaining weight.

Very often, people who end up losing weight, they say, “No,” to all the bad foods, the foods we want them to give up, the sugar and the simple carbs and conventional dairy and grains, but they’re a little hesitant to embrace more healthy fats, so that’s the number one strategy for people that are struggling to keep their weight on, but we’ve got a wonderful guide that outlines these strategies, so, hopefully, Gigi, you take advantage of this free subscription period and get to dive into some of these guides.

Dr. Dale Bredesen: Yeah. Thank you, and then Huma is asking, “My father was having so much word-finding trouble, reading trouble. In a little over a month, started talking and reading just with the KetoFLEX 12/3 diet and exercise.” Fantastic! This is again… Energetics are an important overall underlying mechanism, a common one, and, again, improving your insulin sensitivity and things like that, very, very helpful.

“He hasn’t formally done testing yet.” I would encourage him, please, at some point, get the testing because you may find that he can do even better, addressing the appropriate things.

Then, she mentions here about, “Dr. Rao” and “in India.” Dr. Rao is actually in the Bay area, but, of course, Dr. Rao comes from India originally, and we do have people, as I mentioned earlier, in ten different countries, who’ve taken the training.

There are people who are actively using this protocol, for example, in South America, in Japan and China, all over Europe, and so many, many different locations where people are beginning to do this.

We encourage people, please, this is nothing but identifying the critical pathophysiology for neurodegeneration and then addressing that. This is the way of the future. This is 21st century medicine, and having the ability to capture the data, just as Dr. Rao did in his paper, and doing this with co-authors from Apollo Health, to look at these different parameters, and to determine, now, what are the ones that are going to be most important?

One of the things we haven’t talked about is, okay, take the people who did the absolute best and the people who did the least on this, and what were the features that distinguished them?

Dr. Rammohan Rao: Yes.

Dr. Dale Bredesen: Applying AI in the long term to these to look to see what things were the most important? We have a very good feeling now for the underlying biochemistry, but we don’t yet know, in some cases, what is the highest priority item? We get ideas from some of the patients, but we don’t always know what are the most critical, and what are the least critical things, and, in some cases, what are the things that haven’t been identified that are the most critical?

So, thanks so much, Ram, for discussing your paper today. This is an important paper. As I say, it’s a first of its kind where you’re taking real-world data from many different physicians and looking at this protocol and showing that, in fact, it does improve, and, as you pointed out, in 74%, there was either improvement or prevention of decline.

Dr. Dale Bredesen: Julie, thank you so much for going over the various pieces, and I hope people will take advantage of the ReCODE subscription, the free subscription, so that they can (get) rolling.

Julie G. (46:05): Mm-hmm (affirmative). Bye.

Dr. Dale Bredesen: All right. So, Ram, thanks again.

Dr. Rammohan Rao: Sure.

Dr. Dale Bredesen: Julie, thanks. I look forward to seeing everyone next time. Meanwhile, stay safe and well.

Dr. Rammohan Rao: Just one last word, Dale, from all the work that you did for the last 15 years or so, and then the clinical trial that you just recently published, and, of course, this real-world data that we have, all it tells us is there is hope that in this age of Alzheimer’s, this terminal illness is coming to a close. That’s my last word on it.

Dr. Dale Bredesen: Yeah. I think it’s a very good point. That’s a great last word. Thank you, Ram. Thank you, Julie.

Julie Gregory: Bye-bye.

Dr. Dale Bredesen: Take care. Bye-bye.