Archimedes, Alzheimer, and Evanthea: A Place to Stand

By Dale Bredesen, M.D., Chief Scientific Officer for Apollo Health

“Give me a lever long enough and a place to stand, and I shall move the world.” — Archimedes

We finally have a place to stand. Over 2000 years ago, the great Greek mathematician, physicist, and engineer Archimedes taught the power of levers to amplify force, so that theoretically one could move even the Earth. This is just what has been needed to move the needle for neurodegenerative diseases such as Alzheimer’s, Lewy body dementia, and ALS, since these have been terminal illnesses without effective treatment. Now, however, we finally have unequivocal results from the Evanthea trial, a randomized, controlled clinical trial that was carried out at six sites around the US.

What the Evanthea trial documented was striking: statistically and clinically significant improvements in memory, executive function, brain processing speed, and cognitive symptoms. Furthermore, overall health was enhanced, with reductions in blood pressure, weight, and amelioration of lipid abnormalities, insulin resistance, and other biochemical parameters, all without side effects such as brain swelling, atrophy, or microhemorrhage.

These results provide the long-sought solution, not a cure but a foundation on which we can build even better outcomes. Of course there will be pushback from those who have been unable to achieve such striking improvements, and Julie G does a superb job of addressing those in her blog, A Critical Review of the Evanthea Trial. Instead of responding to the pushback here, allow me to address a different question: now that we have a solid therapeutic foundation — a place to stand — and quite a remarkable lever, as well, with 90% of the trial subjects improving, how do we go about enhancing the lever of the protocol — i.e., its efficacy — so that we truly can treat every patient successfully, with a return to normalcy that is sustained for the remainder of each patient’s life?

We actually uncovered a number of clues to help answer this question during the Evanthea trial:

● First, working with an expert team makes a substantial difference: four of the six intervention sites achieved outstanding improvements, while outcomes at the remaining sites were more limited. The distinguishing factor was the preparation and training of the care teams, and their ability to devote sufficient time to each patient to optimize brain energetics, reduce inflammation, and address toxic contributors — an approach that is straightforward in concept but challenging to implement consistently. Getting the fundamentals right, and supporting adherence over time, makes all the difference.

● Second, how does one test additions to the basics of the protocol when there are multiple components? As I’ve noted in earlier publications, one possibility is to do the basics for several months, achieve a stable improvement, and then add whatever is believed may improve outcomes, such as plasmapheresis, or hyperbaric oxygen, or stem cells, or intranasal peptides, or a promising drug candidate, or craniosacral manipulation, or mitochondrial transfusion, or something else. Then one can observe any improvement or decline in the relatively isolated setting of the new treatment, having kept the basics constant. At one of the trial sites, Dr. Craig Tanio’s in Florida, this approach was undertaken: patients received additional therapeutics after six months of the basic ReCODE protocol, including Apex laser and hyperbaric oxygen. Dr. Tanio observed further cognitive increases at that time, suggesting that these additional therapeutic modalities did indeed enhance outcomes beyond the basics.

So here is the current status: for prevention, we have not yet observed a failure; for SCI, virtually 100% of people improve and return to normal; for MCI, in the trial 90% of patients saw improvement, some major and some minor; and for dementia, although we occasionally see improvements back to the normal range in cognitive testing, more commonly we see partial recovery. Therefore, if we all get tested while asymptomatic or at the time of SCI, we should see a dramatic reduction in dementia due to Alzheimer’s disease.

But now we have a stable, proven foundation — with three successful trials and hundreds of documented improvements — so that we can determine what additions actually move the needle toward better outcomes. We can now readily determine which of the many candidate modalities increases the lever arm and enhances outcomes. We finally have a solid place to stand.