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

Over the past decade, it has become increasingly clear that Alzheimer’s disease is not a simple disease caused by amyloid or misfolded proteins or aggregated tau, but is instead a complex disease with dozens of potential contributors. We have all been learning about these often-surprising contributors, from the oral microbiome to sleep apnea to leaky gut to mycotoxins and on and on. With the holiday season upon us, it’s a good idea to remember that airline travel may be a contributor, as well: the stress, especially with overnight flights or missing connections or canceled flights; the exposure to COVID-19 and other respiratory pathogens; the circadian disruption with time zone changes and sleep loss; the dietary disruption (often with some airport or airplane junk food!); the long stretches of sitting, with little exercise; and the exposure to hours of indoor air, with the potential for high carbon dioxide levels (not carbon monoxide, which is highly toxic and can be lethal, but carbon dioxide, which we breathe out, so it’s really about ventilation) and other toxins, such as those from jet fuel.

Recent research found that increasing carbon dioxide levels were associated with slower cognitive performance ( ), even at relatively low levels of carbon dioxide. As levels increased above 400 ppm, processing speed decreased, and performance on standard cognitive tests deteriorated, just as it did with exposure to air pollution, which is a proven contributor to cognitive decline. While it is not yet clear whether this carbon dioxide exposure may increase dementia risk, the term “aerotoxic syndrome” was coined in 1999 for the overall risk of cognitive compromise in very frequent flyers such as pilots and crew members ( ).

Therefore, if you are planning air travel over the holidays, or at any time in the future, you may wish to consider the following:

● Try to avoid “red eye” flights if at all possible. Especially for those who have some degree of type 3 (toxic) cognitive decline, this stress can cause significant setbacks.

● Minimize airport stress — show up early and avoid running down the tarmac after the plane!

● Enjoy some relaxing music, meditation, or whatever you like.

● If you are changing time zones, use melatonin to help readjust. If you are flying to the east, get some sun exposure early in the day (i.e., when the sun is up in the east but not west), and if you are flying west, get some sun exposure late in the day (i.e., when the sun has not yet set in the west, but has in the east). This helps to reset your circadian clock.

● Wear an N95 mask to minimize viral exposure.

● Avoid junk food if possible (yes, we all know that’s difficult over the holidays!), and take some plant-rich, KetoFLEX 12/3-type food with you (we need to convince the airlines to offer KetoFLEX 12/3 …).

● Get up and move about the cabin every hour, if possible, to avoid long stretches of sitting.

● For frequent flyers, consider getting a genetic test for detoxification to determine if you are particularly susceptible to toxin exposure. Examples are IntellxxDNA or 3×4. The genetic test should also tell you if you have the genetics associated with hypercoagulation (too much blood clotting), in which case movement is important, and you might wish to consider taking a mild blood thinner such as nattokinase, pycnogenol, or omega-3 fats.

● Make sure you’ve optimized your resilience: is your vitamin D optimal? Zinc? Glutathione? Vitamin C? Are you insulin sensitive?

● Get outdoors if possible, get some exercise, and avoid too much time indoors.

● If you think you have been exposed to COVID-19 (as we often find out after arrival, or after being at a meeting), make sure you get plenty of sleep, use the protocol we’ve posted in the Guides, and consider some dilute hydrogen peroxide mouthwash and nasal rinse ( ). (Note that hydrogen peroxide use has been criticized, but these dilute solutions for short periods have not shown toxicity.) 

Please travel safely, and enjoy the holidays!       

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