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Type 2 Diabetes and the Brain
Did you know that researchers find an utterly clear and repeatedly confirmed connection between eating too much sugar (it’s less than one might think!), keeping too much of it in our blood (happens naturally as we age), and then cluttering up our brain …
DIY Memory Health: Part 2 of 3
By: Dr. Deborah Gordon, February 5, 2018
How is your brain rejuvenation program going?
In the first article, I described the basic lifestyle habits associated with improved and maintained brain function. Let’s talk more specifically about each step and where to go from here.
Anti-inflammatory diet: Have you been eating real food?
Did you go grain-free or gluten-free? After 6 weeks of eating 100% gluten free you have the opportunity to test yourself to find out if gluten is inflammatory for you. After 6 weeks truly gluten free start consuming a lot of it: have some at each meal for 2-3 days. If you feel fine (not just your belly, but your skin, brain, bowels, sleep and mood), it may not be inflammatory specifically for you (good news). However, gluten still increases intestinal permeability so it’s smart for everyone to limit it to some degree (bad news?).
Eating window 12 hours or less.
How is this one working for you? Which 12 hours are best? Do you find you sleep better with an emptier stomach?
Eight hours of sleep every night.
Is it working? If not, you may need some more attention: this is a critically important area. Check out Solutions for Insomnia for some starting steps.
Regular exercise. I bet you’re doing this, right? How many days a week? How does your body feel?
Brain challenge: Is it time for a BrainHQ break right now?
Feed your brain: Which supplements, if any, have you tried?
Let’s get on with the topic of the day. Your labs are back, let’s go over them. We can learn something, and cover a bit of the associated controversy, with each one of them.
Homocysteine levels should be between 5-8 micromol/L for ideal brain function, and it’s good for your heart at that level too.
- To raise a low homocysteine, eating animal protein will increase the raw material for homocysteine, but you may need to supplement with amino acids such as methionine, n-acetylcysteine, taurine and lipoic acid.
- To lower a high homocysteine, I recommend starting with methyl B12, 1 mg daily, methyl folate, also 1 mg daily, and B6 in its P5P (pyridoxal-5 phosphate) form, 25-50 mg daily. If those supplements are ineffective, genetic studies can help identify whether alternate strategies can be helpful.
Fasting blood sugar should be below 100 mg/dL, Hemoglobin A1C below 5.5 and Fasting insulin less than 7 mmIU/mL.
- Elevations of any one of those numbers suggests a tendency toward type 2 diabetes. Elevations in both blood sugar and insulin are hard on your cardiovascular system and your brain. The short answer is to turn to my article on Solutions for Type 2 diabetes. Essentially, reducing the carbohydrate portion of your diet is a great first step.
B12 level should be over 500. To raise that level, methyl B12 (or hydroxy or adenosyl B12) in a sublingual form, taken 1-5 mg daily, usually corrects things quickly.
hsCRP is ideally less than 1.0 mg/dL, and reflects the body’s level of inflammation.
- Levels from 1-5.0 indicate specific cardiovascular inflammation and thus risk; higher levels reflect inflammation in other areas of the body, arthritis, injuries, or even an acute illness.
- Steps that can help to reduce levels of increased inflammation include that anti-inflammatory diet we talked about last article, as well as the certain supplements
- the essential omega-3 fatty acids DHA/EPA from some form of fish oil. (Plant based omega 3’s such as flax seed or oil are helpful in other ways, but do not take the place of fish oil when it comes to brain or heart health.) It’s good to look for a high-quality oil, in a ration of EPA/DHA 3/2, taking about 1000-1500 mg daily.
Albumin and globulin levels. Okay, this one gets complicated, but an ideal ratio albumin/globulin is 1.5/1.
- Albumin is the all-purpose protein made by your liver, and globulin reflects the activity of your immune system. Adjustments to that ratio would depend on which of the two values is out of range.
- A low globulin level could reflect malnutrition or specifically liver insufficiency
- A high level of globulin could indicate an over-active immune system. Abnormalities in the other directions should probably be discussed with a physician.
Vitamin D levels I like to see between 50-70 ng/mL for most people, or a bit higher (up to 85) if someone has had cancer. It’s important to get at least some of your vitamin D from the sun, and then normalize it with supplements.
- Any supplementation with vitamin D should also include supplementing with vitamin A and vitamin K2. An excellent combo choice is Da Vinci Labs A.D.K.
Zinc and copper are evaluated in relation to one another. When measured in the same units (mcg/dl), you’d like to have a copper level about 75-100 and a zinc level half again as high (110-150). The excess free copper can be a brain hazard, so lowering high copper levels are as important as increasing zinc.
- Copper is high in nuts, organ meats, and most multi-vitamins! Search out and reduce sources of copper from your supplements, but you can continue to eat liver.
- Zinc is absorbed from animal foods only, requires robust digestive enzymes, and can be supplemented as zinc citrate or picolinate form, 15-50 mg daily as needed, taken with meals. If you have the rare finding of abnormally low copper, more liver for you!
Ahah, now the hormones. Fixing most of these will require a physician’s cooperation.
- Thyroid hormones are looked at a little more thoroughly than in most doctors’ offices and all three values should be attended to, looking for a Free T4 about 1.0 ng/dl, a free T3 in the range of 3-4 pg/mL, and a TSH between 1.0 and 3.0 mIU/mL. (A significant change in any of those values can mean a significant change in function, even if the values are still in the “normal” range. Deserves at least a re-test.)
- Pregnenolone is a precursor for cortisol and a protective substance in the brain. Pregnenolone you’d like to see approaching 100. Both Biotics Research and Klaire Labs make an excellent Pregnenolone 25 mg. supplement that will gently bring up both pregnenolone and cortisol, taken one to two times a day. When levels of either or both hormones are out-of- range high, some further investigation is needed: stress? Adrenal dysfunction?
- Testosterone and Estradiol are the major sex hormones, and both decline with advancing age. Women’s hormones drop out precipitously at menopause and men’s levels fade more slowly. There is a clear beneficial role for both hormones, in both sexes—but at different levels. For my female patients I prescribe bio-identical estradiol and progesterone; for men I recommend bio-identical testosterone and tweaking as needed to keep their estradiol levels adequate (good for brain, mood, and bones) but not too high (bad for the prostate.)
A hefty handful of supplements, I admit. Frankly, I don’t see a good way around this for most folks past a certain age. I heartily endorse getting as much good health as you can from your diet: eating a nutrient dense diet (meat, organ meat!, fish, eggs, cheese, and lots of vegetables, a little fruit) will help tremendously, but it will only get you so far.
Why do we have to take supplements, I’m often asked: “My aging parents never took vitamins!” I’m not sure which is more important, but I am absolutely convinced that our food is not as nutritious, our lives are more toxic (both stress and organic chemical compound exposures), and that more of us, not just the genetically fit and strong, are living longer and wanting the best from life.
How important is it to do everything? The answer completely depends on your genes (are you at any risk for Alzheimer’s disease?) and your lab tests. The greater my risk of any condition the more I do to correct it. I have been concerned about breast cancer all my adult life, and have done what I could to mitigate my risk. It would have been great to have 3 children early in life, but I did medical school instead. I never drink excessively, I eat lots of cruciferous vegetables, and exercise regularly. I do my best to get 7 or 8 hours of sleep every night.
You get the idea, it’s a balancing act. By the way…how’s your balance?