The Bredesen Protocol UK

The Bredesen Protocol UK: A Revolutionary Approach to Reversing Cognitive Decline

Introduction: A New Hope for Alzheimer’s Disease

For decades, an Alzheimer’s diagnosis has been synonymous with inevitable cognitive decline and eventual loss of independence. However, groundbreaking research led by Dr. Dale Bredesen is challenging this narrative. The Bredesen Protocol, also known as ReCODE (Reversal of Cognitive Decline), represents a paradigm shift in how we approach Alzheimer’s disease and mild cognitive impairment (MCI) in the UK and globally.

Unlike conventional treatments that offer minimal and temporary benefits, the Bredesen Protocol has demonstrated sustained cognitive improvement in patients for up to 11 years—something previously unheard of in dementia care. This comprehensive guide explores how this revolutionary protocol works and its availability in the UK.

Understanding the Bredesen Protocol: What Makes It Different?

The Failure of Conventional Treatments

Traditional Alzheimer’s treatments have focused on single-target approaches, primarily:

• Cholinesterase inhibitors (such as donepezil)
• NMDA receptor antagonists (such as memantine)
• Anti-amyloid antibodies (recent additions)

Research has shown that these monotherapies are associated with more rapid decline than no treatment in patients over multi-year follow-ups, with anti-amyloid antibody treatment leading to accelerated cerebral atrophy.

A Precision Medicine Approach

The Bredesen Protocol takes a fundamentally different approach. Rather than targeting a single pathway, it recognizes that Alzheimer’s disease results from an imbalance in an extensive plasticity network, with the brain’s amyloid-beta precursor protein (APP) acting as a molecular switch mediating plasticity-related signalling.

This protocol is:

• Personalised: Tailored to each patient’s unique biochemical profile
• Multi-factorial: Addresses multiple potential drivers of cognitive decline simultaneously
• Metabolic: Focuses on optimising metabolic health to support brain function
• Systems-based: Treats Alzheimer’s as a network insufficiency rather than a single-pathway disease

The Science Behind the Protocol

The APP Molecular Switch Theory

Dr. Bredesen’s research suggests that APP functions as a molecular switch, with different processing pathways leading to either neuroprotective or neurodegenerative outcomes. The amyloidogenic processing produces four peptides that mediate neurite retraction, synaptic inhibition, and cell death, while non-amyloidogenic processing produces two peptides that promote neurite extension and inhibit neurodegeneration.

Identifying the Root Causes

The protocol evaluates numerous potential contributors to cognitive decline, including:

1. Metabolic dysfunction: Insulin resistance, protein glycation, and energy deficits
2. Inflammation: Chronic systemic or neuroinflammation
3. Infections: Chronic pathogens including herpes viruses, Borrelia, and others
4. Toxin exposure: Heavy metals, mycotoxins, and organic pollutants
5. Hormone imbalances: Thyroid, sex hormones, and neurosteroids
6. Nutrient deficiencies: Vitamins, minerals, and essential fatty acids
7. Vascular factors: Poor circulation and nocturnal hypoxemia
8. Gut health: Dysbiosis and intestinal permeability

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Clinical Evidence: The Remarkable Results

Case Studies Showing Long-Term Improvement

In a groundbreaking case series, seven patients demonstrated sustained cognitive improvement for periods ranging from 6 to 11 years. All outcome measures revealed improvement, including MoCA scores, CNS Vital Signs Neurocognitive Index, and partner assessments, with no serious adverse events recorded.

The Proof-of-Concept Trial

A pilot study involving 25 patients with dementia or MCI showed remarkable results: 84% of patients demonstrated improvement on multiple cognitive measures, with statistically significant improvements in MoCA scores, CNS Vital Signs Neurocognitive Index, and Alzheimer’s Questionnaire Change scores. Perhaps most importantly, six patients who had struggled with or discontinued work were able to return to employment with improved performance.

Sustained Improvements Over Time

What sets the Bredesen Protocol apart is not just initial improvement but sustained benefits. One patient, a 75-year-old female professor, showed improvement from a MoCA score of 24 to 30 over 17 months, with her hippocampal volume increasing from the 14th to the 28th percentile for her age. After seven years on the protocol, she has sustained her improvement, describing her cognition during years three to five as “the best in 20 years”.

Components of the Bredesen Protocol

1. Comprehensive Diagnostic Testing

The protocol begins with extensive evaluation including:

• Genetic testing: ApoE genotype and hundreds of genomic variants.
• Blood biomarkers: Metabolic, inflammatory, and hormonal markers.
• Cognitive assessments: MoCA, CNS Vital Signs, and partner questionnaires.
• Brain imaging: MRI with volumetrics.
• Pathogen screening: Testing for chronic infections.
• Toxin assessment: Heavy metals, mycotoxins, and organic pollutants.
• Gut health analysis: Microbiome and intestinal permeability testing.

2. Dietary Interventions

The protocol emphasises a plant-rich, high-fiber, mildly ketogenic diet with a fasting period of 12-16 hours each night. Patients are encouraged to consume organic produce, wild-caught low-mercury fish, and modest amounts of pastured meats, while avoiding processed foods, simple carbohydrates, gluten, and dairy. Blood ketone levels are monitored with a goal of 1.0-4.0 mM beta-hydroxybutyrate.

3. Exercise and Physical Activity

Exercise is a cornerstone of the protocol, with recommendations for at least 45 minutes per day, six days per week for aerobic exercise, and twice per week for strength training. High-intensity interval training (HIIT) is recommended at least twice weekly.

4. Sleep Optimisation

Quality sleep is essential, with a target of 7-8 hours nightly. All patients are screened for sleep apnea using home sleep studies, and those diagnosed receive treatment with CPAP or dental splint devices.

5. Stress Management

The protocol incorporates stress reduction through biofeedback and heart-rate variability training, with a minimum of 10 minutes daily using validated tools like HeartMath.

6. Brain Training

Patients engage in daily cognitive training using evidence-based platforms like BrainHQ for a minimum of 15 minutes, targeting speed and accuracy of information processing across 29 cognitive exercises.

7. Targeted Supplementation

Based on individual deficiencies and needs, the protocol may include:

• B vitamins (methylcobalamin, methylfolate, P5P)
• Vitamin D3
• Omega-3 fatty acids (DHA and EPA)
• Coenzyme Q10
• Minerals (magnesium, zinc)
• Herbal supplements (curcumin, Bacopa monnieri, Ashwagandha)
• Neuroprotective compounds such as quercetin or resveratrol

8. Hormone Optimisation

For patients with suboptimal hormonal status, bio-identical hormone replacement is provided to optimise sex hormones, neurosteroids (DHEA, pregnenolone, vitamin D), and thyroid function.

9. Treatment of Infections and Toxins

Identified infectious agents are treated with appropriate antimicrobials, including valacyclovir for herpes simplex, herbal protocols for Epstein-Barr virus, and organism-sensitive treatments for tick-borne infections. Toxicity from metals or biotoxins is addressed through targeted detoxification with binding agents, sauna, and dietary modifications.

Real Patient Success Stories

The Professional Who Nearly Quit

A 67-year-old woman with a demanding analytical job found herself unable to remember what she had just read, couldn’t recall four-digit numbers, and became lost on familiar roads. Told she had the same problem as her mother who died in a nursing home with severe dementia, she contemplated suicide. After three months on the protocol, all symptoms abated. Two and a half years later, at age 70, she remained asymptomatic and continued working full-time.

The Entrepreneur’s Remarkable Recovery

A 69-year-old businessman with 11 years of progressive memory loss and documented Alzheimer’s pathology on FDG-PET scan had been advised to “get his affairs in order” and was closing his business due to cognitive decline. After six months on the protocol, he could recognise faces again, remember his schedule, and perform his work without difficulty. His lifelong ability to add columns of numbers in his head returned. After 22 months, his neuropsychological testing showed dramatic improvement, with some scores increasing from the 3rd to the 84th percentile. Ten years later, he continues to operate his successful business at multiple sites.

The Youngest Patient

A 44-year-old yacht captain, homozygous for the ApoE4 allele, presented with four years of cognitive decline affecting his navigation abilities and work performance. After addressing mycotoxin and mercury exposure alongside nutritional optimisation, his MoCA score improved from 26 to 30. Six years later, he continues working as a yacht captain without navigational problems or memory deficits.

Accessing the Bredesen Protocol in the UK

Current Availability

While the Bredesen Protocol originated in the United States, awareness and implementation are growing in the UK. Practitioners trained in functional and precision medicine are beginning to offer this approach to British patients seeking alternatives to conventional dementia care.

What to Look For

When seeking a Bredesen Protocol practitioner in the UK, consider:

1. Training and certification: Look for practitioners with formal training in the ReCODE protocol
2. Comprehensive testing capabilities: Ensure access to necessary diagnostic tests
3. Multidisciplinary team: The protocol works best with support from health coaches, nutritionists, and personal trainers
4. Ongoing monitoring: Regular follow-up and protocol adjustments are essential

NHS vs. Private Care

Currently, the Bredesen Protocol is not available through the NHS and is offered privately. However, the cost is far less than assisted living facilities or anti-amyloid antibodies, both of which are much more costly and less effective.

Who Can Benefit from the Bredesen Protocol?

Ideal Candidates

The protocol has shown the most success in patients with:

• Subjective Cognitive Impairment (SCI): Early concerns about memory
• Mild Cognitive Impairment (MCI): Documented cognitive decline without dementia
• Early Alzheimer’s Disease: MoCA scores of 19 or higher
• ApoE4 carriers: Those at genetic risk for Alzheimer’s

Less Optimal Scenarios

The protocol has shown limited success in late-stage Alzheimer’s disease, and patients with MoCA scores below 19 may have more modest improvements.

Challenges and Considerations

The Commitment Required

The protocol is not easy to follow, requiring significant diet and lifestyle changes and multiple daily supplements. However, these demands are mitigated by the fact that patients had previously been told their prognosis was poor and cognitive decline essentially untreatable.

Secondary Decline and Re-optimisation

Some patients experience secondary decline after initial success, often due to newly emerging factors such as sleep apnea, chronic infections, or toxin exposure. When these factors are identified and addressed, cognitive improvement typically occurs again, suggesting the protocol is addressing the actual drivers of decline.

The Future of Alzheimer’s Treatment in the UK

Ongoing Research

A randomised, controlled trial is ongoing to further validate these results and determine how frequently such sustained improvements occur in patients treated with precision medicine protocols.

Implications for Healthcare

The success of the Bredesen Protocol challenges fundamental assumptions about neurodegenerative diseases and suggests that:

1. Early intervention matters: Addressing cognitive decline at the SCI or MCI stage offers the best outcomes
2. Root causes can be identified: Comprehensive testing reveals treatable contributors to decline
3. Network-based approaches work: Addressing multiple pathways simultaneously creates synergistic effects
4. Sustained improvement is possible: Cognitive decline is not inevitably progressive

Potential for Prevention

For those at genetic risk (particularly ApoE4 carriers), the protocol offers a potential preventive strategy, addressing risk factors before cognitive symptoms emerge.

Practical Steps to Get Started in the UK

1. Initial Assessment

Begin by finding a functional medicine practitioner familiar with the Bredesen Protocol or willing to learn about this approach.

2. Baseline Testing

Arrange for comprehensive testing including:

• Genetic testing (ApoE and related variants)
• Comprehensive metabolic panel
• Inflammatory markers
• Hormone levels
• Nutrient status
• Toxin screening
• Cognitive baseline assessment

3. Lifestyle Foundations

While awaiting test results, begin implementing fundamental changes:

• Adopt a whole-foods, plant-rich diet
• Establish a consistent sleep schedule
• Begin regular exercise
• Practice stress reduction techniques
• Eliminate processed foods and sugar

4. Personalised Protocol Development

Work with your practitioner to develop a customised plan based on your test results and individual needs.

5. Support System

Engage family members, consider working with a health coach, and connect with others following the protocol for support and accountability.

Conclusion: A Paradigm Shift in Dementia Care

The Bredesen Protocol represents the first demonstration of sustained cognitive improvement in patients with Alzheimer’s disease and MCI for periods extending beyond a decade—something never reported with conventional treatments including anti-cholinesterase inhibitors, glutamate receptor antagonists, or anti-amyloid antibodies.

For UK residents facing cognitive decline or concerned about their risk for Alzheimer’s disease, the Bredesen Protocol offers genuine hope. While it requires commitment and is not yet widely available through conventional healthcare channels, the evidence of sustained cognitive improvement—in some cases for over a decade—makes it worthy of serious consideration.

The question is no longer whether cognitive decline can be reversed, but rather how to make this revolutionary approach accessible to the millions who could benefit from it. As awareness grows and more practitioners receive training, the Bredesen Protocol may well represent the future of dementia care in the UK and beyond.

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References

1. Bredesen, D.E., Ross, M.K., & Ross, S. (2024). Sustained Cognitive Improvement in Alzheimer’s Disease Patients Following a Precision Medicine Protocol: Case Series. Biomedicines, 12(8), 1776. https://doi.org/10.3390/biomedicines12081776
2. Toups, K., Hathaway, A., Gordon, D., Chung, H., Raji, C., Boyd, A., Hill, B.D., Hausman-Cohen, S., Attarha, M., Chwa, W.J., Jarrett, M., & Bredesen, D.E. (2022). Precision Medicine Approach to Alzheimer’s Disease: Successful Pilot Project. Journal of Alzheimer’s Disease, 88(4), 1411-1421. https://doi.org/10.3233/JAD-215707
3. Bredesen, D.E. (2014). Reversal of cognitive decline: A novel therapeutic program. Aging, 6(9), 707-717. https://doi.org/10.18632/aging.100690
4. Kennedy, R.E., Cutter, G.R., Fowler, M.E., & Schneider, L.S. (2018). Association of Concomitant Use of Cholinesterase Inhibitors or Memantine with Cognitive Decline in Alzheimer Clinical Trials: A Meta-analysis. JAMA Network Open, 1(7), e184080.
5. Alves, F., Kalinowski, P., & Ayton, S. (2023). Accelerated Brain Volume Loss Caused by Anti–β-Amyloid Drugs: A systematic review and meta-analysis. Neurology, 100(20), e2114-e2124.