Monday, 25 February 2008

Stengler's Medical Mystery: Surprising Cause of Memory Loss

Memory lapses -- as in, what is her name? -- are an uncomfortable but generally inevitable part of the aging process. Sometimes these lapses are amusing -- but there's only anxiety and fear, no humor at all, when memory decline creeps into and interferes with everyday life. This is what had begun to happen to 69-year-old Brad, a financial consultant whose professional success had brought him the home and lifestyle that a high-level career affords. Rather suddenly, Brad began to have trouble remembering things he'd just been told. He sometimes got lost while driving in areas he'd long known well. As a way to compensate he began to carry a pen and notepad at all times, constantly jotting down reminders about things people told him and tasks and errands he needed to do.

DIFFERENT DOCTORS, DIFFERENT ANSWERS

Always an active and forceful person, Brad wasn't the type to simply accept that dementia might be setting in. Because his cholesterol levels were moderately elevated and he worried about his heart, the physician he saw most regularly was a cardiologist. When he called her to discuss his increasingly frequent memory lapses, she referred him to a neurologist for an evaluation. This doctor examined Brad, ran standard tests and gave him the much-feared diagnosis -- it appeared he was in early-stage dementia, perhaps from vascular problems or possibly as the first symptoms of Alzheimer's disease.

Facing this dire diagnosis prompted Brad to call Mark Stengler, ND, in the hope that a physician trained and experienced in treating illness with natural substances might offer a way to strengthen his memory and perhaps even ward off dementia. Dr. Stengler first reviewed Brad's medical history, including when his memory problems started and how rapidly they had progressed. He quickly realized that this disturbing symptom first presented itself just a few months after Brad's cardiologist had put him on a statin drug (Lipitor) to lower his cholesterol. Knowing that statins have been anecdotally linked to a wide variety of side effects, including false dementia, Dr. Stengler decided to investigate if a more natural protocol to lower Brad's cholesterol could replace the drug. By stopping the Lipitor without endangering Brad's cardiovascular health, they would determine if his dementia was real or a side effect of the drug. His cardiologist was informed of the treatment plan.

NATURAL TREATMENT BEGINS

This wasn't going to be merely a matter of substituting a vitamin regimen for his prescription drug, however. The first step prescribed by Dr. Stengler was a diet to reduce Brad's LDL cholesterol (low-density lipoprotein, the potentially dangerous one). It included:

  • Regular consumption of soluble fiber, including foods such as beans, barley, oats, peas, apples, oranges and pears. Soluble fiber reduces the absorption of cholesterol from the intestines into the bloodstream.
  • At least two servings a week (optimally four or more) of fish such as anchovies, Atlantic herring, sardines, tilapia and ocean or canned salmon, specifically for their omega-3 fatty acids. This could also be accomplished with supplements.
  • A daily handful of nuts rich in monounsaturated fatty acids, such as almonds and walnuts. A Spanish study found that a walnut-rich diet reduced total cholesterol by as much as 7.4% and LDL cholesterol by as much as 10%.
  • Ground flaxseeds -- up to a quarter-cup daily with 10 ounces of water or tossed into a salad or shake. This has been shown to reduce total and LDL cholesterol.

To manage his cholesterol, Dr. Stengler also had Brad double his number of weekly aerobic exercise sessions, from twice each week to at least four times. He prescribed plant sterols, shown to reduce LDL cholesterol by up to 14%, recommending Beta sitosterol, which works by inhibiting cholesterol absorption in the digestive tract by up to 50%, without disrupting the more beneficial HDL cholesterol. Dr. Stengler prescribed a 1.5 gram soft gel capsule to be taken with breakfast and dinner for a total of three grams daily. Brad would need to continue this regimen for life, since in taking his medical history Dr. Stengler had learned that his elevated cholesterol had genetic roots.

JUST REMEMBER THIS... MANY MEDS CAUSE FALSE DEMENTIA

Brad is now six months off Lipitor and into his new program and his memory has improved significantly. He has no need for memory-enhancing supplements, although he does take a multi-vitamin daily per Dr. Stengler's advice. Dr. Stengler also monitors Brad's cholesterol levels regularly. He says that they have remained in a normal range and Brad had no reason to return to statins.

Clearly Brad's memory problems were not symptoms of early dementia... but rather side effects of the statin drug. But statins are not the only drugs that may trigger side effects that mimic dementia. Other drugs that can cause these problems include tricyclic antidepressants and certain medications for Parkinson's disease -- which is ironic in that PD itself can eventually cause dementia. Pain medications (narcotics such as OxyContin and Vicodin) can also cause memory problems, as can regular use of over-the-counter antihistamines including Benadryl, Chlortrimaton and Tavist.
These drugs have a common denominator: They all have anti-cholinergic properties, which means they suppress neurotransmitters that regulate certain aspects of mental functioning, especially those that relate to memory. This explains why anti-cholinergics can actually cause cognitive problems, and why the principle drugs to treat AD are in the pro-cholinergic category.

When concerned about memory lapses, many people today turn to a variety of supplements. A more effective strategy would be to schedule a visit to a naturopathic physician to review the medications they take regularly, both pharmaceutical and OTC, as these may be where the problem lies. In fact, a study published in the British Medical Journal reported on 372 elderly people without dementia who were taking anti-cholinergic medication. After following this group for eight years, the researchers found that 85% of this group had mild cognitive impairment, compared with 35% of the people in a second group who had never used the drugs. As Dr. Stengler says, this is an important reminder why people and their doctors should wonder whether symptoms of early dementia might relate to medication -- and therefore be reversible. That's advice worth remembering.

Source(s):

Mark A. Stengler, ND, a naturopathic physician and leading authority on the practice of alternative and integrated medicine. He is director of the La Jolla Whole Health Clinic, La Jolla, California, and associate clinical professor at the National College of Naturopathic Medicine, Portland, Oregon. He is author of the newsletter Bottom Line Natural Healing, www.DrStengler.com.

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