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 Supplements for Patients with Alzheimer's Disease 
The following is one in an ongoing series of columns entitled Mind Boosters by . View all columns in series
Ray Sahelian Alzheimer's Disease (AD) is a progressive deterioration in mental functioning first described by Alois Alzheimer in 1907. The onset most commonly starts in one's 80s, although it has been known to start as early as age 30. One of the major cognitive problems with AD is the inability to acquire new knowledge. Loss of the sense of smell is common, and the mental deterioration proceeds to affect language and motor skills.

While scientists have not fully determined the actual causes of Alzheimer's disease, a number of treatment options have been proposed. These include the use of antioxidants, blocking the breakdown of acetylcholine, and improving blood flow to brain cells. There are currently no effective pharmaceutical drugs for treating AD. If someone you know has AD, I believe it is worthwhile exploring nutritional therapies.

Vitamins E and C It's quite likely that quite a number of different antioxidants are beneficial. A highly publicized article in The New England Journal of Medicine reported that the daily use of 1,000 units of vitamin E was effective in slowing the progression of this disease. Researchers at the Rush Alzheimer's Disease Center, Rush University, in Chicago, Illinois, found through an epidemiological survey that the use of vitamin E and C supplements reduces the risk of developing AD.

Blocking the Breakdown of Acetylcholine Another approach that has been tried is to prevent the degradation of acetylcholine, the brain chemical associated with learning and memory. This can be achieved by providing drugs that block the activity of the enzyme cholinesterase, which breaks down acetylcholine. Two of these drugs are tacrine (Cognex) and donezepil (Aricept).

A Chinese herbal extract called huperzine A has been shown in preliminary studies to block cholinesterase even more potently than tacrine. Early studies indicate that huperzine A is much safer than tacrine.

Improving Blood Circulation Any step taken to reduce atherosclerosis, or hardening of the arteries, is likely to improve blood circulation to the brain. A study in The Journal of the American Medical Association had good news about the herb ginkgo biloba. Therapy with 40 mg of ginkgo three times a day for one year had a positive effect in patients with AD. There are several compounds in ginkgo that improve circulation and act as blood thinners and antioxidants.

Combination Therapy The nutritional approach to treating patients with AD is still very new, and there are no standards that have been developed. It may take trial and error to find the ideal regimen for each patient. In addition to antioxidants, ginkgo, and huperzine, B vitamins at about two to five times the RDA should be helpful.

Include plenty of fresh fruits and vegetables in order to obtain important carotenoids and flavonoids. Vitamin E, between 200 and 400 units a day, preferably of mixed tocopherols, should be taken with a meal. The dosage for vitamin C is 250 mg once or twice a day. A 40-mg dose of ginkgo twice daily with breakfast and lunch is recommended. Huperzine A is an exciting addition to the nutritional armamentarium of natural therapies for AD. A dosage of 0.02 to 0.05 mg per day can be tried instead of the standard cholinesterase inhibitors.

Summary Finding an effective therapy for AD is very challenging. However, with a great deal of patience, and trial and error, it is likely that a combination of nutrients can be found that can improve quality of life and cognitive function. Even though many nutritional options have been presented in this article, it is important not take all of these supplements at the same time, but to gradually add one, and then another, in low dosages in order to determine the effectiveness of each addition. The use of nutrients is especially appropriate in the treatment of AD since currently there is no effective pharmaceutical therapy for this condition.

Ray Sahelian, M.D., is the author of the newly published Mind Boosters: A Guide to Natural Supplements That Enhance Your Mind, Memory, and Mood (St. Martins Press, $14.95, 2000). For more details, updates, and to ask questions, see

Le Bars, P.L., et al. 1997. A placebo-controlled, double-blind randomized trial of an extract of ginkgo biloba for dementia. JAMA 278:1327-1332.
Morris, M.C., et al. 1998. Vitamin E and vitamin C supplement use and risk of incident Alzheimer disease. Alzheimer. Dis. Assoc. Disord.Sep;12(3):121-6.
Sano, M., Ernesto, C., Thomas, R.G., et al. 1997. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. N. Engl. J. Med. 336:1216-1222.
Xu, S.S., et al. 1995. Efficacy of oral huperzine-A on memory, cognition, and behavior in Alzheimer's disease. Chung Kuo Yao Li Hsueh Pao 16(5):391-5.

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 About The Author
Ray Sahelian, M.D., is a popular and respected physician who has been seen on numerous television programs including NBC Today, Dateline NBC, and CNN, and quoted by countless major magazines such as Newsweek He......moreRay Sahelian MD
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