Book Review: The Alzheimer's Antidote

Alzheimer’s Disease (AD) is generally viewed as an unstoppable disease with a cause that is too complex to understand or prevent. Amy Berger, author of The Alzheimer’s Antidote, counters that AD may not be as enigmatic as commonly believed. Medical literature often refers to AD as “Type 3 Diabetes” and like most chronic diseases, it is related to chronically elevated insulin. Berger is far too nuanced and too practical to claim bulletproof treatment or prevention of this dignity-robbing disease. However, her approach of using a ketogenic diet and other lifestyle modifications is an important step towards improving cognition in AD-afflicted people. Some of the same tactics can also mitigate the risk of developing AD in the first place.

This is the only way I could make the review any more glowing.

Berger postulates that the defining factor of AD is the brain’s inability to properly fuel itself via glucose. The good news is that brains unable to properly metabolize glucose can still metabolize ketones. Ketones are produced by the liver when one eats a very-low-carbohydrate diet, so Berger promotes this ketogenic way of eating (along with other ketone-boosting interventions) to improve cognition in a person suffering from AD.

The book highlights the work of Dr. Dale Bredesen. In contrast to the disappointing results from drug-based AD treatments, Bredesen’s work has been largely successful. His ketogenic approach has allowed many of his severely AD-impaired patients to go back to work and lead their normal lives. Berger shares his quote: “AD is not a mysterious, untreatable brain disease-- it is a reversible, metabolic/toxic, usually systemic illness with a relatively large window for treatment.”

Berger discusses brain health from many angles, and she spends lots of time underscoring the value of cholesterol for a healthy brain. She is highly critical of the idea of cholesterol-lowering medications (statins) and calls out the fact that people who take them have increased risk of brain fog, cognitive impairment, depression, hormonal imbalances, diabetes, low libido, infertility, and memory loss. Furthermore, antacids (e.g. Pepto-Bismol) and proton pump inhibitors (e.g. Prilosec) can lead to brain-atrophying vitamin B12 deficiency. With common usage of these drugs and with common diets being nutrient-poor and insulin-spiking, it is no wonder that we are seeing cognitive decline in people earlier than we used to.

The Alzheimer’s Antidote pushes back against a common idea that beta-amyloid plaques are a driving factor in Alzheimer’s. Rather than disease causes, these plaques are effects: the plaques build up when an enzyme that could degrade them instead is too busy degrading excessive insulin. Long before beta-amyloid plaques show up in the brain, decreased brain glucose metabolism can be detected in PET scans (including in people just in their 30s and 40s). Berger also downplays common concern about the APoE4 gene variant. While APoE4 carriers do have an increased AD risk, focusing on genetics distracts from the root cause of elevated insulin levels.

For AD sufferers, for AD caregivers, and for anyone who cares about maintaining cognitive health, this book is a terrific resource. In a a practical, compassionate, and realistic manner, it teaches the reader how to implement a low-carb diet to improve cognition. It also makes the case for lifestyle practices like exercise and intermittent fasting. Berger’s work gives plenty of “why” and lots of "how" but it ultimately provides something else even more important: hope.

If you want to see a heartwarming real-life example of Berger's approach, see here. That video is what inspired me to finally read this book.

While you will find Berger's name in several of my favorite podcasts, I think one of her best interviews is here on the Peak Human podcast.