Dr. Mikhail (Misha) Kogan’s response to recent headlines and article in Medical News Today “Alzheimer’s risk 10 times lower with herpes medication”

It is often that we hear news of a possible breakthrough to cure Alzheimer’s disease. However, over many years of getting such messages, no real progress has been made. Dr. Dale Bredesen, one of the leading Alzheimer Disease researchers and the writer of the bestseller book “The End of Alzheimer’s Disease (https://www.amazon.com/End-Alzheimers-Program-Prevent-Cognitive/dp/0735216207/ref=sr_1_1?ie=UTF8&qid=1532528516&sr=8-1&keywords=the+end+of+alzheimer%27s+bredesen) explains the reason for why all the single interventions fail. The model is like a “leaky roof with 30 holes.” You plug one problem with a drug or a supplement but 29 are still leaking. The idea behind this thinking and the treatment program that Dr Bredesen calls ReCode – Reversal of Cognitive Decline–is that we have to support the entire metabolism to optimize or resolve dysregulation that is contributing to a patient’s cognitive decline.

So should we even pay any attention to the news of yet another “miracle Alzheimer’s cure” next time it comes up. Yes, of course we should, but not because we will be seeing a “cure,” instead, we need to pay close attention to learn how to plug each individual “hole” and look for new “holes in the roof.”

The idea that viral infections may be contributing to Alzheimer’s disease is not new. In fact it has been suggested years ago but no concrete clinical evidence was found to establish a causative relationship. This changed recently with 3 studies pointing to the link. The detailed journalist review of findings of these studies in a simple language can be found here (https://www.medicalnewstoday.com/articles/322463.php)

I think the review is rather good but unfortunately it misses the entire point. It is very likely that antiviral drugs, despite one study showing a possible dramatic decrease in risk of developing AD, will be yet another “here today gone tomorrow” approach. Yet what we have learned here is possibly fundamentally important – virally triggered brain inflammation may be one of the “bigger holes” that needs to be addressed early and aggressively. I personally doubt that medications will be an answer (see below link and Dr. Cooper’s comment) but understanding of how to avoid viral flares by supporting the full organism to optimize immune function very well could be.

Being personally very doubtful of any new simple “cures” I asked my mentor in Memory Disorders, Dr. James Cooper, emeritus George Washington University Professor of Medicine, to write a few thoughts on this topic. In his usual very concise and yet wise way he returned my questions with more questions!

“A lot of questions come up. Why weren’t these subjects treated? How are they different? In several ways, they are not the usual cases with herpes.  See also https://tinyurl.com/y778a7a2

The review Dr. Cooper provided is the detailed analysis of possible problems with the study and why we should cool our excitement and wait for more studies to shed light on the matter. Meantime, I personally strongly believe that life style optimization, removal of known toxins, individually tailored nutritional and herbal supplementation in situations where specific metabolic shifts require more than just lifestyle treatments, maintaining a positive outlook and meaningfully engaging in life are our safest and most effective ways of minimizing future risk of cognitive decline. I will not start giving all patients with known herpes infections anti-viral medications. One of the question for me now is to decide if I should monitor viral titers and immune markers to see if a given patient’s immune system effectively got over herpes infection and maintains a healthy state. Of course genetics do play a role and will probably be my next topic to write about. And I will be very curious to hear Dr. Cooper’s opinion on that matter.