Testosterone for Alzheimers ?

In The End of Alzheimer's  by Dr Bredesen on p 209 he advises the above: ONE and TWO

ONE
Free testosterone is low if it is less than 6 pg/ml, take more testosterone.

This test better in obese?

My free testosterone results.  They were acceptable in Dr Bredesen's criteria and in normal limits in my lab range below

TWO
Lately I have had total testosterone testing see below.

These more recent tests were lower than the 500-1000 level that Dr Bredesen would like to see.
Bredesen writes that levels less than 300 are very low.

Thus my endocrinologist and I decided to increase my 100 mg a week to 150 mg a week,
 even though normal levels are 86 to 780 ng/dL on in my hospitals lab

The endocrinolgist that fired me link 
also she didn't want me taking testosterone because my Hct and Hgb was a little high. 

I asked my urologist (a professor at KUMC that specialized in testosterone) about the risk of stroke.

The urologist was not concerned as I was on a blood thinner. 

I feel that my Alzheimers is worse.

 This week I screwed up writing a check to my wife. 

I filled it out to my last name rather than than her last name.  

It looked worked but I thought it was okay.

The check was for $125 but I wrote One hundred twenty dollars. 

Our bank let her have $120.

When I go to sleep I have routine 

where I take two deep breaths and then I say

Peace

Serenity

Tranquility

Contentment

Two nights ago I couldn't remember the T word. 

I made a memory bridge.

I would think of a train carrying Quails. 

I remember the memory cue but could not remember the word till I woke up this morning. 

It was disturbing to me during the night half asleep trying to remember the word Tranquility. 

I wonder if my Alzheimers is getting worse. 

It may be due to my higher Hgb A1c.

I recently began some ice cream and bagels. 

My ketone level fell below 1.0 and my glucose levels went up.

It may be due to my low testosterone after stopping injections. 

I started testosterone 100 mg/ week today.

I am going to get another skin glucose monitor again.  Previously it helped me stay on my fasting.

I will use it again when I am tempted to eat a carb during the day.

Today after one cup of ice cream last night:

Glucose 171 (I had been running glucose 220)

Ketones 1.4

Weight 208.8 

I have followed the advice from The End of Alzheimers by Dr Dale Bredesen with the following.

Revisiting testosterone link

When I increased my testosterone link

What I do on Bredensen's ReCODE link

I am a physician and can do these complicated maneuvers. 

For the average family they might have to be followed by their physician each month. 

However Alzheimers is inexorable.  

We can't really know if these items make any difference.  

From The End of Alzheimers :

Perhaps I am not getting worse. 

In Jan. I had a bad day:

I forgot how to spell "YES"

If I am stressed or perhaps overworked I may not perform as well, as simple as that.

Nothing to do with my Hgb A1c or Testosterone.  

However, no down side on trying to get better glucose results

 and improve libido with testosterone.

I will also be resuming Cialis this week.

Price reduction with Cialis link

I am gaining more respect for Dr Dale Bredesen

 I am gaining more respect for Dr. Dale Bredesen and his books. 

My first Amazon review was in April 2019.

I was brutal. 

One star. 

Later in October 2019 I still gave him only one star

 but with more explanation

Subsequent to this review I made several more in my  Blogs.  

What I agree with Dr Dale Bredesen on. link

I actually do much of what Dale Bredesen MD advises. 

1-I keep my LDLp below 1,000.  (LDLp is the particle count which is more accurate than LDLc)

2-I keep my systolic blood pressure under 120.

3-I also exercise 150 minutes a week

4-I have  a sleep apnea machine since 2004 and sleep 7-8 hours a day

5- He advises Magnesium threonate 2 gram a day.  I take 3,750 mg of Magnesium maleate a day which has helped my leg cramps at night tremendously.

6- I get my Resveratrol with wine

7- I get Nicotinamide riboside 100 mg in Enduracin (nicotinic acid)  2,000 mg which I take for cholesterol, triglycerides and HDLc. Both chemical are in the same molecular pathway.

8- He advises Omega 3: DHA 1g EPA 0.5 to 1.0 gram 

I take 4,000 mg of Lovaza which breaks out as:

DHA 375 x 4= 1500 mg
EPA 465 x 4 = 1860 mg

Update March 8, 2021.

Now I take 3 of these tablets a day.

DHA 375 X3 = 1125

EPA 465 X3 = 1395

I reduced those omega piils and then started taking Antarctic Krill oil 

Krill oil has 

 EPA 80mg

DHA 52 mg

I end up now with less EPA and DHA.  

I did it to get the carrier of DHA  to go past the brain barrier into the brian. 

DHA is not made iin the.  No way to know if my good DHA level in the blood gets past the blood brain barrier.  

It will be interesting experiment of one person. 

I made this decision based on Dr Michael Davidson's information below. 

9- I take Vitamin D 2,000 to 4,000 IU a day

9- I take Vitamin D 2,000 to 4,000 IU a day

10- I take Citalopam for depression or rather dysphoria. 

11- I take Testosterone 100 mg IM

That leaves 20 things I don't do on Bredesen's list

The other 21 items are nostrums that have no human trial evidence. 

I am now reading the second book in the series:

The End of Alzheimer's Program 

The first protocol to 

Enhance Cognition and Reverse Decline 

At any age.

I am less pessimistic about the course of my Alzheimer's since I have completed nine months of my YEAR THREE book.

Click below for

Free view of my new AZ book

Thus I feel more charitable towards Dr Bredesen's books.

I was very upset with the title The End of Alzheimer's. 

His Avery publisher probably wrote the title of the book.

I will start my review of his book briefly now.

I have done better on my MOCA test scoring 30/30

MOCA test link

Thus from my personal experience I am not so skeptical of Dr Dale's list of "survivors". I don't like the use of that term as people with AZ can live as long as 20 years.

I find my switch to Bigalow green tea is endorsed in the book. 

I will go back to only eating 72% coco chocolate.

I will still drink my  glass of whole milk each day

I was on 14 hour fast each day on LCHF 8 months. 

Months of ketone level on IF link

Last 2 weeks of IF my glucose went up link

Anxiety from stress of fasting link

It may well be that the 8 month Intermittent fasting with high ketones levels did improve my cognitive ability. 

However I also started a Cialis/testosterone plan for a month till the my testosterone was too high.

I have stopped the Cialis, Testosterone and Intermittent fasting.  

I got lab work to see if I can resume testosterone.  I have n0 libido

Alcohol

I have tolerated my alcohol for the last 3 years. 

My See No Evil bar link

I have been having bagels in the morning and some ice cream at night, as comfort food in this time of Covid 19 shut down.

Subsequently my morning ketones run around 0.5.  

Thus I will experiment with exogenous ketones as Dr Bredesen advises. 

Yearly visit to my Florida Neurologist

I did better this year on my MOCA 
(Montreal Cognitive assessment)
than I did the prior two years. 
Is this a "cure"
from my self prescribed Cialis/Testosterone AZ treatment?

I had a perfect score 30.  
I didn't miss any questions.
Normal is a score > 26



Dr Elliot was most impressed that I remembered the five words:
truck, banana, violin, desk, green when I finished the test. 
I told him I changed it to green banana truck and then
just violin desk in shape of violin.

These are all the words that start with "S"
that I could name in one minute. 





I was very pleased with my MOCA results. 
I still do badly with math.



This neurologist said he had a patient with
 proven Amyloid plaque on PET SCAN.
The patient was still good after 8 years. 
 He wondered if the patient really had Alzheimers? 

But with the positive PET scan he knows he had Alzheimers.

I told Dr Elliot I've done better after 2 months of Viagra (low dose 10 mg) then Cialis (full dose 20 mg). 

I told him it is similar to weight lifting which works by pushing more blood through the brain.

He said he is not sure if he believes that theory.

I said I have two things in my protocol that improve Alzheimers.
1- improved blood flow to the brain with Cialis
2- improved strenuous exercise with sex (although its just one arm)

He laughed laughed like crazy.

I asked him for a Testosterone level as I am trying to get my level greater than 300 as Dr. Bredesen suggests.  I think my level is low now as this week my libido has gone down. 

Excerpt from The End of Alzheimers by Dr Bredesen below on 
Testosterone. 



He ordered a testosterone level for me. 







I spoke to him about Dale Bredesen's book, The End of Alzheimers
opinion on Vitamin D.  Except below. 


Dr Elliot  agrees that a Vitamin D level greater than 50 is probably better than borderline normal of 30 for Vitamin D2/D3. 
The two different tests makes it difficult for me.

 
With winter I had a low Vitamin D   level at 23 which is low normal. 

 Lab below done in Florida on Jan 30, 2020

Record of Vitamin D in Topeka. 

He is ordering a Vitamin D level.

Dr Bredesen advises getting a Zinc level.  
I didn't get it before when I did a bunch of other tests which I thought was more. 
However, now that I have been on Intermittent Fasting since for about three months I thought a Zinc level might be a good idea.  Bariatric surgery patients develop mineral deficiencies. 
Dr Elliot is also ordering a Zinc level for me. 

Dr Elliot  thinks Intermittent fasting is a good idea.

I also purchased Biotin as my nails have been breaking.

Revisiting the role of Exogenous Testosterone

2017 article link














My testosterone levels while on 100 mg Testosterone intramuscular injection per week





Based on Dr Dale Bredesen advise in The End of Alzheimer's I am going to increase to 150mg/wk

LDL-P improved despite 10 lb. gain on 60% fat diet

I gained 10 pounds after this last road trip to NC, FL and LA.  I didn't change my diet.  I was more sedentary because of driving.  I think my weight gain was mostly due to starting testosterone 200 mg IM every two weeks on May 26.  I "believe" my muscles have more tone or more response to my moderate weight lifting.   I had read that testosterone may lower HDL-C.   My HDL-C stayed the same at 47.  However,  my HDL-P went down from 30.3 to 28.2.  The latest trend seems to follow HDL-P. 



IMPORTANT POINT :


After gaining 10 pounds on a low carb diet that is 60% fat my LDL-P decreased from 779 to 504.



LDL-C went up from 52 to 58.  NOTE the reverse discordance.

Non-HDL-C went down from 63 to 62.



My Hgb A1c went down from 8.4 to 7.4. 

I made no changes to Victoza, Actos or Glucophage.

I did decrease my lipitor to 10 mg and added Niacin (endur-acin) 1,000 mg a day.

I have chronic A. Fib so I take ASA 81 mg and 4,000 mg of SAM's triple strength fish oil

Today I am 5 pounds above my weight on June 1.  Again I attribute this to testosterone.

I continue to average 3 oz of ETOH a day.  Mostly wine with dinner.  



More lab:

TG 30  (was 54)

Total Cholesterol 109 (was 110)

Non-HDL-C 62 (was 63)

LDL size 21.1(was 20.8)

Small LDL-P 163 (was 386)

LP-Insulin resistance score:17 (was 44)

HDL size 9.7 (was 9.1)

Large HDL-P 5.7 (was 4.7)
Large VLDL-P less than 0.7(was 1.2)


FINAL POINT

Nutritionists would tell me Atkins was Lipid neutral (or better) in the A to Z Gardner trial or the Sachs NEJM Comparative Diet study because of weight loss.  My book documents that I maintained my weight in 2011 with 60% fat in my diet yet my LDL-P and Apo B was execellent.


I hit 263 pounds after this last road trip.  I weighed 261 pounds when I had this last lab test done.  I decreased my statin (atorvastatin purchased in India) from 20 to 10 mg by cutting the tab in half.  I started low dose Niacin (Endur-acin 1,000 mg).


I gained weight on 60% fat and yet my LDL-P improved.  This is just one case study.

Having the talk about when I need to be admitted to nursing home

My wife had a long career running different types of nursing homes. 

We talked about when she would no longer could take care of me. 

She  thinks she can't leave me at home by myself for six days.

She watched me walk down the hill with the dog and trying to keep up, I ended going faster and faster and the big dog caused me to step on the grass which threw me off balance.  She thought I was going to fall.  I didn't but I have fallen in the past. 
Once with a black eye. My first black eye link,
then my concussion link.

I still drive, still cook, still walk outside, I don't get anxious when she goes to her daughters for two days.  

When to move an Alzheimers patient to a home article link

1-Medication management 
I take 12 medications not counting several supplements.
I have a routine and rarely miss pills. 
I also call in my own prescriptions from my Doctor.

2- Mobility

3- Wandering
I take a mile walk each day.  
I take my iPhone with me.
I go in a circle, same route everyday.

4- Caregiver stress
I have told my wife I have no problem going to an Independent living facility if she feels I am too much for her to take care of. 
My biggest fear link 


5- Long distance caring

6-Rely on a plan not a promise

The Basic Living Skills assessment includes:

• Self- Management.
• My wife pays the bills and makes the travel arrangements.
• 
  
• Basic Communication.
• I wear hearing aides but still need to ask people to repeat their sentence as their  syntax will confuse the message for me.  Previously I could infer what they meant as my intuition as always been good.
• Dressing.
• Twice I tried to put my shirt on as pants.  Didn't work and it took a while for me to figure it out.
• Toileting.
• Other than getting up five times a night to urinate.  Once I did pee in the corner of the room.
• Grooming.
• I cut the long hairs in my nose.  A real surgical procedure.  
• Bathing.
• No problems
• Health, Safety, and First Aid.
• I put my own band aides on.  I do finger sticks on myself for glucose and ketones each morning .
• Nght-time Routines.
• I checked my testosterone level recently it was extremely high and I had to stop testosterone immediately. Four months ago my dose was increased 40 mg but I was having trouble figuring how much to draw up with the syringe.  100 mg was easy as it was one half a cc. I was giving myself a shot in my butt.
• I exercise each day.
• I walk each day.
• I stretch each day
• I take my meds in AM and supplements in afternoon.

Activities of functional living skills (AFLS) Link

My personal experience using LCHF diet and diet medicine to deal with weight regain after hitting plateau

I lost 30 pounds on Invokana 

Then started Atkins Induction phase 20 g CARB/d. 
Lost another 10 pounds in a week. 

Strangely this week I also felt the initial effects of nausea, early satiety of Victoza again. 

1-6-11 #LCHF No wt. loss 258 lbs


1-12  #Victoza caused 5 lb wt. loss 

5-12 # Insulin gained to 265 lbs

3-14  Started Invokana, 
10-14 wt. down to 235 lbs on Invokana

6-23-15  weigh in at Obesity Clinic. 244 lbs
 I Started  Qsymia

# Atkins Induction 20 g CHO/d 10-20-14

NK 1.6 10-29-14, then
Victoza suddenly seems to have side effects again with Nausea, early satiety last 5 days. 224 lbs. on 12-2-14

 On LCHF diet I simply avoid carbs as best I can.

I came back from Hawaii on March 1, 2014 and weighed in at 265.  

This is the closest I got back to my highest weight of 280 in March 2006.

I attribute both high weights to Insulin.
  

On March 4, 2014, I started Invokana and stopped Insulin.

My glucose immediately improved going down below 150.

 I also lost weight without changing diet or exercise. I was 239.5 lbs
 before leaving for Europe on Aug. 17, 2014.

Last week on, Oct 8, 2014. I came back from a 30 day cruise and I lost two more pounds to be at a new recent low of 237.
I ate well, tried to limit carbs, and drank alcohol each night 
but I tried to walk 10,000 steps a day.

After a week of following LCHF more carefully at home, I am down to 233.5.

On Oct 20, I started Induction phase again of Atkins
 which means I tried to eat less than 20 g CHO.

 I also stopped alcohol.  On Oct. 27
 I am down to 229 pounds.

I had my lab taken this morning. My lab data here

Update 11-1-14

Interesting development as of 10-30-14.  My Victoza is decreasing my appetite with some nausea and a tired feeling similar to when I first started the injections in Jan. 2011.  Has the improved ratio of my body fat to lean muscle improved to the point that the hormone is more effective or my central adipose tissue is producing less hormones to induce insulin resistance? My weight is down to 224 pounds. I am in the land of temptation NOLA.

Update 11-19-14

Intermittent epigastric pain.  3/10 lasting a minute or two.  

Update 4-8-15 

I have been traveling for the last 3 months.
 I circumnavigated the world.  46 of the travel days was on Oceania cruise.
The good news is I am at 233 lbs.
I was 231 lbs when I left Florida on Dec 30.

I follow Atkins or LCHF in general.
 I am not hungry.
 I probably walk more than I do at Kansas.
 My high intensity interval training is walking the stairs on the ship.
 No weight lifting and I ran out of testosterone 2 months ago.
 I continued Victoza, Invokana, metaformin, Actos,  and atorvastatin 10mg faithfully.

My LDLc was: 71, 
non-HDLc 85, 
Triglycerides 68, 
HDLc 68.  
I am awaiting Hgb A1c and Liposcience profile for advanced lipid testing.  see Metrics on 60% fat link.

My last month was in Hawaii.  Maui always presents the greatest challenge to my LCHF diet and exercise. 

I had frequent pasta on the cruise but I mitigated those carbs with walking almost after every meal and walking stairs.   I did drink a lot of alcohol.  I am after all trying to be a Bon Vivant.  

I have been having some epigastric pain since Nov.  It started after a large steak.  I had a EGD or gastroscope in Dec.  Despite 12 hours fasting I still had food in my stomach.  I believe my gastroparesis is more from Victoza than diabetes.  

I felt better in Jan while taking tetracycline for Malaria prevention.  I have diverticulitis and perhaps this antibiotic made the pain better? 

However after a very large spicy meal in Sydney I had what I thought was diverticulitis in my left lower quadrant. It was very different from the epigastric pain and was better after 3 days of resuming tetracycline.  

I had a normal ultrasound of abdomen in Dec. and my amylase and liver function blood tests are normal.   When I peaked my alcohol consumption while on the premium drink package for 16 days from Sydney to Auckland on Oceania I had no abdominal pain. I had at least 10 drinks a day.

UPDATE July 16, 2015

Despite stopping Victoza, I continued to have vague epigastric discomfort intermittently.  No nausea, not related to ETOH.  I had a contrast CT scan of abdomen/pelvis which showed diverticulosis and small hiatal hernia. 

On June 24, 2015 I started the lowest dose of Qysmia. I was 241 pounds.  The only change in my diet and exercise was to decrease my ETOH to 4oz week.  After 3 weeks I lost 6 pounds. 

I am on the next higher dose of Qysmia and have started a Trans-Canadian train trip followed by a 29 day Land of the Midnight Sun cruise.  The Saga of Topeka Tubby continues. 

 UPDATE 9-6-15

I just returned from a 28 day cruise on Holland America.  It was part of a 54 day vacation.  
When I left for Canada on July 14 I weighed 235.5 lbs.  
On August 11 I ran out of Qsymia.  I resumed Victoza on August 14 to replace the Qsymia and ran out of it on Aug 29.
I weighed 240 lbs  first day back in the states on Sept. 1 in NYC.  
I ate a lot of carbs in NYC.  I weighed 245 lbs back in Kansas today 9-6-15.
I hope that now I can resume my LCHF diet that I will rapidly get back to 240 lbs. 
Most interesting is that the mild abdominal pain came back on Victoza.  This is the only diet medicine that has abdominal pain as a side effect?

I am 63 years old.  I lost 80 after going on 1500 calorie diet and one hour exercise a day in 2007.  I gained 50 lbs back despite 2 hours of exercise a day.  I did not want to go back to a sub-starvation lifestyle.  LCHF since 1-11 has allowed me to enjoy my life without further weight gain.  Invokana and Victoza have helped me lose another 30 pounds recently.  

My goal is to get off Actos.  I decreased my dose today (9-6-15) from 45mg to 30 mg. 


UPDATE 5-12-18

Still on Low Carbohydrate High Fat diet. 
Usually run 205 to 211 lbs. 

Trying to gain muscle mass with little weight gain. 
 Try to eat 150 grams of protein a day.  
Try to lift weights everyday alternating 
upper body on even days and 
lower body on odd days. 
 I try to do 25 repetitions with lowest weight or till my muscle burns on last 3 reps.  
I try to get up to 3 sets but with breaks in the routine I have not been able to get to that many sets.  After two weeks I get to two sets.  

Saropenia at 66 years old is what I am trying to avoid.  
Unfortunately with large weight loss is also large muscle loss.  
I only learned about high protein with high repetition resistance training last year. 

Older men lose much of their muscle mass in their legs.  Fortunately for me I do better with lower body exercises can do more sets sooner. 

My goal is to decrease my visceral fat from 15 to 9 while not losing muscle mass. (my body composition scale at home can read this for me)

In simpler terms, I want my waist to go from 41" to 39".

If I am not on strict LCHF diet, my fasting glucose will go up to 180.  I am happy with  150 and a Hgb A1c of 6.5.

Insulin always makes me gain a lot of weight.  

I went off Actos and my FG shot up to 300.  
I did lose 5-10 lbs. 

I went on Invokana and Victoza.  I had already been on metformin. 

LCHF has not caused weight loss despite being in serum nutritional ketosis.  

Diet medications caused weight loss and definitely not exercise.
 Yoni Freedman taught me you can't outrun your fork and Eric Westman echoed that at a meeting. 
Obesity specialist clinic know this.  Guidelines don't know it yet. 

I am happy on Low Carb High Fat as I am never hungry and my diet medications, now Belviq, keeps the hunger at bay despite low leptin due to being reduced obese with billions of fat cells the never go away. 

205-210 lbs is a good weight.  I just want to see if I can improve my insulin resistance with loss of visceral fat and not muscle loss. 

UPDATE 9-5-18
I was on a seven day cruise out of Paris to Normandy.  Very nice. Great drink package and met good Australian drinking buddies. Good time. I keep on LCHF on cruise with occasional bite of ice cream. 
I stopped lifting weights on this trip and since the trip.  I have been disappointed with trying to get more muscle with  less fat. I ate 200 gram protein a day and got up to two sets of 25 reps.  Increased weight as it got easier so that I would feel the burn in the last few repetitions. At 66 yo I am on testosterone 100mg/d yet it is an effort and while I did look better, my weight went up as I was on low dose Actos to improve my FBS.  No real difference in FBS, around 150.
I will still lift weights and walk 20 minutes a day for health. However in accordance with my Bon Vivant diet I will not push the protein (at least 110 g/d) high fat and try not to eat any carbs.  I am not hungry on meds. 
This last week I had diverticulitis.  I took flagyl and bactrim.  Flagyl causes an antabuse reaction so I have not drank any alcohol for last 8 days. 

DATE           Weight    Glucose   Ketones

6-30-2018           209.6            164               0.6

9-5- 2018             211.4            170              1.3

THE SPONGE SYNDROME LINK