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Could Alzheimer’s Be Prevented By Antibiotics or Antivirals?

Quite some time ago during my internal medicine residency, articles began to appear in medical journals advancing the idea that stomach ulcers might be caused by bacteria. Mainly, I remember how dismissive most gastroenterologists were of this idea. “It is utterly impossible,” said one lecturer, “that any bacteria could survive in the intense acidity of the stomach.”

And then, in an effort to prove his point, the extremely dedicated Australian researcher Barry Marshall, MD, drank a petri dish filled with the bacterium Helicobacter pylori (H. pylori) and did indeed develop ulcers. Buried in the ulcers were colonies of H. pylori, thriving in the acid environment. Ugh, you might be thinking, but at least Marshall received a Nobel Prize for his efforts.

Almost 40 years later, we now know several illnesses are linked to chronic infections. For example, chronic lung disease and asthma are frequently associated with smoldering mycoplasma and chlamydia infections. The potpourri of bacteria in untreated chronic gum disease slowly generates a widespread inflammation in your arteries that leads to deposits of cholesterol and significantly increases your chances of heart disease and strokes.

In the 21st century, we don’t see the vast numbers of people with chronic syphilis who filled the asylums of the 19th century. Instead, we’re battling a cousin of the syphilis bacterium (Treponema pallidum) in the form of Borrelia burgdorferi, the cause of chronic Lyme disease.

Alzheimer’s and bacteria
The current controversy over whether or not Alzheimer’s disease (AD) could possibly be triggered by a chronic infection sounds very similar to Dr. Marshall and his struggles with H. pylori. When you read the editorials by researchers making a case for AD as an infection, you sense they’re battling vested interests to get funding for research. Their ideas are too far out of the box and the pharmaceutical industry is preoccupied with developing useless and expensive drugs (Namenda, Aricept) that neither cure nor stop the progress of AD and are meant to be taken for years and years.

Wouldn’t it be a game-changer if you could get tested for your personal susceptibility to AD and, if positive, be prescribed a generic antibiotic or antiviral and know your AD risks had plummeted dramatically?

This next section, in which I’ll attempt to explain the mechanics behind this astonishing news, is a little complicated. If you haven’t yet had your coffee, you can stop reading now with the take-away that “scientists are working on it.” Add this Health Tip to your Facebook page and get on with your eggs. Or just keep reading.

Risk #1 is genetic
AD undeniably runs in families. We all carry two copies of the APOE gene (“E” is for epsilon, not the letter “E”), one from each parent. There are three different APOE genes: e2, e3, and e4. It’s APOE-4, present in 20% of the population, that not only increases the risk of developing AD, but also increases your risk for atherosclerosis, heart disease, stroke, and macular degeneration.

Risk #2 is plaque build-up in your brain
If you’ve read anything about AD, you’ve come across the words “plaque” and “amyloid.” These are terms used by pathologists to describe what they see under the microscope in the brains of those who had Alzheimer’s before death. The depositing of plaques made up of the protein amyloid (a distant cousin to starch) interferes with brain function. As more and more amyloid gets deposited in the brain, mental function declines until an Alzheimer’s patient enters a vegetable-like state and eventually dies.

Risk #3 is an infection
Here’s where it gets interesting. Throughout our lives, there are many bacterial infections we acquire and rid ourselves of without any complications. One large group of these is called community-acquired pneumonia (as opposed to pneumonia acquired in a hospital or other institution) and the most common causes are mycoplasma (M. pneumoniae) and chlamydia. You can also get herpes (a virus), Lyme disease, mononucleosis (a virus), and a bunch more. We find evidence of previous infection via blood tests, looking for the antibodies our immune system create against the infection.

Because the organisms causing these infections are very tiny, they can pass through the protective shield called the blood-brain barrier and enter the brain. Although the idea of any infection entering your brain does sound spooky, if you’re either APOE-2 or APOE-3, you have a powerful defense system that clears the infection away without any permanent damage. The only symptom you might notice is a headache or some temporary difficulties with concentration.

Risk #4 is the important part: how you clear infection from your brain
If you’ve got the APOE-4 gene, when the infection moves through the blood-brain barrier your brain responds differently and starts forming the amyloid plaque of Alzheimer’s. In other words, Alzheimer’s develops from your brain’s inability to clean up an otherwise relatively innocuous infection.

Can you say controversial?
This research is highly controversial because scientists have been able to duplicate all this only in mice. And even though we all like baked brie, we are not mice. The process of the research went like this: they took groups of APOE-4-positive and APOE-4-negative mice and infected them with chlamydia. Later, they examined the mouse brains and found Alzheimer plaques only in the APOE-4-positive group. The APOE-4-negative mice showed normal brain tissue.

If you’ve stayed with me this long you’re undoubtedly asking “What does this mean for me?” and “If I’m at risk, is there anything I can do to reduce my Alzheimer chances?”

Controversial again. Doctors definitely do not agree on this:

  • Consider getting tested for the APOE-4 gene. This is readily available from your physician.
  • If you have the APOE-4 gene, although you’re at increased risk for Alzheimer’s it certainly doesn’t mean it’s inevitable. However, you’re also at increased risk for heart disease and here you can do something: healthful eating, smoking cessation, keeping blood pressure and cholesterol under control.
  • If you have the APOE-4 gene, consider getting tested to see if you’ve ever had chlamydia, mycoplasma, herpes, or Lyme. If you test positive for any of these, ask your doctor about the possibility of being at risk for a smoldering infection and discuss the usefulness of taking an antibiotic (minocycline) or antiviral (valcyclovir) daily for 6 to 12 months. Both are safe for long-term use, though you’ll need probiotics to restore your intestinal microbiome after the carpet bombing it will receive from the antibiotic. If you’re reluctant to take long-term antibiotics for an unproven theory, you can instead work on lowering the inflammation in your body with dietary changes and anti-inflammatories like turmeric.

I know I’ve thrown a lot at you for a Tuesday morning. Here’s what I personally would do:

  • If I had early heart disease and/or Alzheimer’s in my family, I’d get tested for the APOE-4 gene.
  • If I were positive for APOE-4, I’d work like a son-of-a-gun toward heart disease prevention: health club, veggies, antioxidant supplements, even statins to get the cholesterol really low. My gums would glisten with good health.
  • If I were positive for APOE-4 and there was a lot of Alzheimer’s in my family, I’d get tested for the infections listed above. If any were positive, I’d definitely take the minocycline or valcyclovir. The minocycline I’d use for a year, the valcyclovir probably indefinitely because the best you can do with herpes is suppress it into inactivity. I’d also eat curry once a week or take encapsulated turmeric twice daily.

And then I’d just hope for the best.

Be well,
David Edelberg, MD

Leave a Comment

  1. ca says:

    Tons to think of here Doc!
    Thanks for sharing.
    I have felt that depression played a huge role in those who developed Alzheimer’s.

    I keep going back to the gut!

    Gum disease really was mostly found in undernourished people when I was a child. Now it is everywhere. I did think it was shown to have higher numbers in smokers!

    None in my family’s, but think I will start the turmeric now.. after reading David Perlmutter’s book “Brain Maker” the role our guts play in our brains health makes total sense.
    I keep thinking “food as medicine”!
    Thanks again for your brilliance and caring.

  2. David Bailey, DC says:

    I just recently finished off a half gallon of “golden milk”. Today, while wondering if I should make some more, my eyes went to your above article. There was my answer.
    Yes, word has it that AD may very well be induced through infection, just like the recent interest in PANDAS, and many other diseases (i.e.cancer).
    Thank you Doc, for the heads up!!

  3. Jim Morrin says:

    Thanks, Doc. One of your best.

  4. Carol Steiner says:

    Would oil pulling to lower bacteria in your mouth be a possible prenative measure against AD?

  5. Rita Starr says:

    Thank you. I have worked on gut health. Having been thinking about taking turmeric ever sense I gave it to my dog in yogurt for a bladder problem. Clears it right up.

    You are such a source of cutting edge wisdom.

  6. Jennifer Clauson says:

    Can you give the citation(s) for the evidence linking APOE+ and infections to AD? Do you know if the mice were examined for Tau protein deposition and if so, was there any difference?

    Thank you

  7. Evie says:

    I think I am doomed. Wish I lived in Chicago. Keep up the good work, Dr. E.

  8. Gina Pera says:

    Thank you, Dr. E. Great, succinct, practical advise. I’m scrolling through my 23andMe files, looking for APO. Not finding it. Must be in there somewhere!

  9. Toni says:

    Hey Doc,
    I open my capsule of turmeric and mix it with coconut oil a little honey some black pepper it taste yummy. My question is should I take the capsule whole instead of opening it? 2nd question I took erythromycin for 4 yrs for a unrelated problem does that count? It took me along time to get my stomach back in decent shape after that long of antib. use in fact I’m still working on it.

  10. Amanda says:

    I wonder if parasites play a part as well?

  11. Fred Broderick says:

    Great information seeing as tho my Dad had one of the worst cases of AD the doctors had ever seen ! Fred Broderick

  12. Dr E says:

    Hi Jennifer
    Just click the green type when you read the Health Tip for the articles I’ve cited. You can also Google “Alzheimer’s + APOE4 + infection” for lots of articles
    Hi Toni
    Erythromycin is a good antibiotic and may have cleared anything worrisome. Ask for an APOE4 test and if you’re negative, probably don’t worry about this anymore. Likely doesn’t make any difference of capsule is open or closed
    Hi Carol
    Definitely not appetizing. I would check APOE4 status before trying this
    Hi Amanda
    I don’t think parasites are involved here

  13. calle says:

    So Doc,

    UTI’s abx, could precipitate Alzheimer’s because it also effects the gut which according to David Perlmutter effects the brain?
    I will go and research and would appreciate others posting what they find.

    My concern is just because you have the gene it does not have to be activated.
    I tend to think “Wholelistic” as we can not separate one body system from the other.
    So wonder if xenoestrogens, and our super clean life styles impact this whole picture.

    Love your articles, brain power and willingness to share.

  14. Linda Kelly says:

    Appreciate all your helpful information. Many of us are looking for guidance on how to maximise our health and motivated to do whatever it takes. I had ongoing issues with gum disease. Had to have a few teeth removed and crown thanks to 60s dentistry. I now use a water pic and the little in-between tooth brushes. Flossing just pulled out my fillings. I clean after every meal as I have food traps between a few teeth. I use a herbal tooth paste a soft brush and warm water. My gum health has improved significantly. I have a plant based diet and add fresh tumeric to everything and cayenne pepper. Never felt better!!

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