Elroy Vojdani, MD, IFMCP, Functional Medicine Physician talks about Alzheimer’s and a test that could potentially determine your risk of developing the disease.
Interview conducted by Ivanhoe Broadcast News in April 2019.
Tell us a little bit about the test.
VOJDANI: The risk assessment tool
Yes please.
VOJDANI: There is a big problem going on with Alzheimer’s in the United States. It is increasing tremendously in prevalence. And it has an issue where we don’t have a lot of tools available to us to identify who may be at risk for it in the future. We know that 47 million Americans right now have pre Alzheimer’s and that’s because it takes 10 or 15 years for the actual disease to develop or symptoms of the disease to develop. But we have no way of identifying those 47 million people are. So the research and the test was really designed to help identify those people.
How does it do that?
VOJDANI: It looks at interactions between the immune system, different proteins in your brain that are associated with Alzheimer’s, abnormalities with the protective lining of your brain called the blood brain barrier. Different bacterial toxins that have been associated with Alzheimer’s. And then actually different foods and environmental chemicals that have also been associated with Alzheimer’s. So it’s a big panel looking at a lot of different things.
Is it a blood test?
VOJDANI: It is a blood test. It’s a simple blood test. One vial draw and the serum is sent out to the lab in Arizona.
What are the risk factors for impending Alzheimer’s that you would find in the test?
VOJDANI: The risk factors that we know concretely for Alzheimer’s are number one a significant family history of Alzheimer’s and there is a gene involved in two thirds of the cases of Alzheimer’s. And then people who have diabetes or high blood pressure are also predisposed to Alzheimer’s. The missing piece of this is the interaction between the immune system and the brain. And we’re learning really for the first time in the last five years that that plays another significant piece of the puzzle. So we have the tools to assess the other parts of this. This is the first time that we can get a glimpse at how abnormal interactions between the immune system are affecting the health of our brain.
Tell me a little bit about the research that led up to the discovery.
VOJDANI: Amyloid beta is the abnormal protein that is the hallmark of Alzheimer’s disease. And it was assumed for decades in medicine that you either developed amyloid beta or not just based on genetics. And we learned really in the last five or 10 years that that’s not entirely true. That amyloid is serving a purpose. It is protecting us from things. What we actually did in our research was map out what amyloid may be reacting to in the environment, right? And that’s a very big group of things, right? We tested 400 different proteins to see what amyloid might react to. And what we found as significant reactions ended up being on the test. The test is really looking for the build up of abnormal proteins like amyloid and Tao in the brain. And then whether your immune system has identified any of those potential proteins that can react to amyloid as being at abnormal levels in your system as well.
You didn’t have to run a trial of an FDA approval for a test?
VOJDANI: Right. We started out with basic science research. And now we’re going to be available for the first time for clinical application. And then we hope to be involved in clinical trials, we’re in plans to be involved in clinical trials here very soon.
But you’ve already tested it in some patients.
VOJDANI: We have tested it on many patients.
How many patients and what did you find?
VOJDANI: I’ve tested it on 40 of my own patients so far. And I have found a really tight correlation between the state of someone’s cognitive disease or their impairment and the abnormalities on the test. So the people that I find that have the most active disease and their memory is the most impaired, have the most abnormalities. I’ve had the benefit of running pieces of this test before in the past. It’s been a part of my practice. But this test is really the first time that I got the whole picture in one. And it has agreed with what I have seen clinically with these people.
Have you been able to use it as a predictor?
VOJDANI: Talking about the prediction of the development of neurodegenerative disease – the clinical data for this is really, really early. One part of this test something called neuro filament light chain has been validated and has been in the literature in the last six months as being a predictor of neurodegenerative disease in general. That includes Alzheimer’s, M.S. and Parkinson’s. Specifically, for Alzheimer’s, I think it’s more of a glimpse into what is going on in my body that may put me at risk in the future. And luckily they’re all things that we can do something about.
For instance with Bailey is barely showing any Alzheimer’s symptoms yet?
VOJDANI: She has absolutely no cognitive symptoms whatsoever.
A lot of times, they’re not really sure they want to know the answer
VOJDANI: Right.
Are you running into that at all?
VOJDANI: Yes. Here in the clinic we do run into people who say I don’t want this information. My counter to that is that’s really based on false notions with Alzheimer’s, right? That if you have this abnormal process going on, that you are doomed to get the disease, which is absolutely not true. We know that with the right lifestyle interventions you can have a significant risk reduction. Much of that data came from a study called the finger trial in 2015. And they looked at people in their late ’60s and ’70s who were very high risk for dementia and they just did a two year intervention on them and ended up with a 30 percent risk reduction. We’re talking about non high risk people 10 or 15 years out away from the disease. I think the numbers that we’ll see will be much bigger than that 30 percent. So you have to wash the fear away and understand that this information is really powerful and really actionable. And it can really change the end of your life.
Let’s talk about actionable. What can people do? What are those lifestyle changes you’re talking about?
VOJDANI: Well a big part of it I think is dietary change, right? We have to take this information of what your genetics say and what your immune systems says about how you’re reacting to your environment and custom tailor a dietary plan, right? Part of this is individualizing the assessment. Understanding that everybody who gets this test has had a very different exposure and they have different genes. So what they need to do is individually different. But we take this information and we design a lifestyle plan. And I would say 80% of that is dietary intervention. Another 15 percent is encouragement to exercise, walk, socialize, use your brain, train your brain like a muscle, do brain games. And, sometimes depending on the situation there are abnormalities that we find that need actual medical treatment.
Which would be?
VOJDANI: Healing things like the intestinal barrier which is a protective barrier, an interface between us and our external environment and very different protocols, different supplements that we use, different prescription medications that we use to do that. And another big part of this test is the blood brain barrier this wrapping around our brain that is designed to protect this most vital organ from the outside. And there are different things that we can do to help heal that barrier.
Drugs, Thinking, What is it?
VOJDANI: Mostly. Supplements actually.
OK.
VOJDANI: And for our patients who are prone to physical injury and fall extensive physical therapy to make sure that they are not having those injuries happen.
And supplements and vitamins and those kind of things.
VOJDANI: Yeah. Vitamins, minerals, amino acids, proteins giving the body the building blocks it needs to restore these parts of the body.
Circling back to dietary, are there some basic ones that you can tell everybody?
VOJDANI: There are definitely dietary plans that I recommend and told my patients that want to do what they can to minimize Alzheimer’s disease. And essentially you want to minimize the intake of simple carbohydrates and you want to maximize the intake of vital nutrient, rich, plants follow those rules. Eat as organic as they possibly can and you’re doing your brain a favor.
I want to circle back to the FDA piece of this.
VOJDANI: We started out with basic science research essentially trying to map out this interaction between the immune system and this abnormal protein in the brain and understand it as much as we can or as much as we have to date this information is really fresh and new. And we are among other labs and groups that are doing the first clinical application of this. So we are now getting glimpses as to what this information means for people who may down the road develop Alzheimer’s disease. To gat to the point where we’re going to get FDA approval I think we need 10 or 15 years worth of data. It’s going to take a long time. At this point when I can confidently say is for anybody out there who wants as much information as they possibly can get. They want to know what is happening between the outside and they’re inside that could potentially put them at risk for this. That’s. This is what this test is perfect for right.
But as far as trials next year?
VOJDANI: No they’re starting. We have plans to start later on this year as well. And parts of this test are actually already in clinical trials. And the data though it’s preliminary looks extremely promising for detection maybe 10 or 15 years before the disease onset. There are parts of this that are very much in active clinical trial. But to get to the point that we have FDA approval for it, I think we probably need another 10 years of data.
If people want this test now, what can they do?
VOJDANI: For people who want this test now it is exclusively licensed to a lab called Cyrex Labs in Arizona. Anybody can ask their physician to order this test. All the samples are sent to Arizona for processing and it is available now.
Do you have a cost?
VOJDANI: Yes it cost us $495 for that full panel of 30 markers. So per marker, I think it’s actually very cost efficient.
And your doctor would be able to give information after or is there is an explanation that comes back with the panel results?
VOJDANI: There is an explanation available to anybody who would like that information. There is an explanation available for anybody who would like that for their physician or for them directly and their physician has the ability to get a free interpretation from the lab directly.
What’s the youngest someone can be to take this test and to get the information?
VOJDANI: There is no age threshold for when somebody is eligible to get this test. I think if it’s being used appropriately someone in their mid 40s would be about the earliest that I would use the test. We know that Alzheimer’s has a 15 to 20 year lag so, thinking about potentially developing it when you’re 65 about 45 would be a good time to do this.
Is there a name for the blood test you get?
VOJDANI: The test is called Alzheimer’s linx. It’s available from Cyrex labs in Arizona. And anyone can ask their physician to order this test. Physicians across the country are able to open an account and order this immediately.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
If you would like more information, please contact:
Elroy Vojdani, MD, IFMCP
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