Alzheimers Disease

Turmeric and Curcumin [1, 13, 14, 15, 16, 17, 18, 21]

Recommendation: Strongly in favor (Early laboratory studies show that turmeric may be of benefit in the treatment of Alzheimer's. However, further studies are needed)

Grade of Evidence: Moderate level of evidence

Gotu Kola (Centella asiatica, Hydrocotyle asiatica) [1, 7, 8, 9, 10, 11, 12]

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly in favor (A few clinical trials have shown that Gotu Kola may be helpful in the treatment of Alzheimer's disease. However, further research is needed)

Grade of Evidence: Low level of evidence

Ginkgo [1, 2, 3, 4, 5]

Recommendation: No recommendation (A few major studies show that ginkgo does not help improve cognitive function in mild Alzheimer's disease)

Grade of Evidence: Low level of evidence

High-dose Vitamin E [19, 20]

Recommendation: Weakly in favor (some well-designed studies have found a significant benefit in slowing the decline of memory function in patients taking high-dose vitamin E)

Grade of Evidence: Moderate level of evidence

Alpha-lipoic acid [6, 22, 23]

Recommendation: Weakly in favor (some studies have found a significant benefit in slowing the decline of memory function in patients taking alpha-lipoic acid)

Grade of Evidence: Low level of evidence

Omega-3 Fatty Acid Supplement [24, 25, 26]

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly in favor (a few studies have shown that omega-3 fatty acid supplements may be beneficial to those that have Alzheimer's. However some studies have shown no benefit in taking the supplement, more studies are needed.)

Grade of Evidence: Very low level of evidence

Vitamin D3 [27, 28, 29, 30, 31, 32, 33]

Recommendation: Weakly in favor (Evidence shows that Vitamin D may help improve cognitive function in mild Alzheimer's disease and low concentration of circulating vitamin D is associated with a higher incidence of developing Alzheimer's disease)

Grade of Evidence: Low level of evidence

Selenium [34, 35, 36]

Recommendation: Weakly in favor (Current evidence does not indicate it is an effective treatment for AD but some evidence shows selenium to be an effective preventive strategy for the development of AD, however it is likely to be useful in conjunction with other treatments)

Grade of Evidence: Very low level of evidence

Vitamin C [37, 38, 39]

Recommendation: No recommendation (Studies on the effect of Vitamin C on Alzheimer's Disease have found it to be preventative but not effective as a treatment of AD on its own, more research is needed.)

Grade of Evidence: Very low level of evidence

Zinc [40, 41, 42, 43, 44]

Recommendation: No recommendation (Although Zinc has been found to be deficient in patients with AD and a few limited studies have found slight benefits in taking Zinc, there is insufficient evidence to validate a recommendation for taking Zinc for the treatment of AD. Further research is needed)

Grade of Evidence: Low level of evidence

Coenzyme Q10 [45, 46, 47, 48]

Recommendation: No recommendation (Coenzyme Q10 may be useful as a preventative treatment or treatment against Alzheimer's according to successful animal trials but human trials have not been successful.)

Grade of Evidence: Very low level of evidence

Citicoline [49, 50, 51, 52, 53, 54, 55, 56, 57]

Recommendation: Strongly in favor (The present data indicate that citicoline (1,000 mg/day) is well tolerated and improves cognitive performance, cerebral blood perfusion and the brain bioelectrical activity pattern in AD)

Grade of Evidence: Moderate level of evidence

Methyltetrahydrofolate (5 MTHF) [58, 59, 60, 61, 62, 63]

Recommendation: Weakly in favor (5 MTHF has been found to reduce the homocysteine (tHcy) levels, high tHcy levels are a significant risk factor for AD. More studies are needed)

Grade of Evidence: Low level of evidence

Choline Alfoscerate [64]

Recommendation: No recommendation (One study has found cognitive improvement in mild to moderate Alzheimer's dementia after treatment with the acetylcholine precursor choline alfoscerate however more research is needed to validate these positive findings)

Grade of Evidence: Very low level of evidence

N-Acetylcysteine [65, 66, 67, 68]

Recommendation: No recommendation (A few limited studies have shown a favourable change using NAC treatment on nearly every outcome measure on patients with AD)

Grade of Evidence: Very low level of evidence

Probiotics [69, 70, 71, 72, 73]

Recommendation: Weakly in favor (A few clinical trials have shown that probiotics may be helpful in the treatment of Alzheimer's Disease. However, further research is needed)

Grade of Evidence: Very low level of evidence

Pyrroloquinoline quinone (PQQ) [74, 75, 76, 77, 78]

Recommendation: No recommendation (A few limited clinical trials have shown that Pyrroloquinoline quinone (PQQ) may be helpful in the treatment of Alzheimer's Disease. However, further research is needed)

Grade of Evidence: Very low level of evidence

Tryptophan [79, 80, 81, 82, 83, 84, 85, 86]

Recommendation: Weakly in favor (Tryptophan is an essential amino acid required to synthesize proteins which is found to be depleted in AD, research indicates it is helpful in aiding sleep and assisting in neurological repair and maintenance. More research is needed. Should be taken at night.)

Grade of Evidence: Very low level of evidence

Vitamin K2 [87, 88, 89, 90]

Recommendation: Weakly in favor (Recent research has indicated Vitamin K insufficiency could not only be a risk factor for AD, but could also contribute to its accelerated progression, more research is needed)

Grade of Evidence: Very low level of evidence

Vitamin B1 [91, 92, 93]

Recommendation: Weakly in favor (Whilst there are some good studies implicating the benefits of Vitamin B complex in the improvement for cognitive function of some patients with neurodegenerative diseases only one study implicated the same for Vitamin B1, more research is needed)

Grade of Evidence: Low level of evidence

Vitamin B5 [94, 95, 96]

Recommendation: Weakly in favor (Whilst there are some good studies implicating the benefits of Vitamin B complex (including Vitamin B5) in the improvement for cognitive function of some patients with neurodegenerative diseases there are only indirect studies implicating the same for Vitamin B5 on its own, however the Vitamin B complex benefit would infer a benefit, more research is needed)

Grade of Evidence: Very low level of evidence

Pyridoxal 5'-Phosphate [97, 98]

Recommendation: No recommendation (There is insufficient evidence to support any claims that P-5-P is able to help treat Alzheimer's. More studies are needed)

Grade of Evidence: Very low level of evidence

Methylcobalamin [99, 100, 101, 102]

Recommendation: No recommendation (There is insufficient evidence to support any claims that Methylcobalamin is able to help treat Alzheimer's. More studies are needed)

Grade of Evidence: Very low level of evidence

Vitamin E [103, 104, 105, 106]

Recommendation: Weakly in favor (A few well-designed studies suggests a possible benefit of vitamin E for the treatment of AD. Use of vitamin E and vitamin C supplements in combination is associated with reduced prevalence and incidence of AD)

Grade of Evidence: Low level of evidence

Acetyl-L-Carnitine [107, 108, 109, 110, 111]

Recommendation: Weakly in favor (Acetyl-l-carnitine showed a slower rate of deterioration of AD and significant improvement in memory tests in these listed studies. Although a Cochrane review of 2003 found insufficient evidence of benefit, more tests are needed.)

Grade of Evidence: Very low level of evidence

Resveratrol [112, 113, 114, 115, 116, 117, 118, 119]

Recommendation: Strongly in favor (Studies have implicated resveratrol as a benefit in the treatment of AD with no marked toxicity)

Grade of Evidence: Moderate level of evidence

Sleep 8 Hours [120, 121, 122, 123, 124, 125, 126]

Recommendation: Strongly in favor (Recent studies have found the glymphatic system is the functional waste clearance pathway for the central nervous system, and is largely disengaged during wakefulness. Researchers have noted increased sleep can lead to an increased clearance of amyloid deposits. More research on sleep is needed)

Grade of Evidence: Moderate level of evidence

Pomegranate [127, 128, 129, 130, 131]

Recommendation: Weakly in favor (Accumulating research offers reasonable evidence that routine supplementation with pomegranate juice or extract is a powerful antioxidant and may protect against Alzheimer’s and well-designed research studies on mice clearly shows its ability to reduce toxic amyloid load. It has been shown to have low toxicity and only rare side effects)

Grade of Evidence: Low level of evidence

Melatonin [132, 133, 134, 135, 136, 137]

Recommendation: Weakly in favor (A few well-designed studies indicated melatonin improved sleep quality and cognitive parameters, more sleep may enable the glymphatic system to remove more amyloid build up)

Grade of Evidence: Low level of evidence

Vitamin B6 [138, 139, 140, 141, 142]

Recommendation: Weakly in favor (A few well-defined studies have shown treatment with Vitamin B group (including Vitamin B6) slowed atrophy in patients with AD. Other early studies have not yielded any significant improvements.)

Grade of Evidence: Low level of evidence

Zinc Picolinate [143]

Recommendation: No recommendation (A few studies have found benefits of using Zinc picolinate in animal studies indicating a reduction in oxidative stress and inflammation, but human studies need to be done before giving a conclusive recommendation.)

Grade of Evidence: Very low level of evidence

Coconut Oil [144, 145, 146]

Recommendation: Weakly in favor (Coconut oil contains a high percentage of medium-chain triglycerides (MCTs) which is converted to ketones and can then cross the blood-brain barrier and can be used as an energy source for the neurons. In AD insulin is depleted, insulin is needed for the transport of glucose into the cells and a lack of utilization of glucose leads to death of the neurons. But with ketones they can cross into the cells without insulin, thus coconut oil converted to ketones feeds and sustains the neurons.)

Grade of Evidence: Low level of evidence

Intermittent Fasting 12 Hours (IF12) - 8pm to 8am [147, 148, 149, 150, 151, 152, 153, 154, 155, 156]

Recommendation: Weakly in favor (There is new evidence in some limited studies suggesting that healthy calorie intake with limited fasting increases lifespan and may reduce neurological decline)

Grade of Evidence: Low level of evidence

Calorie Restriction Diet (CREAHR) - Average Healthy Requirements [147, 148, 149, 150, 151, 152, 153, 154, 155, 156]

Recommendation: Weakly in favor (There is new evidence in some limited studies suggesting that healthy calorie intake with limited fasting increases lifespan and may reduce neurological decline)

Grade of Evidence: Low level of evidence

Intermittent Fasting (IF3BB) - No Eating 3 Hours Before Bedtime [147, 148, 149, 150, 151, 152, 153, 154, 155, 156]

Recommendation: Weakly in favor (There is new evidence in some limited studies suggesting that healthy calorie intake with limited fasting increases lifespan and may reduce neurological decline)

Grade of Evidence: Low level of evidence

Pesco-Vegetarian Diet (Vegetarian With Fish) [147, 148, 157, 158, 159, 160]

Recommendation: Weakly in favor (Numerous studies have implicated a vegetarian diet with fish had a protective effect on neurological decline and associated diseases)

Grade of Evidence: Low level of evidence

Gluten Free Diet [161, 162]

Recommendation: No recommendation (There is insufficient evidence to validate a gluten free diet as a therapy for AD)

Grade of Evidence: Very low level of evidence