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Do Herbal Supplements Protect Against Dementia?

by Martha Stettinius, Dementia Expert
February 14, 2013

Question: Is it true that there are certain herbal supplements that can be taken to protect one from dementia?

Answer: Thank you for asking this very popular question. No, there are no herbal supplements that have been proven to protect people from developing Alzheimer’s disease or other dementias. Also, supplements are not required to be approved by the Food and Drug Administration, so their effectiveness and safety cannot be assured. Supplements can have serious reactions with medications, so check with your doctor before taking a supplement. That said, here are the supplements that are most often promoted as preventing Alzheimer’s disease (the most common form of dementia) and other dementias, or to slow the progression of dementia:

a) Caprylic acid (marketed as a “medical food” called Axona®), and coconut oil:  Alzheimer’s disease has been called “Type III Diabetes,” because the brain, like the rest of our bodies, can become insulin resistant, metabolizing glucose less effectively. Brain imagery has shown decreased use of glucose in the parts of the brain affected by Alzheimer’s disease. However, if our bodies, including our brains, run on fat, not glucose (as in a very low-carb diet), we’re using something called “ketones” for energy, which is perfectly healthy and efficient. A product called Axona has been shown in a recent study to improve the cognitive functioning of some people with Alzheimer’s disease by overcoming their brains’ resistance to glucose by fueling them with ketones. A prescription, FDA-designated “medical food,” Axona is a powder mixed with water or food and consumed once a day. According to Accera, the maker of Axona, “Ketone bodies are naturally occurring compounds that are produced mainly by the liver from fatty acids during periods of extended fasting. Ketone bodies have been demonstrated to protect neurons.” The active ingredient of Axona is caprylic acid, a medium-chain triglyceride (fat), which the body breaks down into ketones.

Coconut oil is a less-expensive, over-the-counter source of caprylic acid, and anecdotal evidence suggests a possible benefit to people with dementia, but there have been no clinical trials to prove it.

b) DHA (an omega-3 fatty acid): According to the National Institutes of Health, DHA (docosahexaenoic acid), an omega-3 fatty acid found in salmon, tuna, bluefish, mackerel, swordfish, anchovies, herring, sardines, and caviar, reduces beta-amyloid plaques (a possible biomarker for Alzheimer’s disease) in mice. Although DHA research shows no impact on people with mild to moderate Alzheimer’s disease, the NIH states that “it is possible that DHA supplements could be effective if started before cognitive symptoms appear.” Experts agree that more research is needed, however. To avoid too much mercury, eat up to 12 ounces of cold-water fish a week. It’s important to note that not all foods or supplements rich in Omega-3 are rich in DHA. In addition to eating these cold-water fish, you could look for a source of fish oil that is high in DHA and “molecularly distilled.” Eggs contain some DHA, and organ meats such as liver and brains, are abundant sources, too. Supplements with DHA from algae are not as easily absorbed by the body as supplements with DHA from fish.

c) Ginkgo biloba: Ginkgo biloba, a plant extract, may have antioxidant and anti-inflammatory properties that protect brain cells. In Europe it is used to treat a number of neurological disorders that affect cognitive function. However, clinical trials conducted by the National Institutes of Health showed that ginkgo was ineffective in preventing or delaying Alzheimer’s disease.

d) Huperzine A:  A moss extract used in traditional Chinese medicine, huperzine A has characteristics similar to cholinesterase inhibitors like Aricept, one class of FDA-approved Alzheimer's medications that lesson the symptoms of Alzheimer’s disease but do not slow its progression. A large clinical trial, however, showed no benefit to people with mild to moderate Alzheimer’s disease.

e) Phosphatidylserine: Phosphatidylerine (pronounced FOS-fuh-TIE-dil-sair-een) is a kind of fat that is the main component of the membranes that surround nerve cells. Phosphatidylserine may strengthen cell membranes in the brain and possibly protect them from damage from Alzheimer’s disease and other dementias. The FDA requires high-quality soy-based phosphatidylserine supplements to display a "qualified health claim" stating that "Very limited and preliminary scientific research suggests that phosphatidylserine may reduce the risk of dementia in the elderly. FDA concludes that there is little scientific evidence supporting this claim." 

f) Tramiprosate (clinically tested as Alzhemed, marketed as a "medical food" called ViviMind™): Tramiprosate is a modified form of an amino acid naturally found in seaweed. Marketed over the Internet as a "medical food" with no proven benefits, it does not have FDA approval.  

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Martha Stettinius was a “sandwich generation” caregiver for 8 years for her mother with dementia, and is the author of the book “Inside the Dementia Epidemic: A Daughter’s Memoir.” An editor with a master’s in English Education from Columbia University, she blogs for and serves as a volunteer representative for New York State for the Caregiver Action Network.

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