Alzheimer's Disease and Antioxidant Therapy - Part II

By William K. Summers, MD
© 1999-William K. Summers, MD

Antioxidants can slow the aging process and slow the progression of Alzheimer's disease. The preferred antioxidant would have multiple ingredients.

In Part I, we discussed free radical damage to the nerve cell using the automobile as a metaphor. The automobile represented the whole cell. The engine represented the nucleus. The mitochondria are the cell's gas tank, and the fuel line is the endoplasmic reticulum. A leak of gasoline at any point will cause automobile corrosion. In the nerve cell, a leak of free radicals will cause "oxidative damage". There is strong evidence that free radical damage is responsible for much of the nerve cell damage in Alzheimer's disease. My friend, Dr. Perry, with his group at Case Western Reserve, has demonstrated this oxidative damage. Mitochondrial damage results in formation of neurofilamentous debris called "tangles". Further, he has shown that Amyloid-8 deposition in Alzheimer's mouse models is associated with oxidative damage.

So, there is a pile of "oxidative garbage" inside the nerve cells of Alzheimer's disease patients. It sounds so permanent and irreversible. What can be done?

The answer is antioxidants. This is a broad category. An antioxidant is any substance that protects against damage of oxidative stress caused by free radicals. One such substance is vitamin E. A famous paper in The New England Journal of Medicine in 1997 announced that 1,000 IU of vitamin E twice a day slowed the progression of Alzheimer's disease. Regrettably, vitamin E in these doses is associated with bowel irritation, headache, deterioration of macular degeneration, worsening of diabetes and more. The solution is to use low doses of multiple antioxidants. Because different antioxidants work in different ways, the toxicity goes down and effectiveness of the therapy goes up. For example, vitamin C is a powerful water-soluble antioxidant. It cleans up oxidative damage outside the cell and in the cytosol (water portions of the cell). Vitamin E is lipid (oil) soluble, and works best in the mitochondria. Using both is logical.

There are five classes of antioxidants: 1. Vitamins 2. Minerals 3. Amino Acids 4. Alkaloids 5. Other

Antioxidant vitamins include vitamin A, vitamin C, vitamin E and vitamins B1, B2, B3, B6 and B12. Minerals include selenium, zinc, copper and manganese. Some amino acids that can repair oxidative damage to proteins are Dimethyl-glycine, L-Methionine and LTaunne. Alkaloids are substances derived from plants (herbs). Examples of alkaloid antioxidants are ginkgo biloba, grape seed extract and chromium picolinate. A good example of the "other" antioxidants is lipoic acid, a very potent intracellular free radical scavenger.

The ideal antioxidant would be a combination of these five classes. The synergistic multiplier effect allows the dose of each component to be less than the maximum. In a combination antioxidant, the vitamin E may be less than 400 IU per day. Used alone, vitamin E would have to approach 1,000 IU per day. Patients have brought me several examples of antioxidant preparations that have combined only 500 mg of vitamin C per day and vitamin E at 200 IU per day. Although such preparations are inexpensive, they will not get the job done. Be careful. Read the labels.

Who should use antioxidants? At the Alzheimer's Clinics, combination antioxidants are recommended both for Alzheimer's patients and those with small strokes. The scientific literature suggests antioxidants would be good for anyone over age 50. The amount of oxidative damage is increased daily inside the cell, similar to an ever-increasing pile of garbage. Antioxidants, then, are like workers who would come along and remove small shovels full of the oxidative garbage daily. This explains why vitamin E has been shown to be helpful in the prevention of strokes and heart attacks.

TO YOUR HEALTH!

This article appeared in the New Mexico Senior Citizens News April/May 1999. The NM Senior Citizen News publishes these articles monthly. You can pick up a copy of the paper at your closest New Mexico Senior Citizen Center.