Lab Tests For Cognitive Brain Health Diagnostic Workup

The goal of lab tests is to rule out reversible or treatable causes of cognitive dysfunction as well as optimizing levels of laboratory tests linked to cognitive health.

Goals

  • ‘Rule out’ reversible/treatable causes of cognitive dysfunction
  • Optimize levels of laboratory tests linked to cognitive health

Methods

  • Check blood levels of biomarkers linked to reversible/treatable causes of cognitive dysfunction
  • ​Check blood levels of measurable micronutrients (e.g., Vitamin B12, Vitamin D, etc.)
  • Replenish deficiencies and supplement to optimal levels for brain health​

Cautions

  • Lab values should not be used in isolation, and need to be put into a full clinical context by a qualified licensed health provider

Rationale

  • Numerous cases of suspected Alzheimer’s disease dementia have multiple underlying exacerbating etiologies that can be corrected
  • Deficiencies of micronutrients have been linked to suboptimal cognitive function

Resources

  • Lab tests can be done and reviewed during clinic consultations

Cognitive Brain Health Diagnostic WorkUp

C-Reactive Protein (CRP)

Reasoning

  • Inflammation plays a role in the development and progression of Alzheimer’s disease (AD)
  • Chronic low-level inflammation can play a role in development of AD

Methods

  • If hsCRP is elevated, need to figure out cause(s) of inflammation and then reverse the causes
    Switch to an anti-inflammatory diet
  • Increase intake of DHA/EPA in the form of fish oil
  • Optimize oral hygiene

Goals

  • hsCRP < 0.9 mg/dL (high sensitivity C-Reactive Protein)
  • Albumin > 4.4 g/dL
  • Albumin:Globulin ratio > 1.7

Homocysteine

Reasoning

  • Homocysteine is an amino acid converted in the body from methionine, and is involved in many metabolic body processes
  • Elevated homocysteine is more definitely associated with increased risk of stroke, heart attack, and blood clots via atherosclerosis
  • May also increase risk of Alzheimer’s disease and related dementias
  • Homocysteine is elevated with inflammation and/or micro-nutrient deficiency (e.g., of vitamins B6, B9, B12)
  • Inflammation plays a role in the development and progression of AD
  • Micronutrient co-factors are necessary for proper metabolism of homocysteine

 Methods

  • Measure and track blood level of homocysteine using routine lab testing
    Adjust health of diet to ensure adequate intake of B-vitamin micronutrients and by checking

    • B-vitamin blood levels
    • B-6 level 60-100 nmoles/L
    • B-9 (folate) 10-25 ng/ml
    • B-12 level 500-1500 pg/ml
  • If needed, take ‘activated’ forms of vitamins B-6 (P5P), B-9 (L-methylfolate [5-MTHF]), and B-12 (Methylcobalamin [Me-B12]) supplements

Goals

  • Homocysteine level < 7 μmol/L

Resources

Ask your doctor to test your homocysteine level and associated B-vitamins (B6, B9, B12)

Blood Sugar Levels

Reasoning

  • The hormone insulin helps control the amount of sugar in the blood.
  • With insulin resistance, the body’s cells don’t respond normally to insulin.
  • Glucose can’t enter the cells as easily, so it builds up in the blood which can lead to type 2 diabetes.
  • Chronically high blood sugar damages the brain, just as it damages many ‘end organs’ (kidneys, eyes, feet, etc.).

Methods

  • For mildly elevated fasting blood sugar, HgbA1c, and insulin resistance, self-care
  • For pre-diabetes and diabetes, primary care and/or endocrinology care

Goals

  • Fasting blood sugar (glucose) level 70-90 mg/dL (Diabetes = Fasting blood sugar > 126)
  • HgbA1c < 5.6 %
  • Fasting insulin < 4.5 microIU/ml

Resources