14d • General discussion
I thought I was losing my mind. Turns out I was just losing my health.
Sarah, 61, came to my clinic convinced she had early Alzheimer's.
Forgetting words mid-sentence. Couldn't focus through meetings. Walking into rooms and forgetting why.
Her mother had died from Alzheimer's at 68. Sarah was terrified she was next.
I ran the full workup:
Cognitive testing: normal for age.
Brain MRI: no concerning findings.
Biomarkers: no evidence of Alzheimer's pathology.
But something was clearly wrong
Then I looked at her labs:
A1c: 6.1% (prediabetic)
Blood pressure: 148/92 (hypertension)
LDL: 156 (elevated)
Body weight: 42 pounds over healthy range
Sleep: 5-6 hours, poor quality
Her brain wasn't failing. Her body was failing her brain.
I prescribed something no pharmaceutical company makes:
Lose 25 pounds over 6 months.
Walk 30 minutes daily.
Mediterranean diet.
Sleep 7-8 hours nightly.
Manage stress actively.
Sarah looked disappointed. She wanted a pill. A diagnosis. Something medical.
Not "eat better and exercise." That felt too simple. Too much like failure.
But she agreed to try. Three months with a health coach. Daily accountability.
Structured program.
Here's what happened:
Month 1: Lost 8 pounds. Sleep improved to 7 hours. Brain fog "maybe 10% better."
Month 2: Lost another 7 pounds. A1c dropped to 5.8%. "I can think again during afternoon meetings."
Month 3: Lost 6 more pounds. Blood pressure 128/84. "I haven't felt this sharp in 5 years."
Six months later:
Lost 23 pounds total.
A1c: 5.4%
Blood pressure: 118/76
LDL: 112
Sleep: 7.5 hours average
Cognitive complaints: resolved.
Sarah didn't have dementia. She had metabolic dysfunction causing reversible cognitive impairment.
Fix the metabolism. Fix the brain.
This isn't rare. I see it constantly:
Sarah asks me now: "Why didn't my last doctor tell me this?"
Because we're trained to diagnose disease, not reverse dysfunction.
We're good at spotting Alzheimer's. Terrible at recognizing reversible metabolic cognitive impairment.
The difference matters enormously.
One is progressive and irreversible. The other responds to lifestyle intervention within months.
If you're experiencing cognitive decline:
Before assuming it's dementia, optimize your metabolic health.
Give it 3-6 months.
You might be surprised how much "early dementia" is actually late-stage metabolic syndrome.
Sarah's mother died from real Alzheimer's. Sarah was terrified of the same fate.
Two years later, she's maintained the weight loss. Metabolic markers stay excellent. Cognition remains sharp.
She still worries about Alzheimer's. Family history doesn't disappear.
But now she's doing everything possible to prevent it. And she has cognitive clarity to enjoy her life while doing it.
⁉️ Have you experienced "brain fog" that improved with lifestyle changes?
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I thought I was losing my mind. Turns out I was just losing my health.
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