A woman with mild cognitive impairment once said to me: “My MCI is not so ‘M’ today.”
That’s the thing about MCI, isn’t it? It is so hard to live with. There are good days, but boy, there are bad days.
What if you could have more good days and fewer bad days? My guest today has a very tangible way for people with MCI do that, and that’s what I want to talk about. So let’s jump in.
Hi, I’m Tony Dearing of GoCogno.com, the website for people with mild cognitive impairment.
This is the second of two videos I’m doing with Dr. Nate Bergman, chief scientific wellness officer at Kemper Cognitive Wellness in Cleveland. He is one of the pre-eminent experts in the treatment of MCI, and host of the “Evolving Past Alzheimer’s” podcast.
He was also kind enough to write the forward to my new book on MCI, “I Want My Mind Back: The Go Cogno Approach to Halt or Reverse Mild Cognitive Impairment” which just published and is available on Amazon here.
Dr. Bergman joined me recently to do a Facebook Live in a private group I belong to for people with MCI, and I’ve been sharing some outtakes from that. Last week, we talked about ketones and MCT oil. If you missed that episode, you can see it here.
Today, Dr. Bergman has a suggestion that I really found interesting. He thinks you should monitor your blood sugar.
It’s something he does with his patients who have MCI, and when you hear the results they’re getting with it, and what it might do for you, I think you’re going to want to consider it.
So here’s a transcript from that portion of my discussion with Dr. Bergman.
Dr. Bergman: “When I first started, when I was in medical school, I spent some time and did some publications with Dr. James O’Keefe, who’s kind of the preeminent cardiologist and cardiovascular guy in the Kansas City area where I’m from and did a lot of my training. We were on a week-long stint in the hospital together, and we sat down for lunch real fast. And I had brought my lunch and I had some fish and some vegetables and a few scoops of rice as well. He looks over my my lunch — and I was very proud of my healthy lunch — and he’s like, “Hey you should probably check your blood sugar.” I was like, that’s crazy. How bad can my blood sugar be? I mean, I’m exercising. You know, how bad could it be? Anyway, he had one of the nurses give me a glucose monitor. He told me to check my blood sugar about an hour after eating. It’s called postprandial glucose. Check your blood sugar 30, 60, 90 minutes after you eat. It turns out postprandial or the blood sugar spike that happens after we eat can be even more damaging to our brains and our hearts and even our eyes than what our fasting blood sugar is. A lot of us get fasting blood sugar blood work done and we can see our glucose but we don’t know what the spike is like, the postprandial, the after meal spike is and that’s really important to know. So when my blood sugar was spiking into the 140s, 150s, 160s after simple rice meals — this wasn’t like having a milkshake and cake, this was basically just from rice — I was just like, “Wow, that’s amazing.” It really kind of opened my mind to the variability in all of us for blood sugar. First of all, you have no idea what your blood sugar is unless you’re checking it. You just don’t. I’ve worn continuous blood glucose monitors and I mean it’s amazing how much variability meal to meal, time of day, based on how much sleep I did, based on how much exercise I’ve gotten. What we’ve seen fairly consistently with people that are responding, that are willing to do and responding to the ketogenic diet is that when you get the improved insulin signaling, which is a hormone that relates to blood sugar and you stabilize blood sugars, often times but not always, often times cognition will improve. I remember hearing this and then verifying this in a few of my patients. We can see even day-to-day variability, Tony, meaning people that have cognitive impairment on days where they’re eating well they’re maybe taking MCT oil, they’re exercising, they have better days. They’re more cognitively intact. They’re more sharp, which is amazing. Over time, cognition degrades but we see a lot of this: good days, bad days, good days, bad days, very much related to blood sugar and insulin. Very much related.”
Tony: “It’s interesting, tying in what you just said, and as you say, it wasn’t one thing. They’re doing other things. They’re getting some exercise. They’re doing some other things and then in combination with this. Just from what I’ve seen, one thing that people with MCI really struggle with is that up and down and I think what you’re talking about here that gives people a chance to even out a little bit more or have more good days and fewer bad days. I think most people would welcome that. Anything about this topic I haven’t touched upon, just generally ketones and ketosis, that you want to make sure people hear as we wrap up?”
Dr. Bergman: “Yeah, I think it’s really worth it to be knowing your blood sugar. Know your sugars: what your glucose is when you’re fasting and then after you eat, about an hour after you eat. It’s worth it to invest the 100 dollars or so to get something like an Avid Labs Precision Xtra, something like that. You can get these at drug stores or get them on Amazon. If you are not comfortable buying something on Amazon like this, you may just go into or call a CVS or Walgreens or Walmart or one of those pharmacies and just say, “Hey I need something to check my blood sugar. What’s the cheapest unit that you have?” You’re going to need a couple things, something like an alcohol swab to clean your finger and you get the lancet needles. Of course, this isn’t medical advice, — you know ask your doctor. You can do this all yourself and you can just basically prick your finger. If you’ve never done this, you just get a little finger prick. There’s a little there’s a little assay like a little tab that sucks up a little bit of blood. You put it into the machine and it’ll give you a readout and if you do that 10 times over the course of a week, 15 times over the course of a week, meaning you do it when you wake up in the morning, you do it after a couple of meals in the day or after a meal in a day, certainly after your bigger meals, after your smaller meals. You see how high your blood sugar is. I mean once your blood sugar reaches into the 90s it’s probably less than optimal. The number of people that have a blood sugar 90 above even fasting, forget about after meals, is enormous and it’s that kind of information I think that really will catalyze or catapult people into taking action.”
One thing I really emphasize with the Go Cogno approach is helping people be advocates for their care and the architect of their own actions. This idea really speaks to that.
It allows you to manage your own care, know what’s going on in your own body, and do something real that has the potential to help you have more good days than bad days.
Does that sound interesting to you? If it does, I have an offer I’d like you to take me up on. I’m looking for one person who would be willing to try this for a week, I mean really commit to it. And I would help you do that, and then afterwards I would write about it, what you did, how you did it, what you found out, what the result was.
So here’s my offer. If you are willing to work with me on this, and monitor your blood sugar for a week and let me write about it, after the article is published, I will refund you the cost of your blood sugar monitor, as a thank you for participating in this.
If you are interested in this ideas, even just to talk about it, email at email@example.com. I look forward to hearing from you.
And I look forward to seeing you again next week. Until then, as always, be kind to your mind.
P.S.: This is just one segment of the full Facebook Live interview I did with Dr. Bergman. He had so much great advice to offer people with MCI. I encourage you to watch the full Facebook Live below.