[HN Gopher] Dementia risk linked to blood-protein imbalance in m...
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       Dementia risk linked to blood-protein imbalance in middle age
        
       Author : pseudolus
       Score  : 303 points
       Date   : 2023-07-21 13:34 UTC (9 hours ago)
        
 (HTM) web link (www.nature.com)
 (TXT) w3m dump (www.nature.com)
        
       | hirenj wrote:
       | NDST1 is a funny one in the list. In principle it shouldn't be
       | out in circulation, so it's probably a sign that actually what
       | you are seeing is a dysregulation in activity of SPPL3 in
       | shedding of this enzyme from the Golgi.
       | 
       | More on reflection: Looks like NDST1 has a protective effect, so
       | maybe this is reflecting the shedding going up for some reason.
       | Would need to check what is regulating SPPL3 activity.
        
         | FollowingTheDao wrote:
         | NDST1 metabolizes glucosamine.
         | 
         | I'm wondering, if taking glucosamine supplements could increase
         | the risk of dementia then.
        
           | hirenj wrote:
           | NDST1 is a bifunctional sulfotransferase and de-acetylase.
           | It's a gatekeeper enzyme (well as much as it can gatekeep
           | with other isoenzymes), that catalyses a sulfation on heparan
           | sulfate (HS) chains. HS makes up a big chunk of the
           | extracellular matrix, and it is this matrix that various
           | signaling molecules travel through to get to the cell.
           | Reducing availability of NDST1 in cells would likely reduce
           | binding of growth factors etc (or increase it, who knows!).
           | It's likely a bunch of subtle effects, and maybe this is
           | actually pointing to some whole other thing that is
           | happening. It's difficult to say without digging into the
           | literature.
        
       | justsocrateasin wrote:
       | Exciting pieces of research coming out right now. I could see
       | using a blood test to find these specific biomarkers, and then
       | getting started earlier on a drug like donanemab that has better
       | results the earlier you start it. Combining a blood test with a
       | preventative/early stage drug like donanemab or lecanemab would
       | have a lot better results than just starting those immuno drugs
       | at the first sign of symptoms.
        
         | hirvi74 wrote:
         | > a drug like donanemab that has better results the earlier you
         | start it.
         | 
         | Do you think there will ever be a point where Donanemab or
         | similar drugs will be recommended for all people after a
         | certain age?
         | 
         | If I am thinking of the same medication, doesn't it have pretty
         | nasty side-effects -- 30% chance of brain bleeding, right?
         | 
         | It's tough, because after a certain age, I think it would be
         | worth the risks (in my non-medical professional opinion), but I
         | am not sure if that is how medicine works in practice. I mean,
         | you wouldn't want to give one medicine for a condition that he
         | or she might never end up getting, but you probably also do not
         | want to wait until it's too late.
         | 
         | I am just hoping that we find some kind of treatment in our
         | lifetimes.
        
       | thereticent wrote:
       | Individual differences in neuronal and glial cell metabolism and
       | excretion, and presumably toxic effects from those changes and
       | associated inflammation.
       | 
       | I just got funded as PI to study blood proteomics and long term
       | cognitive outcomes after large vessel stroke, with a focus on
       | early identification of post-stroke dementia. It's a very cool
       | area to be in.
        
         | mrtomservo wrote:
         | As someone who has had a (brain stem) stroke, and also as
         | someone with close family members that have/had dementia, thank
         | you for your work.
        
         | jxramos wrote:
         | I've always been curious about this. Can you briefly summarize
         | how you take peripheral blood and fractionate it out to these
         | small bits. What's the deal exactly? Is it like centrifuged and
         | the plasma pulled out and everything is solution there or it's
         | in the buffy coat or down deeper? Where are these proteins
         | found exactly and how are they purified?
        
         | Aurornis wrote:
         | What an awesome space to be working in. I have a lot of
         | appreciation for people working on addressing unknown areas of
         | human health and well-being. Always makes what I'm working on
         | feel insignificant in comparison.
        
         | echelon wrote:
         | Congrats! That sounds amazing! Thank you for doing this
         | important work.
         | 
         | What are your thoughts and the general consensus within your
         | field for how individuals might prevent dementia?
         | 
         | Are there untested, but plausible hypotheses for the causal
         | mechanisms -- perhaps chronic inflammation, liver or metabolic
         | disease, bad gut microbiota, a multitude of factors? Or does
         | more data need to be gathered?
        
           | ddorian43 wrote:
           | A hypothesis is also linked to metabolic psychiatry (having
           | diabetes, mental illnesses like depression/paychosis),
           | diabetes, insulin resistance in the brain.
        
           | [deleted]
        
         | hirvi74 wrote:
         | Thank you for your efforts. It's unsung heroes like you and all
         | the other researchers behind the scenes that improve the lives
         | of countless individuals.
        
         | theptip wrote:
         | Any hints in the literature as to whether these protein
         | imbalances are downstream of some other cause that is itself
         | harmful, or harmful in themselves? (I.e. direction of causative
         | arrow)
        
         | SubiculumCode wrote:
         | Do you use neuroimaging as one of your outcome measures? I'm
         | curious as a neuroimaging scientist.
         | 
         | Also: Congrats on the funding!
        
         | JPLeRouzic wrote:
         | As someone having a blog on neurodegenerative diseases (and
         | someone in their 60s), thank you for working in this area.
        
         | moneywoes wrote:
         | Amazing
         | 
         | Thank you for your work
         | 
         | Aside from good sleep are there any evidence based practices
         | for mitigating these risks?
        
           | ddorian43 wrote:
           | Kinda hard for evidence based. Maybe look into low carb
           | diets. There are small studies for increase life quality and
           | cognition (I do it).
        
       | mcdonje wrote:
       | Anyone know what could cause these types of protein imbalances?
        
         | 1MachineElf wrote:
         | The HN submission _Could leak in blood-brain barrier cause poor
         | memory?_ (2021) may provide a clue:
         | https://news.ycombinator.com/item?id=26520453
         | 
         | >People with ApoE4 have a hard time getting rid of amyloid beta
         | peptide in their brains, which causes an accumulation of
         | plaque. With healthy aging, the pumps in the blood-brain
         | barrier work less efficiently in getting rid of the amyloid
         | beta peptide. The pumps work even less well in people with
         | Alzheimer's disease.
         | 
         | >Recent work suggests that the leak in the blood-brain barrier
         | that occurs with Alzheimer's may be due to an age-related loss
         | of pericytes. Astrocytes, by contrast, seem to be overactive.
         | Recent work suggests that preserving pericyte function by
         | giving the factors that they secrete or even transplanting them
         | could lead to a healthier blood-brain barrier.
         | 
         | >Other findings raise the question of whether the brain's
         | source of nutrition and its grip on control of the immune and
         | endocrine systems could deteriorate with aging. Another finding
         | raises the possibility that the rate at which many drugs are
         | taken up by the brain may explain why older folks sometimes
         | have different sensitivities to drugs than their children or
         | grandchildren.
         | 
         | Pair that with this part of OP:
         | 
         | >This regulation is important in preventing proteins from going
         | rogue and clumping together, which is what happens to the
         | amyloid and tau proteins in the brains of people with
         | Alzheimer's disease, the most common cause of dementia.
         | 
         | I'm just a layman, but it sounds like BBB health is a major
         | factor for regulating this in the brain. In some individuals,
         | including those with identified genetic biomarkers for
         | increased Alzheimer's risk, the BBB ages faster, leading to
         | decreased regulation of protein/peptides. So learning more
         | about how to improve BBB health could eventually help people
         | maintain a healthy brain longer.
         | 
         | Avoiding excessive alcohol seems to be an important factor for
         | BBB health, according to this 2021 study performed on mice:
         | https://pubmed.ncbi.nlm.nih.gov/33516661/ ; also this research
         | published in 2022:
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204474/
         | 
         | OP refers to "amyloid and tau proteins" while the 2021 article
         | I referenced refers to "amyloid beta peptide" - at this point,
         | I'm really not sure how precisely these terms are being used.
         | Are they interchangeable in this context, or is there an
         | important nuance that I'm missing?
        
         | dsign wrote:
         | I learned a lot about aging by watching this Minecraft
         | video[^1] and building the kelp farm. That farm stops working
         | after some (long) time, given the way that kelp grows in
         | Minecraft. If Avomance had done the math beforehand, he would
         | have discovered that he needs a costly full row of observers
         | for the farm to work forever.
         | 
         | Biological systems are not designed, but evolved, and evolution
         | ends up selecting systems (which we call "organisms" or
         | "individuals") which are good enough for it to be
         | reproductively successful. In practice that means "low-
         | maintenance" and "energy-efficient". Functional errors and
         | their organism-wide effects slowly accumulate, and although our
         | biology has everything material it needs to fix each and every
         | error[^2], its healing program/intelligence is far from
         | perfect.
         | 
         | [^1]: https://www.youtube.com/watch?v=Sf9I3YORSzM
         | 
         | [^2]: Compare this with a car, for example. If your lights go
         | bust, the car won't grow a new one; you need to change them.
         | But biological organisms have a lot of self-healing capability.
        
         | FollowingTheDao wrote:
         | Nonsteroidal anti-inflammatory drugs increase GDF15 which was
         | one of the key markers in the study
        
           | garganzol wrote:
           | But NSAIDs do not worsen dementia. Quite the contrary, the
           | symptoms improve due to lowered inflammation.
           | 
           | So, as other posters suggested, those proteins can be the
           | effect markers but not the root cause indicators.
        
             | FollowingTheDao wrote:
             | What?
             | 
             | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690966/
             | 
             | I'm not saying that it isthe root cause at all either, I'm
             | saying they're a marker as well. I'm saying there a marker
             | as well, possibly from NSAIDS.
        
         | bitwize wrote:
         | Probably the usual suspects: inflammation, gut bacteria, the
         | American diet.
        
         | Aurornis wrote:
         | That is the question.
         | 
         | These are correlated to dementia risk, but that doesn't mean
         | they're directly involved causing dementia. They could be a
         | related effect of the root cause(s) of dementia.
         | 
         | There are many examples in medicine where we've attempted to
         | directly modify measurable markers like this without fixing the
         | underlying disease.
         | 
         | They could be useful clues for discovering the root cause,
         | though!
        
           | carbocation wrote:
           | Bingo. More explicitly, there is no strong reason to think
           | that the proteins from the correlational analysis are causal
           | for dementia.
           | 
           | The proteins from the Mendelian randomization also don't have
           | to be (can be in a pleiotropic pathway) but there is at least
           | reason to think that they could be causal.
        
           | mcdonje wrote:
           | If these are correlated, then not every treatment for them
           | would necessarily be as effective against dementia. However,
           | if the cause of the protein imbalances is something people
           | can take steps to prevent, then doing so would logically have
           | a greater than zero chance of mitigating dementia risk.
        
             | Aurornis wrote:
             | > However, if the cause of the protein imbalances is
             | something people can take steps to prevent, then doing so
             | would logically have a greater than zero chance of
             | mitigating dementia risk.
             | 
             | Or correcting the protein imbalance could interfere with an
             | important feedback loop that we don't yet understand, which
             | could possibly make the situation worse. Or maybe the
             | protein imbalances are involved in counteracting the issue
             | that causes dementia, and that's why they're elevated.
             | 
             | This is a common theme in biological systems. A good
             | example would be cortisol, which has become known as the
             | "stress hormone". Many people assume that lowering cortisol
             | must therefore be a good thing, but if you were to
             | indiscriminately lower cortisol during periods of stress
             | you'd end up in a far worse condition than you were before.
             | Cortisol is part of your body's reaction to stress and part
             | of the system that responds to it, so artificially lowering
             | it can interfere with your stress response process.
        
               | mcdonje wrote:
               | Good points. Thank you.
        
               | nonethewiser wrote:
               | It makes me think of running a fever. Its easy to think
               | of fevers as bad but I imagine it would be a lot worse to
               | simply stop the fever (if that were even possible).
        
               | smolder wrote:
               | > (if that were even possible)
               | 
               | Indeed it is. Tylenol, for instance, is marketed as a
               | fever reducer.
        
               | nonethewiser wrote:
               | Well perhaps this proves my intuition wrong. Is it OK to
               | reduce a fever then? But how so if its purpose is to kill
               | off something worse?
        
               | smolder wrote:
               | IANAD, so someone please correct me, but I think there's
               | some truth that treating a mild fever will just interfere
               | with what the immune system is doing, to its detriment.
               | On the other hand, very high fevers in themselves are
               | quite dangerous and so being able to lower someone's
               | temperature is a benefit.
        
         | petercooper wrote:
         | This is unscientific anecdata, but my dad had celiac disease.
         | After a few years, he got "bored" of it and refused to go along
         | with the diet. Within a couple of years, he got vascular
         | dementia (at a relatively young age) and ended up having a
         | brain haemorrhage. The studies are pretty early stage on
         | finding connections between celiac disease and brain damage but
         | the TGM6 protein, common in people with gluten related
         | sensitivities, has been implicated. So, and this is all
         | spitballing for now, I think diet, and inflammation in
         | particular, could prove to be a big deal. At least, I believe
         | it's not following the diet that "got him", as it were.
        
           | aszantu wrote:
           | I agree, I fall into depression after I eat anything seed
           | based
        
         | pella wrote:
         | (Guinea Pig) : diet, gut microbiota, ... ( ?? )
         | 
         | "The Effects of Different Diets on Guinea Pig Health, Hair
         | Morphology and Blood Protein Concentration"
         | 
         | ~ "Guinea pigs (Cavia porcellus) have biological similarities
         | to humans, which make them a suitable animal model in multiple
         | fields of research. "
         | 
         | https://lsmu.lt/cris/handle/20.500.12512/115773
        
         | stefantalpalaru wrote:
         | [dead]
        
       | bilsbie wrote:
       | How might this interact with the APOE4 genotype?
        
       | submeta wrote:
       | For those who, like me, tried to find ways to influence this
       | imbalance positively, the article mentions one specific protein
       | called GDF15 as having a strong association with dementia risk.
       | The researchers identified 32 proteins in total that were
       | strongly associated with an increased risk of developing dementia
       | if their levels were unbalanced in middle age.
       | 
       | The article doesn't provide specific steps on how to influence
       | the levels of these proteins. The purpose of this research seems
       | to be more about identifying potential biomarkers for early
       | detection and risk assessment of dementia rather than outlining
       | therapeutic interventions.
       | 
       | Edit:
       | 
       | GDF15, or Growth Differentiation Factor 15, is a protein that is
       | naturally produced by our bodies. It's a stress-responsive
       | cytokine, meaning that it's part of the body's response to
       | conditions of stress or damage. It has roles in various
       | physiological and pathological processes, including inflammation,
       | metabolism, and apoptosis (a form of cell death).
       | 
       | In terms of influencing GDF15 levels, most research so far has
       | been in the context of pharmaceutical interventions, particularly
       | in relation to conditions such as cancer and cardiovascular
       | disease.
        
         | TaupeRanger wrote:
         | Well, it's just a correlation. No causal link has been
         | established, and anything you do to get "less" GDF15 could put
         | you at greater risk for other types of diseases, since we have
         | no idea what the relationships between these things are. I
         | wouldn't lose sleep over this - like many things in health and
         | nutrition, we must simply admit our ignorance while seeking and
         | hoping for a breakthrough.
        
           | steelframe wrote:
           | > I wouldn't lose sleep over this
           | 
           | Good, because poor sleep habits earlier in life have been
           | strongly correlated with development of dementia later in
           | life.
        
             | Tempest1981 wrote:
             | Ha! So raising kids is likely correlated. And attending
             | college... (or maybe I was doing it wrong)
        
               | chad_c wrote:
               | And just living!
               | 
               | Our time is short.
        
               | gunapologist99 wrote:
               | Thankfully, we only have so long. Also thankfully, we
               | have so long!
        
         | FollowingTheDao wrote:
         | GDF15 is a gene that is activated by NSAIDs.
         | 
         | So avoiding them would be a good place to start.
         | 
         | https://www.uniprot.org/uniprotkb/Q99988/entry
         | 
         | https://www.sciencedirect.com/science/article/abs/pii/S01637...
         | .
         | 
         | Is also causes insulin release.
         | 
         | But NSAIDs have been linked to dementia in the past, so...
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690966/
         | 
         | it would be pretty crazy if drug companies were causing all of
         | the dementia and Alzheimer's, wouldn't it?
        
           | Supermancho wrote:
           | > it would be pretty crazy if drug companies were causing all
           | of the dementia and Alzheimer's, wouldn't it
           | 
           | This makes sense from 10k feet. If you perennially treat
           | conditions in the body to reduce symptoms, but the conditions
           | persist, aren't you just masking the inflammation/trauma that
           | accumulates? Perhaps this is the best we can do for the human
           | condition, with current technology.
        
             | FollowingTheDao wrote:
             | I agree that the modality of treating symptoms and not
             | curing disease is probably causing more problems then just
             | having the disease.
             | 
             | I disagree that it is the best we can do. I have
             | essentially cured my self of an "incurable" disease, one
             | which was treated with drugs that masked the symptoms while
             | my nervous system kept collapsing. when doctors see my labs
             | and I tell them my story they are uninterested. That has
             | nothing to do with technology and everything to do with
             | curiosity and compassion.
             | 
             | My mother was told to take a baby aspirin everyday for her
             | heart. Then the doctor one day to her just to stop taking
             | them. It turns out that "just stopping" casued her to have
             | a mini stroke (TIAs) which was well known issue when
             | stopping long term low dose aspirin. That, and the fact
             | that psychiatrists killed my nephew with medications, has
             | led me to truths about the medical and pharmaceutical
             | industries that see them as an obstacle to human health.
        
               | Supermancho wrote:
               | I happen to have been taking a blood thinner since I was
               | 9 (almost 40 years now) due to a congenital defect and
               | then the ongoing surgeries. I am aware of the evils of US
               | pharma. Perhaps "the best we can do" was flippant.
               | Apologies.
        
             | criddell wrote:
             | There are a lot of conditions for which treatment of
             | symptoms is really the only option. I take ibuprofen and
             | tylenol fairly frequently to deal with cluster headaches.
             | If anybody can recommend a different course of action, I'm
             | all ears.
             | 
             | Dementia terrifies me. My dad died last year with Lewy Body
             | Dementia. After witnessing this, I totally understand why
             | Robin Williams decided to end his life.
        
               | GonzoVeritas wrote:
               | I've taken Ibuprofen for years for my recurrent
               | headaches, and only recently (after decades) discovered
               | that I had two underlying issues that seemingly caused
               | them. The first was gluten intolerance, which presented
               | as inflammation, and apparently I was also chronically
               | dehydrated. I cut out wheat and started drinking tons of
               | water and the headaches, which plagued me all my life,
               | have almost completely disappeared.
               | 
               | Had I not found the cause, I would still be popping Advil
               | almost daily. Of course, my issue and solution is almost
               | certainly vastly different from yours or any other
               | person, but the key was finally discovering the
               | underlying cause. That was the tough part.
               | 
               | All that said, the damage has been done, hopefully the
               | dementia doesn't set in anytime soon. My mother just died
               | this year with dementia, it was NOT an easy ride.
        
               | criddell wrote:
               | Dehydration is definitely one of my triggers. I think I'm
               | fine on the gluten front (although I've never removed it
               | from my diet). I think some dust or grass or mold
               | allergies are another trigger of mine.
               | 
               | I'm very sorry to hear about your mom.
        
               | berdon wrote:
               | Have you tried diltiazem for cluster headaches? I got
               | them after coming off of the medicine for heart related
               | issues. Started taking it again and they vanished.
        
               | criddell wrote:
               | Nope, but I'll look into it. Thanks!
        
               | hazmazlaz wrote:
               | There is some interesting early research into psilocybin
               | and cluster headaches:
               | https://americanmigrainefoundation.org/resource-
               | library/can-....
        
               | bebopfunk wrote:
               | This supplement stack + oxygen + verapamil + magic
               | mushrooms has turned clusters into almost a non issue for
               | me. I went through several years of being too broke to
               | really address them, and too pig headed to think
               | something as simple as vitamin D would help. But my last
               | set of clusters was a walk in the park compared to the
               | ones before it.
               | 
               | https://web.archive.org/web/20210119212133/https://vitami
               | ndw...
               | 
               | If you decide to try Verapamil make sure you get the
               | extended release pills. I don't have the link handy but
               | you can find research journal articles that help nail
               | down dosage. As for the oxygen, you may have to get your
               | own regulator and mask to get what you need. 15lpm and a
               | rebreather mask works amazingly for me. If your doctor is
               | difficult about it just get them to write a script for
               | oxygen, find a local supplier and pay out of pocket. It
               | was only $80 to rent the tanks I needed to get me through
               | my last cluster season.
               | 
               | A couple of home remedies I've tested and found effective
               | were cardio and putting my feet in some super hot water.
               | Both sound silly but seem to work in my experience. So if
               | you don't have the other stuff yet, or aren't able to get
               | to it in time, give either a try. I do burpees as soon as
               | I feel one coming one (and after I've chugged a 5 hour
               | energy).
               | 
               | The last and most effective solution is LSD or Magic
               | mushrooms. If you micro dose then periodically you can go
               | a lot longer between cluster headaches. A tiny bit of
               | mushroom also seems to work as an abortive for me when I
               | feel one coming on.
               | 
               | I'm still experimenting and learning. But hopefully this
               | info may give you some things to research or try
               | (assuming you haven't already, but I'd much rather share
               | this information repetitively then not share something
               | that could help you).
               | 
               | Feel free to reach out if you ever want to chat. Always
               | down to provide research I've found out just lend an ear,
               | I know how debilitating and isolating they can be.
        
               | criddell wrote:
               | Thank you so much for sharing all of this. I've copied it
               | to my phone so I can refer to it later.
               | 
               | I take quite a lot of vitamin D (6000 IUs daily),
               | cetirizine (zyrtec), and nicotinamide riboside (300 mg),
               | and a cheap multivitamin. I'm a little wary about adding
               | stuff to that but I'm definitely going to look into all
               | the things you've mentioned.
               | 
               | Psychedelics are super interesting to me but I really
               | wouldn't know where to start. I'm 53 ferchrisakes. Last
               | time I was around people buying mushrooms was 35 years
               | ago at a skate park.
               | 
               | > just lend an ear
               | 
               | Say... that reminds me. Tinnitus isn't something you are
               | dealing with as well, is it?
        
         | mfer wrote:
         | I think it would be really useful to understand what influences
         | these proteins so we can potentially stop dementia from
         | happening or reduce it.
         | 
         | From other research, I suspect we can influence things. Certain
         | populations (based on lifestyle choices / environment) have
         | lower rates of dementia than other places.
        
         | croes wrote:
         | The imbalance could just be a symptom of the reason for
         | dementia not the reason as such.
        
           | wongarsu wrote:
           | Which is a good argument against medication that just lowers
           | GDF15 levels. But if you approach it as "what lifestyle
           | changes lower GDF15" then there's a good chance that those
           | changes would also attack the actual reason for dementia.
        
             | autokad wrote:
             | yeah strongly agree. it was thought that those plaques in
             | the brain was the cause of alz; however, some research has
             | indicated that's the body's defense against what is going
             | on, not the cause. so you could take a medication that
             | lowers GDF15, and its possible it actually increases the
             | onset of dementia.
        
             | croshan wrote:
             | Exactly. I know if medication were to be developed,
             | checking "are GDF15 levels significantly lowered" would be
             | part of the trials.
             | 
             | But how often does the medication development process check
             | the result we care about: "does this medication then go on
             | to reduce the chance of dementia?"
        
               | wbl wrote:
               | Always. Secondary endpoints are heavily disfavored in FDA
               | approval.
        
         | markstos wrote:
         | Is GDF15 found in animal foods, plant foods, both or maybe
         | neither because we create it?
        
           | FollowingTheDao wrote:
           | not only do we create it, but it's stimulated by nonsteroidal
           | anti-inflammatory drugs. You know like ibuprofen that
           | everyone takes all the time.
           | 
           | Edited to remove Tylenol and replace it with ibuprofen. For
           | some reason I thought Tylenol wasn't ibuprofen. Thanks!
        
             | Spooky23 wrote:
             | Best honestly to minimize use of this type of medication.
             | Tylenol is rough on your liver.
        
               | reducesuffering wrote:
               | NSAID's have issues with your stomach, ears, and stroke
               | risk. Best to minimize them all, with the smallest
               | combination dose of tylenol + 1 NSAID.
        
             | petemill wrote:
             | Tylenol / Acetaminophen / Paracetamol is not an NSAID.
             | Ibuprofen and Aspirin is.
        
       | elamje wrote:
       | For those of you here that care about what's going on inside of
       | you - Function is tracking 100+ biomarkers over time, bi-
       | annually, and has additional testing available for state-of-the-
       | art early cancer detection (Grail) and Alzheimer's risk.
       | 
       | https://www.functionhealth.com/whats-included
       | 
       | I work here and it's amazing to watch this space unfold. Lots of
       | great stuff going on in the diagnostic space. Measurement is the
       | first step towards understanding your biochemistry and making
       | changes!
        
         | scottyah wrote:
         | This looks great, I'm just hesitant to sign up with any
         | startup-y looking company these days that says they're going to
         | be around for my lifetime. You might get more traction from
         | people like me if you guarantee that our data will be easily
         | exportable and testing methods reproducible.
         | 
         | I imagine the testing methods might be your bread & butter, but
         | it's so hard to trust any claims if the results aren't
         | auditable. I think about how these results will matter a lot
         | more to me in 40-50 years, and how unlikely it is for ANY
         | business to last that long.
        
           | elamje wrote:
           | Yeah, our internal engineering team in the US are members (me
           | included) that want the same thing! Do you have any
           | suggestions on file format with the ideal schema? I've done
           | deep dives on PubMed and GitHub but haven't found a great
           | answer for all use cases.
           | 
           | I personally track a lot of my stuff in a spreadsheet right
           | now but am on a personal hunt for a standard format
        
           | hn_throwaway_99 wrote:
           | I wouldn't really be concerned about the longevity of the
           | business as long as I can get just a print out of the data,
           | which I'm assuming is a pretty obvious feature because I'd
           | want to share results with my doctor.
           | 
           | Note that, on an individual level, the format of the export
           | really doesn't matter much with the rise of LLMs. I had some
           | past bloodwork results in PDF format, and I was amazed how I
           | could just copy and paste the test results into ChatGPT and
           | it was able to correctly parse and interpret the results.
           | Others may have privacy concerns but I LLMs being able to
           | read and parse a PDF dump of bloodwork is going to be an easy
           | commodity.
        
         | dusanh wrote:
         | I got excited about this and then I noticed it's US only.
        
         | johndavi wrote:
         | Any early access codes you're spraying around? Also how does
         | Function compare to something like your out of the box test-
         | ordering companies? https://www.ultalabtests.com
        
           | elamje wrote:
           | Not at the moment, but the waitlist is a real waitlist that
           | moves forward, not the typical smoke and mirrors email
           | marketing grab.
           | 
           | Not familiar with that provider, but our core offering tracks
           | this over time. I would recommend comparing the pricing of
           | their tests to the equivalent for us. We are bi-annual for
           | biomarkers that our CMO selected - i.e. some aren't
           | interesting to track in 6 month intervals. You can always add
           | testing at higher frequency if you'd like.
        
         | yieldcrv wrote:
         | nice, like I always say
         | 
         | no conflict == no interest
        
       | hospitalJail wrote:
       | Huh, I wonder if this explains why Fasting could prevent
       | Dementia. Although hard to imagine autophagy only targets the
       | excess.
        
         | Yoric wrote:
         | Is there any reason to believe that fasting could prevent
         | dementia?
        
           | ccvannorman wrote:
           | There seems to have been a few studies as described here:
           | https://www.discovermagazine.com/health/the-growing-
           | science-...
           | 
           | But, in my opinion there is more research to be done here to
           | establish whether or not (and to what degree) there is a
           | strong link
        
           | garganzol wrote:
           | Fasting increases insulin sensitivity, which in turn helps to
           | prevent dementia. Fasting activates growth hormone, which in
           | turn helps to heal damages that might lead to dementia.
           | Fasting activates autophagy which eradicates marginal
           | tissues, thus helping to prevent dementia.
           | 
           | So fasting has quite a few cards upon its sleeve and the
           | effect is enormous. But, a therapeutic fasting should be done
           | right and should include water, minerals and vitamins. So
           | it's not quite a full fasting per se, it's more about
           | creating the right conditions for an organism to reboot the
           | broken parts.
        
       | mycall wrote:
       | > Yu and his team have previously found that people with immune
       | diseases are more vulnerable to Alzheimer's later in life [2]"
       | 
       | Does this include autoimmune issues like developing allergies in
       | life?
       | 
       | [2] Zhang, Y.-R. et al. Alzheimers Res. Ther. 14, 130 (2022).
        
         | SpaceManNabs wrote:
         | Not a doctor or a researcher in this base, but I think they are
         | using immune to include auto immune as a subset. lots of people
         | call some subcases of Alzheimer's as diabetes 3.
        
       | eloq wrote:
       | [flagged]
        
       | treeman79 wrote:
       | Got exposed to lot of natural gas over a 3 month period. (Long
       | story) Eventually figured out that my blood begin clotting like
       | crazy. I have factor 5, so I was predisposed to it, but I was
       | having 2-3 TIAs a week for a couple of years. Huge cognitive
       | decline.
       | 
       | Only when a large clot showed up in lungs did they figure out
       | what was going on.
       | 
       | Week after being on blood thinners and simple programming
       | problems that were taking me weeks to solve were back down to
       | minutes.
        
         | ncr100 wrote:
         | Wild.
         | 
         | Blood clots can be scary. (personal exp). Glad to hear you know
         | why they are happening and how to fix it.
         | 
         | Happy clear-thinking !!!
        
         | garganzol wrote:
         | It has an official name - vascular dementia. A kind of dementia
         | that is caused by vascular problems like blood clots in vessels
         | making it hard to deliver the blood to the brain.
         | 
         | Oftentimes it is close to impossible to spot this in a usual
         | bloodwork, but were they able to spot D-dimer anomalies in your
         | case?
        
         | hn_throwaway_99 wrote:
         | Would definitely like to hear more about how they were able to
         | narrow down to find a root cause. I also have factor 5 and have
         | suffered some other non-specific symptoms (primarily extreme
         | fatigue) but haven't been able to nail down a root cause. I'm
         | curious if there was a test to find out how "thick" your blood
         | was before you went on blood thinners.
        
           | treeman79 wrote:
           | Trial and error. Symptoms start back up every-time I go off
           | blood thinners. Visual issues , TIAs, cognitive. Clears up
           | when I start back up. Covid started when I was just getting
           | treatment so lost access to doctors, so no further
           | investigating was done.
        
         | Pr0ject217 wrote:
         | That's crazy.
        
       | ramblerman wrote:
       | Since protein is a key factor in building muscle, is there any
       | reason to assume keeping up with strength training in middle age
       | would direct most of that protein to a better use and keep the
       | balance?
       | 
       | I realize the question is "bro-science", but I'm genuinely
       | interested, perhaps someone educated could expand on it.
        
         | radicaldreamer wrote:
         | Ever seen dementia in someone who lifts? Me neither...
        
           | aszantu wrote:
           | seen cancer in someone who'd eat white bread and banana in
           | the morning, then go lift weights afterwards. Within 3 months
           | he war breathing heavily when comming up the stairs. I
           | noticed. Within 2 more months he was dead. Guy was 70 or so.
        
       | 98codes wrote:
       | The article doesn't say anything to infer that it's odd, but the
       | rate of incidence of dementia being 20% seems awfully high to me.
        
         | skybrian wrote:
         | How old are the people you're imagining? Among people who live
         | long enough, it seems fairly common.
        
       | agentgumshoe wrote:
       | [flagged]
        
         | [deleted]
        
       | pella wrote:
       | related:
       | 
       | "Blood protein levels predict leading incident diseases and
       | mortality in UK Biobank"
       | 
       | https://www.medrxiv.org/content/10.1101/2023.05.01.23288879v...
       | 
       | ( May 03, 2023 ; open, pre-print; not-yet peer-reviewed ;
       | Alzheimer's dementia included .. )
       | 
       | Abstract:
       | 
       |  _" The circulating proteome offers insights into the biological
       | pathways that underlie disease. Here, we test relationships
       | between 1,468 Olink protein levels and the incidence of 23 age-
       | related diseases and mortality, ascertained over 16 years of
       | electronic health linkage in the UK Biobank (N=49,234). We report
       | 3,123 associations between 1,052 protein levels and incident
       | diseases (PBonferroni < 5.4x10-6). Forty-four proteins are
       | indicators of eight or more morbidities. Next, protein-based
       | scores (ProteinScores) are developed using penalised Cox
       | regression. When applied to test sets, eight ProteinScores
       | improve Area Under the Curve (AUC) estimates for the 10-year
       | onset of incident outcomes (PBonferroni < 0.0025) beyond age, sex
       | and additional health and lifestyle covariates. The type 2
       | diabetes ProteinScore outperforms HbA1c (P = 5.7x10-12) - a
       | clinical marker used to monitor and diagnose type 2 diabetes. A
       | maximal type 2 diabetes model including the ProteinScore, HbA1c
       | and a polygenic risk score has AUC = 0.90 and Precision-Recall
       | AUC = 0.76. These data characterise early proteomic contributions
       | to major age-related disease."_
       | 
       | Alzheimer dementia * 10 proteins:
       | 
       | (jpg)
       | https://www.medrxiv.org/content/medrxiv/early/2023/05/03/202...
       | 
       | And you can check the data ( protein * disease ) :
       | 
       |  _" Our Shiny https://protein-disease-ukb.optima-
       | health.technology app [Username: ukb_disease, Password:
       | shinyappUKB] provides visualisations for sensitivity analyses run
       | across cases over successive years of follow up, allowing for
       | interrogation of individual protein-outcome relationships."_
        
       | denial wrote:
       | (Paywalled link of paper:
       | https://www.science.org/doi/10.1126/scitranslmed.adf5681)
       | 
       | Abstract:
       | 
       | A diverse set of biological processes have been implicated in the
       | pathophysiology of Alzheimer's disease (AD) and related
       | dementias. However, there is limited understanding of the
       | peripheral biological mechanisms relevant in the earliest phases
       | of the disease. Here, we used a large-scale proteomics platform
       | to examine the association of 4877 plasma proteins with 25-year
       | dementia risk in 10,981 middle-aged adults. We found 32 dementia-
       | associated plasma proteins that were involved in proteostasis,
       | immunity, synaptic function, and extracellular matrix
       | organization. We then replicated the association between 15 of
       | these proteins and clinically relevant neurocognitive outcomes in
       | two independent cohorts. We demonstrated that 12 of these 32
       | dementia-associated proteins were associated with cerebrospinal
       | fluid (CSF) biomarkers of AD, neurodegeneration, or
       | neuroinflammation. We found that eight of these candidate protein
       | markers were abnormally expressed in human postmortem brain
       | tissue from patients with AD, although some of the proteins that
       | were most strongly associated with dementia risk, such as GDF15,
       | were not detected in these brain tissue samples. Using network
       | analyses, we found a protein signature for dementia risk that was
       | characterized by dysregulation of specific immune and
       | proteostasis/autophagy pathways in adults in midlife ~20 years
       | before dementia onset, as well as abnormal coagulation and
       | complement signaling ~10 years before dementia onset.
       | Bidirectional two-sample Mendelian randomization genetically
       | validated nine of our candidate proteins as markers of AD in
       | midlife and inferred causality of SERPINA3 in AD pathogenesis.
       | Last, we prioritized a set of candidate markers for AD and
       | dementia risk prediction in midlife.
        
         | refurb wrote:
         | The key question is - how strong was the correlation? Was it
         | associated with a 5% higher chance of dementia? Or several fold
         | higher risk of dementia?
        
       | olliej wrote:
       | I know that's not what this is saying in any way, shape, or form,
       | but I am waiting for FB posts using this as evidence support
       | balancing humours to prevent dementia.
        
       | thomashabets2 wrote:
       | Is there a test for it?
        
         | ccvannorman wrote:
         | +1 - How would one get bloodwork done to specifically test for
         | these proteins?
        
       | 3cats-in-a-coat wrote:
       | This is literally the same cause as "child dementia", which was
       | reportedly called this due to similar symptoms, despite the cause
       | is different, a genetic anomaly that causes accumulation of
       | protein in nerve tissue and the brain. Well, it was thought to be
       | different, but I guess not.
        
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       (page generated 2023-07-21 23:01 UTC)