which of the 36 holes in the roof can you plug? | by Functional Nutritionist Andrea Nakayama of Holistic Nutrition Lab

which of the 36 holes in the roof can you plug?

Last year, I attended the Cleveland Clinic Grand Rounds where Dr. Dale Bredesen spoke about the reversal of cognitive decline associated with Alzheimer’s Disease.

Even if you’re not interested in dementia and it does not or has not affected your life or your work, read on. There was something poignant that the good doctor said that caught my attention other than the condition-specific wisdom he shared.

I think you’ll appreciate this as much as I did.

Dr. Bredesen spoke to a personalized therapeutic approach to addressing the disease based on multiple modalities that target the underlying or root causes of the condition (ie. a functional approach). Just like the reversal of AIDs required a “cocktail” therapy, he stipulated that trying to target Alzheimer’s with one single agent was a mistake.

There are just too many compound factors that lead to the disease expression!

In therapeutic care I like to think of it as developing a strategy vs. a tactic.

He said he likens the condition to 36 holes in a roof…

You can’t just plug one hole and expect the problem to resolve.

Instead, we have to plug multiple holes.

In fact, what he found in his research was that essentially plugging even half the holes can lead to complete reversal of symptoms. One hole isn’t enough. Many holes make a difference!

When Dr. Bredesen said this, my ears perked up. Do you know why?

Because this means that we all have a role. We can all feel confident that when we work together (practitioners in partnership), we’re plugging multiple holes and making a bigger difference.

I got excited because I was thinking of you.

I was wondering…what holes can you comfortably plug?

I went and looked up Dr. Bredesen’s published research and his therapeutic protocol. Each step is based on the following:

  • the physiological goal found to be contributing to the disease (what)
  • the approach required to address the biochemical reversal of that development (how)
  • the justification for that course (why)

And when I looked at the actual list I just had to share it with you…(click to view full size).

Dr. Bredesen's therapeutic research protocol | Holistic Nutrition Lab

Look at how much you can do!

Seriously, look what a role you can play in helping to reverse the symptoms of Alzheimer’s disease. Print out this table, get out your highlighter, and draw a big circle around the areas that are within your scope and feel comfortable to you to address.

If you’re overwhelmed by the language or the appreciations, just search for the words and things you can do.

I bet there’s more than one. And remember, every hole matters, even though no one will do the trick alone.

You can do this for dementia and the same applies for any chronic condition.

The holes you can plug matter.

Please plug them with confidence and the best know-how you can.

That’s how we #dochange in healthcare.


Bredesen, D. (2014) Reversal of cognitive decline: A novel therapeutic program. AGING, Vol 6, No 9 , pp 707-717

Functional nutritionist and educator Andrea Nakayama (FNLP, MSN, CNC, CNE, CHHC) is leading patients and practitioners around the world in a revolution to reclaim ownership over our own health. Her passion for food as personalized medicine was born from the loss of her young husband to a brain tumor in 2002. She’s now regularly consulted as the nutrition expert for the toughest clinical cases in the practices of many world-renowned doctors, and trains a thousand practitioners online each year in her methodologies at Holistic Nutrition Lab. Learn more about Andrea here.

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[…] Working with conditions that are multifactorial requires that we address the many root causes. Alzheimer’s specialist Dr. Bredesen calls this “plugging the 36 holes in the roof.” […]