We used to think memory loss was just “bad luck” or aging. The work of Dr. Dale Bredesen and associates has reframed it as a pattern of root causes you can measure and modify. Here are five primary risk factors—one from each subtype—and what to do next.
1. Inflammatory (“hot”): Chronic oral inflammation
Why it matters: Gum disease and oral dysbiosis keep the immune system on a low boil, sending inflammatory signals that can damage the brain over time. Microbes trapped in apical lesions within root canals as well as cavitation sites breed microbes that can translocate into the brain.
Check it: Ask your dentist to screen for periodontitis and use a cone beam scan to assess deeper infections sites; review CRP (C-reactive protein) and ferritin with your clinician.
Do this: Treat periodontal disease, floss or water-floss daily, add tongue scraping, and address upstream drivers (refined carbs, smoking, mouth breathing, apnea and poor sleep).
2. Glycotoxic (“sweet”): Insulin resistance
Why it matters: Chronically elevated insulin and glucose hurt neurons, impair synaptic signaling, and accelerate amyloid/tau pathways.
Check it: Fasting insulin, fasting glucose, HbA1c, and—ideally—an oral glucose tolerance test with insulin. Today, we also have access to continuous glucose monitors, an affordable tool that allows us to identify exactly what is triggering glucose imbalance.
Do this: Prioritize fiber-rich, lower-glycemic plant-heavy meals; build daily walking + resistance training; aim for 7–8 hours of sleep. Many people see labs improve within 8–12 weeks.
3. Atrophic (“cold”): Low trophic support such as low thyroid, sex hormones, minerals or vitamins
Why it matters: Neurons need growth signals and nutrients. Low thyroid, low estradiol/testosterone, vitamin D or B12 deficiency starve the brain of maintenance cues.
Check it: TSH with free T4 (± free T3), vitamin D (25-OH), B12/methylmalonic acid, zinc, copper, omegas, etc. and age-appropriate sex hormone panels.
Do this: Correct deficiencies and imbalances with targeted nutrition, supplementation and clinician-guided hormone optimization when appropriate.
4. Toxic (“vile”): Biotoxin or heavy-metal exposure
Why it matters: Mold/mycotoxins, mercury, lead, solvents, and pesticides can inflame microglia, disrupt mitochondria, and impair detox pathways.
Check it: Detailed exposure history (home, job, hobbies), indoor air/moisture assessment, and clinician-selected labs for metals and mold when indicated.
Do this: Remove the source (fix water intrusion, ventilate, use PPE), support clean air/water, and follow evidence-based remediation and medical protocols rather than DIY “detox.”
5. Vascular (“pale”): Midlife hypertension & elevated cholesterol
Why it matters: High blood pressure damages small vessels that feed memory-critical regions, reducing oxygen and nutrient delivery. Elevated cholesterol can increase risk of vascular blockage.
Check it: Home BP monitoring (morning and evening for 1–2 weeks), lipid panel, and sleep apnea screening if snoring/daytime sleepiness are present.
Do this: Target <120–130/80 with lifestyle (Plant-based nutrition, walking, strength training, stress reduction) and medications if needed; treat sleep apnea to protect vessels.
A quick action plan
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Test, don’t guess: Ask for labs that screen for your risk and that cover inflammation, glycemic control, nutrients/hormones, and vascular risk.
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Fix the environment: Mouth, home air, water, sleep, movement, and food are daily levers.
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Stack small wins: Even modest improvements across these five domains add up to better brain protection.
Want a comprehensive screening and actionable program, check out our evidence-based cognitive performance program here.