Dementia/Alzheimer’s – Semaglutide

[Ka Rose]

Hi!

I have 65 yo male who has a family hx of dementia and Alzheimer’s.  He is starting to notice short-term memory loss (some days better than others) and he had reached out to me about semaglutide.  Any dose recommendations? Also, oral vs sub-q?

Thank you

Ka

 

[Craig Mullen]

Ka,

you may want to look at liraglutide, as this GLP-1 was shown to have significant benefits amongst those with established dementia.

https://aaic.alz.org/releases-2024/glp-drug-liraglutide-may-protect-against-dementia.asp?

https://www.imperial.ac.uk/news/255214/weight-loss-drug-slow-alzheimers-decline/?

[Ka Rose]

Thank you Craig!

[Craig Mullen]

Anytime.

Also, for ease of dosing, I would just stick w the normal sema titration protocol for SQ. The EVOKE trial is currently underway looking at semaglutide and other GLP-1 options in patients w dementia – I anticipate similar benefits to be established.

I would recommend keeping him on the lowest effective dose. You may also want to consider cutting his weekly dose in half and administering every 3-4 days to keep plasma concentrations more stable.

[Clyde Boswell]

If using glp-1 in new onset dementia or cognitive decline, I recommend beginning at 0.125mg semaglutide or 1.25mg Tirz because often times these patients already have a decrease in appetite.

In addition to GLP-1 therapy, I always check nutrition status. These patients are often in caloric deficits. If need be, recommend meal prep companies like Factor for convenience.

Other considerations include Ta1, which I use in nearly every cognitive decline patient. Humanin as well, and I have found a lower dose of 25 units daily to be very effective and will alternative with other mitochondrial peptides. I do get a baseline IGF-1 level and often will rx CJC/Ipamorelin twice daily with daily exercise.

I also advise patients to begin a neuro plasmalogen in the morning (3-4 caps) and Glia plasmalogen at night) 3-4 caps. Ketone esters have been a hallmark in treatment of these patients in my experience and I have been limiting use to before 1pm due to some sleep pattern issues I’ve noticed.

 

Hope this helps

[Val Koganski]

Ka,

In addition to the low dose 0.125mg of semaglutide weekly, keto esters, and plasmalogens, I also use IV Exosome and a 4-week course (5 days a week) of Cerebrolysin. My first patient on this protocol showed significant drop in the levels of p-tau217 went from 0.28 to 0.15pgl/ml (LabCorp) in 6 months. Just started my second patient.

Can try it.

Val

 

[Naomi Fayzulayev]

Thank you for sharing your protocol. Where do you order Cerebrolysin from? I am having a hard time finding a supplier.

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