Plasmalogens: The Missing Critical Link to Cognitive Decline

December 20, 2020

Plasmalogens - What Your Brain Needs (And may not have)

Bet you hadn't ever heard about plasmalogens! Well, you will now and need to fully understand. This topic just got moved up to the front of the line. If you want a healthy brain, and want to keep it healthy, you need to understand this important advance in our understanding of Alzheimer's.

What are plasmalogens? Start with Wikipedia. They are a particularly configured fatty acid combination built on the glycerol backbone with a chemically active phosphate group and a PUFA (fish oil) group in the middle. We have known about them since the 1920s but didn't fully appreciate their importance until just the last decade. They make up about 20% of your brain. Let me repeat that. They make up some 20% of your brain, and maybe even more of the fats (70%) that surround your axons, the wires that connect your brain cells to each other. 

They play a huge role in heart disease too. Really. Whole separate topic. Now, you can measure blood plasmalogen levels in populations and you can see them decline with aging. Ok, so we take fish oil, which helps a little because it gives you the building blocks for that middle position.

But something curious happens in Alzheimer's. It's not till we have lost some 70-80% of our frontal executive neurons that we start to get symptomatic from it. We have thought that the accumulation of amyloid and tau tangles are the characteristic pathology of Alzheimer's, but getting those takes a biopsy, something we are cautious to do on one another's brains. Here's where plasmalogens come in. Population studies show that serum plasmalogen levels drop steadily with aging. We are all on track to get cognitive issues, eventually. But individual studies seem to show sudden and dramatic drops in them, and they correlate directly with cognitive issues. And not just minor drops. 75% drops. Why the dramatic drop? Some instigating event, some environmental change: trauma, anesthesia, loss of a nutrient, exposure to pesticides.....all the things that have been shown to be risks for Alzheimer's.

And it gets even more interesting. If you look at folks with APOE4 genes, those with high (one APOE4 gene) and even higher (two APOE4 genes) you find some folks in their 90's with no cognitive issues, and their plasmalogen levels are normal. So, plasmalogen levels trump APOE4.

Do we understand why they are so critical to healthy brains? Well, they aren't just structural components of membranes. They also play a biochemical role in being in situ antioxidants. Their chemical structure makes them uniquely able to soak ok free oxygen radicals before they cause harm. They play a huge role in helping your axons make synapses (connections) to other neurons. Is that it? There must be more. (There is..stay tuned.)

And just why does their level decrease? Well, we know that their manufacturing starts in the peroxisome. Peroxisome! Ever heard of that? Sounds like you have to tune in next week. Our aging tired brains can only learn so much in one week.

But here is the promise. We have the ability to measure your plasmalogen levels with a blood test. And then we now have the ability to give it to you as a supplement and restore your blood levels. And that has been shown to make folks better.

WWW: What will Work for Me? I'm listening to Bredesen's Town Hall meeting with Goodenowe, the superstar Ph.D. whose lab has been furiously spewing out all sorts of plasmalogen research. I'm going to listen twice, maybe three times till I get it right. And I've ordered my plasmalogen test. We should all get one if we have any concerns about how our brains work. This concept pulls many disparate threads together and makes sense. Let's get at it.

References: Lipids in Health and Disease, J Psych Neurosci, Brain Sci, Nature, Fitzgerald, Frontiers Phys., Atherosclerosis, Wikipedia

Pop Quiz

1. What is a plasmalogen? Answer: A fatty acid made from PUFA fatty acids, that are abundant in your brain and your heart.

2. What is the connection of plasmalogens to Alzheimer's? Answer: Folks with cognitive decline have dramatic reductions in their plasmalogens before they get the cognitive decline.

3. How much damage do you have to have to your brain to get symptoms? Answer: Probably on the order of 60-80%

4. Can you replace plasmalogens? Answer: Yes. Now you can.

5. Does that have an impact on cognition? Answer: Yes, in proportion to replacing back to normal levels.