My Personal Brain Health Journey

This is the final article in my brain-health series. We’ve covered a lot in the first three pieces:

1. Your Genes Are Not Your Fate. Genetics can raise your risk, but they don’t determine your destiny. There are meaningful ways to influence your personal risk of Alzheimer’s disease.
   
2. Establish Your Brain Health Baseline. Start with genetic screening, key blood markers, cognitive testing, and a review of modifiable risk factors.
   
3. Overcoming Healthcare Headwinds. Our healthcare system isn’t always set up for prevention, so it helps to recognize common barriers and learn how to navigate them.
   

In this last article, I’m sharing my own journey, from fear to action. I’m not doing this because you should copy my path—everyone’s motivations, fears, and test results are different—but because seeing one person’s story can help you imagine your own. If anything here sparks an idea you can use, that’s a win.

I’ll also be upfront: I may never be able to prove whether the steps I’m taking today will affect if—or how—dementia impacts my health decades from now. But I know I can influence my risk of dementia just like I can influence my risk of cardiovascular disease or diabetes. And in the short term, the benefits have already shown up: I feel more energetic, I am mentally sharper, and I am physically stronger.

A Timeline Overview

From Paralysis to Action

For almost two decades, as my parents battled Alzheimer’s, I was told—often by experts—that there wasn’t much you could do. That helplessness felt consistent with what I witnessed.

My dad died in October 2018, seven years after my mom. Only then did it hit me that I might face the same fate. I stayed stuck there—somewhere between fear and resignation—for more than four years.

Everything shifted when I finally heard a physician say, without hedging, that there are steps you can take to influence neurodegenerative risk. That message was life-changing. In January 2023, I moved from paralysis to action, focusing first on building muscle mass and improving cardiorespiratory fitness.

January 2023: Exercise

In January 2023, I discovered The Drive, Dr. Peter Attia’s podcast. Attia, who runs a longevity-focused clinic in Austin, talks often about the “four chronic diseases of aging”—heart disease, cancer, neurodegenerative disease, and type 2 diabetes/metabolic dysfunction. Naturally, I zeroed in on his views about neurodegeneration.

Attia highlights how metabolic dysfunction, inflammation, and oxidative stress relate to dementia—and he emphasizes exercise as the single most impactful lever we can pull to lower risk of many chronic diseases (admittedly, exercise is his “hammer”—the tool he believes we should use the most).

What resonated with me was his specificity. He doesn’t just say “work out more.” He offers a framework with measurable targets. Inspired by that, I began lifting weights twice a week and added structured cardio—tracking metrics like lean mass, VO₂ max, heart-rate recovery, and more. My execution isn’t perfect, but I have a plan and objective ways to gauge progress.

September 2023: Brain Health Baseline & Targeted Interventions

Eight months into my physical training, I decided to add a medical professional with a focus on brain health to the team. In the summer of 2023, I began working with a company that synthesizes input from multiple neurological researchers and clinicians to create personalized brain health plans. If Attia gave me the blueprint for exercise, this team helped me translate lab and cognitive data into diet, supplement, and prescription recommendations.

After a year of working with them remotely (they were out of state), I wanted someone local—an in-person clinician who understands prevention and takes brain health seriously. I found that partner in October 2024 and have worked with them ever since.

October 2024: Ongoing Maintenance With Concierge Care

I moved to a concierge medical provider in October 2024. They don’t bill insurance, which means the services have transparent prices and I pay them directly (there’s also a quarterly subscription that covers most of what I need).

Having medical support outside the traditional healthcare system has been a breath of fresh air. Blood draws happen right in my home, and when I have a question, I can text my provider and usually get a reply the same day—often within minutes. Because they maintain a smaller patient panel, they can spend more time with each person. I recognize that this level of access comes with added expense and isn’t an option for everyone, but for me, the combination of accessibility, continuity of care, and the potential for lower long-term healthcare costs has been well worth it.

Specific Test Results and Interventions

Beginning in September 2023, I completed two rounds of cognitive testing and bloodwork and adjusted my plan after each round. Here are some highlights from that process.

Cognitive Testing

Round 1 (September 2023): The cognitive test assessed 15 clinical domains, including verbal and visual memory, executive function, and attention. The results placed me in the highest quintile (“high function and high capacity”) in 10 domains, the second-highest in 4, and the second-lowest in 1 (Simple Attention). That outlier felt off; my physician and I suspected I had misunderstood instructions on that subtest. Overall, the results were reassuring.

Round 2 (July 2024): My pattern shifted slightly: highest quintile in 8 areas and second-highest in 7. The Simple Attention score normalized, reinforcing our suspicion that the earlier dip wasn’t meaningful.

Takeaway

• Cognitive scores can fluctuate, and small changes aren’t necessarily concerning. Periodic testing helps you spot trends and target interventions where they matter. 

Blood Marker Testing

It’s not practical to review all my blood test results, but I wanted to share three specific results that changed how I think about prevention.

Vitamin B12 (and Homocysteine)

Low B12 can elevate homocysteine, a marker of inflammation linked with vascular and cognitive risk. My B12 was low. I also have a common genetic mutation of the methylenetetrahydrofolate reductase gene (MTHFR), which affected my ability to metabolize B12. Although my homocysteine was “normal,” it wasn’t optimized.

With a simple methylated B-complex supplement, my B12 rose to the high end of the reference range, and my homocysteine dropped well below the target.

Takeaways:

• There’s a difference between “normal” and optimized. Depending on the marker, the more optimized end of normal might be lower (homocysteine) or higher (B12).
• Second opinions can help. My local internist wasn’t inclined to address my low B12 while the brain-health team tool a more proactive stance.
• Risk matters, too. My internist told me that excess B vitamins are typically excreted in urine, so the downside of taking a supplement was low. 
  

Uric Acid

Uric acid is tied to systemic inflammation. When elevated, it can contribute to high blood pressure, gout, and arthritis symptoms, and may also have implications for brain and vascular health.

Traditional healthcare typically checks uric acid only when a patient shows gout symptoms—and I have a family history of gout. Because I was focused on prevention, however, I discovered that my uric acid levels were high before any symptoms appeared. My internist agreed to start me on allopurinol, which quickly brought my levels back to normal.

Takeaway:

• Proactive, broader testing can surface risks that standard, symptom-driven care misses—giving you time to act before problems snowball.
  

Testosterone

Adequate testosterone is critical for physical, mental, and emotional health for both men and women. Many people, including traditional healthcare professionals, view testosterone solely in the context of sexual or reproductive health, but that’s shortsighted. My brain health team said it’s also critical for long-term brain health.

I had several non-sexual symptoms consistent with low testosterone: persistent low energy levels, difficulty building muscle mass, difficulty recovering from exercise, and decreased bone density (I had osteoporosis), among other symptoms. My initial labs were low, but follow-up testing showed my body could make enough testosterone—the issue was insufficient stimulation from the brain.

With a prescription to stimulate natural production (not replacement), plus dosage adjustments, my levels improved and so did my symptoms.

Takeaways:

• In a symptom-driven system, you may never realize you have an issue if you don’t know what to watch for. Looking back, I probably struggled with low T symptoms for several years.
• Different clinicians weigh risks and benefits differently. My brain-health team and internist agreed that I had symptoms of low T. Ironically, it was my endocrinologist, the person who specializes in hormones, who was unwilling to treat without libido/erectile symptoms. Gather multiple opinions, then decide.
• You can move at your pace. I waited months before addressing this issue because I wanted to focus on other interventions first. A recommendation is not an obligation.
  

What’s Working for Me Now

• Strength + Cardio: Two days of lifting weights, plus structured cardio aimed at cardiorespiratory fitness (I track VO₂ max and heart-rate recovery).
• Targeted Nutrition & Supplements: Guided by my personal lab results, with periodic retesting to evaluate effect.
• Concierge Access: Faster answers, easier logistics (e.g., in-home labs), and more time with a clinician who prioritizes prevention.
• Periodic Re-Testing: Cognitive and blood markers to monitor trends and refine the plan.
  
  

If You’re Just Starting

It’s easy to feel overwhelmed—I certainly did. My path wasn’t a grand plan; it unfolded step by step: I stumbled onto Attia’s work, decided to get deeper testing, and only later switched to concierge care. You don’t need to do everything at once.

A few ways to begin:

• Pick one lever and make it consistent (walk more, start resistance training, or get baseline labs).
• Measure something you care about (VO₂ max, resting heart rate, body composition, or a lab marker).
• Schedule periodic check-ins with yourself (and your clinician) to adjust course.

I don’t know exactly what’s next for me, but I’m eager to keep learning and iterating. If you’re on a similar path, I’d love for you to do it alongside me..

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