White Matter Disease

Dear Dr. Dean,

My Mom was diagnosed with White Matter disease and vascular dementia in August, 2012. She has been ill off and on since January, 2015. She also has Waldenstrom's Macroglobulinemia. She has suffered from profound weakness and frontal headaches, which have been especially bad for the past two weeks. Her Dr. said to prepare for Hospice, all due to dementia. She takes Lasix 40 mgs in the morning, and 80 mg in the evening.

CalaRose, Salisbury NC

Dear CalaRose,

Cerebral white matter disorders can be genetic, demyelinative, infectious, inflammatory, toxic, metabolic, vascular, traumatic, neoplastic, and hydrocephalic. Each classification signifies a distinct disease process, and, within classifications, diseases vary greatly. Nevertheless, all are associated with cognitive or emotional dysfunction of some kind with similarities in brain-behavior dysfunction. Metabolic disorders of white matter also exist, including dementia from vitamin B12 deficiency. One of the most common white matter disorders is a variant of vascular dementia called Binswanger’s disease.

Treatment of white matter disorders with drugs that modulate immunity appear to have a beneficial effect on the patient’s cognition. Potentially, stimulants and cholinesterase inhibitors may counteract the slowing of attention and memory loss. Also, because of the similarity with MS, some treatments that benefit MS patients may help with white matter disease.

Obviously, with the variety of causes, and not having the opportunity to know more about your mom’s condition, here are some general suggestions that may be helpful.

First, make sure she is getting an abundance of Vitamin B6 (pyridoxal-5-phosphate, if possible), B12 (methylcobalamin) and folic acid (methylfolate). Also, Benfotiamine (a fat-soluble form of Vitamin B1). CaAEP (calcium aminoethanolamine phosphate) 100 mg 3 times per day was a mainstay in Dr. Hans Nieper’s treatment of MS. Because of the inflammatory cause of many types of white matter disorders, I recommend high-dose Whole ground turmeric and boswella each day. Phosphatidylserine (300 mg/day), acetyl-L-carnitine (1500 mg/day) and vinpocetine (20-40 mg/day) may help improve cognitive function. Vinpocetine is especially beneficial for vertigo and balance problems.

Low dose naltrexone (LDN) starting at 1 mg/day in the morning may help if there is a component of autoimmune dysfunction. LDN has been known to help with MS and other autoimmune-related conditions. LDN is available by prescription at compounding pharmacies.

Finally, cholinesterase-inhibiting substances such as galantamine may help with cognitive disorders.

Wish I could be more specific—and hope these suggestions will help,

Ward Dean, MD

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