Just Learned You carry the APOE4 gene? Start Here

I imagine your head might be spinning. You don’t know where to begin, who to trust, or what comes next. This post is for you.

Let’s start with this: Your genes are not your destiny. They may load the gun, but you decide whether to pull the trigger.
This is where the exciting field of epigenetics comes in—the science of turning genes on or off.
Diet, lifestyle, and environment all play a powerful role in either amplifying or silencing risk-related genes.

Step One: Understand the Big Picture

Start by learning about the many contributors to Alzheimer’s disease.
The idea of forgetting who we are—and who we love—is terrifying. But that fear can be transformed into powerful motivation.

One of the best starting points is Dr. Dale Bredesen’s second book, The End of Alzheimer’s Program.
(He also wrote a more technical book, The End of Alzheimer’s, which lays the scientific foundation.)

Dr. Bredesen uses a powerful analogy:

Alzheimer’s is like a roof with 36 holes—plugging just one isn’t enough. You have to seal all of them.

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Step Two: Start With Basic Labs

Ask your primary care physician for the following tests:

• Hemoglobin A1C

• Fasting Insulin

• Comprehensive Metabolic Panel

• CBC (Complete Blood Count)

• Homocysteine

• Vitamin B12 & Methylmalonic Acid (MMA)

• Vitamin D

• DHEA & Pregnenolone

• Female Hormones

• C-Reactive Protein (hs-CRP)

• Full Lipid Panel (with ApoB)

• Full Thyroid Panel (including Free T3 & Reverse T3)

• Omega-3 Index

• Lp(a) – Lipoprotein(a)

• Fibrinogen

• Ferritin

It might be wise to confide in your primary care physician, but, if you live in the USA where health care is a “for profit” system, request this information is not added to your medical record.

I'll explain the importance of these labs in a separate, upcoming post.

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Step Three: Explore Your Genetics

If you have your full genome file (from 23andMe, etc.), upload it to Dr. Rhonda Patrick’s website FoundmyFitness.com.
For a small fee, you’ll receive a report that flags additional genes worth knowing.

In my case, I discovered I also carry 3 additional impactful genes:

• MTHFR variant (affecting methylation)

• Lp(a) variant (lipoprotein related to cardiovascular risk)

• DIO1 variant (which affects thyroid hormone conversion)

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Step Four: Make Foundational Lifestyle Changes

• Move daily. Exercise delivers oxygen to the brain and supports neuroplasticity.

• Eat real food. Shop the perimeter of the grocery store. Read every label.
  → If you see added sugars, treat them like they say added cyanide.

• Prioritize sleep. Deep sleep is when your brain “cleans house.”
  → Aim for 8 hours, earlier bedtimes, and skip alcohol (you’ll see why if you wear an Oura Ring!).

• Care for your oral health. Infections and inflammation in the mouth affect your brain.

• Practice intermittent fasting. Try to eat within an 8-hour window.

• Ditch sugary drinks and anything with corn syrup.

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Step Five: Eat Brain-Smart Fish

Incorporate SMASH fish into your meals:

• Salmon

• Mackerel

• Anchovies

• Sardines

• Herring

These are rich in phospholipid-bound DHA and EPA, the most brain-accessible forms of omega-3s.

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Step Six: Start with These Three Supplements

If you’re eager to take immediate action, consider starting with:

• Methylated B-Complex

• Citicoline (CDP-Choline)

• DHA Omega-3

You’ll fine-tune your supplement routine as you learn more about your labs and genetics.

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Final Thoughts

You can’t implement everything at once—and you don’t have to.
This is a journey. Some interventions will matter more for you than others, depending on your biomarkers and risk profile.

But one thing’s for sure: you’ve taken the first step, and that’s the most important one.