Your p-tau went up. Is your brain getting worse?

Hi Phoenix friend,

Your p-tau went up. Does that mean your brain is getting worse?

A higher result can feel like bad news. A lower one can feel like proof that all your effort is paying off.

With a small change, one comparison may not tell you either.

That was one of the worries Phoenix members brought to this interview. Others asked what a normal result means when they still have symptoms, and which tests lead to action rather than more worry.

I put those questions to Dr. Grant Fraser, a physician who works in anti-aging and regenerative medicine and carries one copy of APOE4.

A better number is not the same as a better brain

On drawing a conclusion from a small p-tau change, Grant said:

He looks for a pattern over time. The method used by the lab, the conditions around the blood draw and your wider health all need context.

You cannot dismiss a rise as noise, then treat a drop as proof your protocol works. (Tempting, though.)

The research notes make that point concrete. In the EVOKE and EVOKE+ trials, oral semaglutide improved Alzheimer's-related biomarkers but did not significantly slow clinical progression.

Those trials studied people with early symptomatic Alzheimer's. They do not settle prevention in people without symptoms. But they show why a better marker and a better clinical outcome are different claims.

Not every useful test is useful to keep repeating

Grant describes the amyloid ratio (Aβ42:40) as a way to assess amyloid buildup. Once abnormal, it can stay fairly static rather than track how much disease progresses.

So a test may help answer one question without being a useful progress chart.

He generally favors p-tau217 over p-tau181 in his practice. That does not make their numbers interchangeable.

GFAP and NfL add another distinction: these markers are not specific to Alzheimer's. More results do not always lead to a different next step.

The limits: using these brain biomarkers to judge whether a prevention protocol works is still experimental. Research-study changes cannot become your personal forecast using another lab's cutoff.

What about symptoms with normal results?

Grant discusses other possibilities a clinician may need to assess, including thyroid problems, B12 deficiency and depression.

A normal result does not make your concern imaginary. Nor does a normal cognitive screen rule out every problem. PREMAZ, the tool discussed in the interview, is a screening product, not a diagnosis.

Persistent or worsening symptoms still deserve clinical assessment.

Make the decision before the blood draw

Here are questions to bring to your clinician:

• What question would this test answer?

• What would a normal, abnormal or unclear result change?

• Who will interpret it with me, and when would repeating it help?

Keep the report, laboratory, method, units and reference range together. Ask what conditions should stay consistent for a repeat test. Grant discusses sleep, time of day and kidney function as part of that context.

For the p-tau tests discussed here, the reference ranges are lab-specific, not separate ranges for each APOE genotype.

Grant also shares the tracking template he uses to bring the wider picture together.

Get Grant's tracking template

It is a discussion aid, not a treatment checklist. The version shown includes experimental options.

And there has to be room left for living. As Grant puts it:

He is talking about trying to do every possible thing for prevention. Friends, enjoyment and time away from checking results still matter.

Watch the full interview

Phoenix: your home for everything APOE4

The answers above are free. The questions came from members.

A member asked which tests would lead to action, not a countdown. I opened the interview with it. Inside Phoenix, you bring your question before the interview is recorded. Members can now post questions for Dr. Dale Bredesen, for example.

That's one piece. Everything else is in one place too, so you stop piecing it together alone:

• Your personal protocol, built around you, kept moving with a quick daily check-in and a monthly review.

• Bloodwork at up to 70% off retail. Ready-made APOE4 test panels, ordered in one click in the app, drawn at Quest, Labcorp or BioReference near you. The app then reads your results against APOE4-specific ranges.

• Supplements at up to 35% off retail on most major brands, from our private store, with APOE4 lists limited to third-party-tested brands.

• A pod each month: a small group of carriers with similar goals, helping each other stay on track.

• Your questions, put to world-class experts before the interviews.

Here's what I care about most. Most partners give patients around 10% off and keep the rest as a commission. Phoenix earns revenue only from your membership, never from anything we recommend. So the full discount goes to you. You buying it never earns Phoenix a cent.

For most members, the savings on bloodwork and supplements alone pay for Phoenix membership several times over. (Test and supplement prices are US only for now. I'm working on other countries next.)

See the member prices and why Phoenix stays independent by not earning a cent on anything we recommend.

Let's build your APOE4 protocol together.

For carriers who are serious about beating the odds.

Apply to join Phoenix

Cheers,

Kevin

P.S. I carry two copies of APOE4. I built Phoenix because I wanted to give myself the best chance of beating the odds. Now I'm building it for you too. Give it sixty days. If you don't feel Phoenix was worth it, tell me and I'll refund you myself.

Educational, not medical advice. Take testing decisions to your own clinician. APOE4 is a risk factor, not a diagnosis.

Research notes: EVOKE and EVOKE+ results, Labcorp's method warning, PREMAZ screening information.

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