What are they?

Plasmalogens are ether lipids found in our brains and tissues. Our brain plasmalogens contain DHA and AA. (Braverman, 2012) Alzheimer’s disease (AD) is associated with decreased plasmalogens, in the brain (Ginsberg, 1995, 1998)(Han, 2001, 2005). Additionally, serum levels of ethanolamine plasmalogens in AD patients are decreased and correlate with the severity of disease progression (Goodenowe, 2007)(Wood, 2010).

Individuals with plasma phosphatidylcholine DHA levels in the highest quartile had a 47% lower risk of dementia than did those with levels in the lower 3 quartiles, independent of the APOE4 allele (Shaefer, 2006)(Mulder, 1998). In addition, low plasma lysophosphatidylcholine levels predicted a diagnosis of mild dementia and AD within 2–3 yr with 90% accuracy, independent of the APOE4 allele (Mapstone, 2014)

Plasmalogens are thought to act as antioxidants to prevent lipid oxidation (mostly of polyunsaturated fats.) (Engelmann, 1994) (Hahnel, 1999) (Sindelar, 1999)

Where do we get them?

Plasmalogens are synthesized in the liver. They are not absorbed well from the diet. Scallops, Oysters, mussels, heart, brains, eggs, deer, and beef/lamb have the highest percentage of plasmalogens and plasmalogen precursors, but less than 1% survive the digestive system and are deposited into the blood/tissues. Even less winds up in the brain.(Fujino, 2017) (Mawatari, 2012)

We may start out with higher/lower plasmalogen concentrations based on maternal/infant nutrition? DHA, choline, and serine are all involved with plasmalogen synthesis. Plasmalogen levels may be related to behavioral abnormalities and may be correlated with maternal nutrition. (Hino, 2019) DHA levels are also dependent on maternal intake and the first two years of nutrition. (Lauritzen, 2016)(Bradbury, 2011)(Swanson, 2012)(Kuratko, 2013)(Singh, 2005)(Mun, 2019)

If the mother had a set amount of DHA/minerals available in her body and it was depleted with each birth, then the last children in the family should always be the unhealthiest, most troubled, and subsequently have the most AD in late adulthood. Unless pregnancy just depletes her reserves and health, preferentially providing for baby. Having more than 5 children was linked with a higher risk of dementia (70% increased risk), but having 3 was more protective than having 1 or 2. (qz)(cnn)

Maternal age and birth order had no affect on the risk of dementia (Kenesivich, 1982) Childhood risk factors - nutrition, trauma, injury, poverty, infection, stress, lead exposure and more - may be related to AD risk in adulthood.(Borenstein, 2006)(Miller, 2008)(Barker, 1986)

Pregnancy and lactation decrease maternal tissue levels of DHA unless the diet contained adequate or supplemental DHA. (Lamontagne-Kam, 2018) This may be partially to blame for the higher AD incidence in women.

Treatment with Plasmalogens?

There is evidence (in mice, not humans) that oral plasmalogens (batyl alcohol and chimyl alcohol) can improve serum levels leading to reversal of atherosclerosis. (Rasmiena, 2015) (Braverman, 2012) Reversal of testicular and glandular issues was found with alkyl glycerol feeding in a plasmalogen deficient mouse model. (Brites, 2011)

Synthetic plasmalogen precursors have been developed and are bioavailable after digestion, increasing serum and some tissue concentrations, but not in the human brain. (rhizotrial) (Fallatah, 2019) Injecting plasmalogens or precursors into the bloodstream, can cross the blood brain barrier but has an extremely short half life. (Braverman, 2012) Injecting precursors into the brain does not result in uptake or transformation into plasmalogens. (Bickerstaffe, 1968)

However, Phosphatidylserine (a brain plasmalogen made from L-serine) taken orally has moderately improved cognitive scores in the elderly and mild AD and dementia patients. (Zanatto, 2014)(Kato-Kataoka, 2010)(Crook, 1992)(More, 2014.) Citicoline (a prescurser to the brain plasmalogen phophatidylcholine) was shown to improve cognition after in stroke and in some AD patients (Alvarez-Sabin, 2011 , 2013)(Gareri, 2015)

Peroxisomal disorders inhibit plasmalogen synthesis, deplete brain/tissue DHA, and increase lipid peroxidation. AD patients suffer some form of lysosomal disorder and may be experiencing a slower form of peroxisomal disorder. DHA ester supplementation has been shown to remyelinate the brains of children with severe peroxisomal disorder, returning some to "normal" health and increasing the lifespan of others. (Martinez, 2000)

How to Increase Plasmalogen levels?

Stress depletes plasmalogens. (Kuczinski, 2006) (Hu, 2016)

• Inositol has been shown to increase serum plasmalogen levels. (Paul, 2019)(Maeba, 2008)(Hoffman-Kuczynski, 2005) (Pettegrew, 2011) Inositol is made by our bodies from the lectins/phytic acid in whole grains.
• DHA ingestion (via fish or supplement consumption) has been shown to increase phosphytidlycholine (plasmalogen) levels in the human brain (Patrick, 2019)
• Aerobic exercise was found to increase plasmalogen production in the liver, resulting in higher serum plasmalogen levels. Whether these plasmalogens cross the blood brain barrier or how is unknown (Felder, 2017)
• Serum plasmalogen levels increased with a “nordic diet” that included berries versus a standard diet. (Lankinin, 2016)

ACTIONS:

Try not to let stress destroy you. Eat fewer polyunsaturated fats (PUFAs). These are soybean oil, corn oil, canola oil, cottonseed oil, margarine, sunflower oil. Read packages and avoid foods with these ingredients. Eat ocean fish and/or consider DHA supplementation. Limit brain stress.