What Are the Six Types of Alzheimer’s Identified by the ReCODE Program?
Last Updated: November 2025
In this FAQ, Dr. Jessica Knape of HealthSpan Internal Medicine in Boulder, CO, explains that Alzheimer’s is not a single disease but a set of distinct subtypes, each requiring different treatment. Using advanced diagnostics and IntellxxDNA genomics, she identifies each patient’s subtype to guide more effective, personalized care.
Traditional medicine often treats Alzheimer’s disease as one condition with a single cause—usually attributed to amyloid protein buildup. However, research from Dr. Dale Bredesen and the ReCODE Protocol reveals a very different reality: Alzheimer’s is not one disease. It is a collection of biologically distinct subtypes, each driven by different metabolic, inflammatory, hormonal, vascular, toxic, or traumatic processes.
Understanding a patient’s subtype matters because each type requires a different treatment plan. This is why one-size-fits-all medications show limited success, while personalized, root-cause approaches are far more effective—especially in early stages.
At HealthSpan Internal Medicine in Boulder, CO, we use advanced diagnostics and IntellxxDNA genomics to identify which subtype(s) are active for each patient. As someone who spent 10 years in memory care and has seen the limitations of symptom-based treatments firsthand, I believe subtyping is one of the most meaningful advances in cognitive medicine.
Here’s an in-depth look at the six Alzheimer’s subtypes identified by the ReCODE Program—and why they matter for treatment and prevention.
BrainSpan Insight
Alzheimer’s has six biological subtypes, each with different root causes.
The ReCODE Program identifies these subtypes using labs, imaging, genomics, metabolic markers, toxin testing, and clinical history.
Subtyping matters because each type responds to different interventions.
Genomics (IntellxxDNA) helps clarify inflammatory, detoxification, hormonal, mitochondrial, and vascular risk pathways.
Personalized treatment consistently outperforms one-size-fits-all drug approaches.
Early detection gives the best chance for stabilization or improvement.
Key Points
Alzheimer’s is made up of multiple distinct biological patterns, not a single disease.
The six ReCODE subtypes: Inflammatory (Type 1), Glycotoxic (Type 1.5), Atrophic (Type 2), Toxic (Type 3), Vascular (Type 4), and Traumatic (Type 5).
Most patients have a combination of subtypes that interact with each other.
Identifying subtypes allows for targeted metabolic, inflammatory, hormonal, and detoxification support.
IntellxxDNA genomics enhances subtype precision by revealing individualized risk patterns.
Early intervention is essential—MCI and early Alzheimer’s respond best.
Personalized, root-cause care is more effective than relying solely on medications
Why Alzheimer’s Has Multiple Subtypes
Alzheimer’s symptoms (memory loss, confusion, processing difficulty) emerge when the brain’s support systems fail. But why they fail is different for each person.
ReCODE identifies Alzheimer’s subtypes based on the primary biological driver:
Is inflammation high?
Is insulin resistance present?
Are hormones depleted?
Are toxins overwhelming detox pathways?
Are vascular issues decreasing blood flow?
Has trauma disrupted brain function?
Are genomic variants playing a role?
These distinctions matter because treatment must match the driver.
You cannot treat toxin-related Alzheimer’s the same way you treat glycotoxic Alzheimer’s.
The Six ReCODE Alzheimer’s Subtypes
1. Type 1 — Inflammatory (“Hot”) Alzheimer’s
Driven primarily by chronic inflammation, this subtype is common in those with:
Elevated CRP or cytokines
Chronic infections
Leaky gut or chronic GI inflammation
Autoimmune tendencies
Periodontal disease
Metabolic inflammation
Typical symptoms develop gradually.
Treatment focus:
Reduce inflammatory load
Treat chronic infections
Heal gut and immune imbalance
Support microglial regulation
Evaluate genetics tied to inflammation (IntellxxDNA markers)
2. Type 1.5 — Glycotoxic (“Sweet”) Alzheimer’s
This hybrid subtype combines inflammation (Type 1) and insulin resistance (Type 2 diabetes physiology).
Common findings include:
High fasting insulin
Elevated glucose or HbA1c
Metabolic syndrome
Excess visceral fat
Brain glucose hypometabolism
Treatment focus:
Improve insulin sensitivity
Consider ketogenic or low-glycemic nutrition
Support mitochondrial function
Lower inflammation
Reduce advanced glycation end-products (AGEs)
This subtype is increasingly prevalent and highly responsive to metabolic repair.
3. Type 2 — Atrophic (“Cold”) Alzheimer’s
This subtype is driven by loss of hormonal, trophic (growth), and nutrient support to the brain.
Common triggers:
Menopause/perimenopause
Low sex hormones
Low thyroid
Low vitamin D, B12, folate
Low nerve growth factors
Chronic stress with adrenal dysfunction
Treatment focus:
Restore hormone balance (with safety-first medical oversight)
Correct nutrient deficiencies
Support adrenal function and circadian rhythm
Improve sleep architecture
Genomics can clarify how hormones and nutrients are processed
Atrophic Alzheimer’s often responds extremely well when addressed early.
4. Type 3 — Toxic Alzheimer’s (“Vicious”)
This subtype is associated with environmental toxins, such as:
Mold/mycotoxins
Heavy metals
Industrial chemicals
Pesticides
Airborne pollutants
Symptoms often include:
Brain fog
Word-finding issues
Executive dysfunction
Mood changes
Multisystem inflammation
Treatment focus:
Identify and remove toxin exposures
Support detoxification pathways
Use binders when appropriate
Correct mitochondrial and inflammatory damage
IntellxxDNA identifies detox gene vulnerabilities
This subtype requires careful medical guidance due to the complexity of detox.
5. Type 4 — Vascular (“Pale”) Alzheimer’s
This subtype is driven by compromised blood flow, often from:
Hypertension
High LDL or triglycerides
Atherosclerosis
Microvascular damage
Sleep apnea
Chronic endothelial dysfunction
Treatment focus:
Improve vascular health
Treat sleep apnea
Reduce blood pressure and lipid risk markers
Support nitric oxide and microcirculation
Genomics can reveal vascular and lipid metabolism variants
Addressing vascular drivers often produces significant cognitive improvement.
6. Type 5 — Traumatic (“Dazed”) Alzheimer’s
This subtype is related to:
Traumatic brain injury (TBI)
Concussions
Repetitive head trauma
PTSD-associated brain changes
Treatment focus:
Support neuroplasticity
Reduce inflammation
Optimize sleep and oxygenation
Improve metabolic resilience
Enhance mitochondrial repair pathways
These patients often need layered treatment strategies combining metabolic, neurological, and psychological support.
Why Subtyping Matters
Identifying Alzheimer’s subtype(s) changes everything.
Without subtyping:
Treatments are generic
Medications offer limited results
Key drivers go unaddressed
Early changes are missed
Patients decline despite “doing everything right”
With subtyping:
Treatment becomes targeted
Metabolic, hormonal, inflammatory, and toxic pathways are corrected
Genomics clarifies unique vulnerabilities
Progress is monitored and measurable
Early intervention becomes powerful
Most patients have more than one subtype, and their treatment plan must address all relevant pathways.
How IntellxxDNA Genomics Enhances Precision
At HealthSpan Internal Medicine, IntellxxDNA helps us refine subtype identification by analyzing:
Inflammatory risk genes
Detoxification and toxin sensitivity genes
Hormone metabolism pathways
APOE and Alzheimer’s-specific variants
Methylation and mitochondrial genes
Vascular and lipid gene variants
Oxidative stress pathways
Genomics turns guesswork into precision and helps us tailor a plan that matches your unique biology.
Early Detection Matters Most
ReCODE subtyping is most effective when applied to:
Mild cognitive impairment (MCI)
Early Alzheimer’s
Subjective cognitive decline
Individuals with strong family history
High-risk genomic patterns (e.g., APOE ε4)
The earlier we identify the subtype(s), the more we can do to preserve or improve cognitive function.
When to Seek Urgent Care
Seek immediate medical attention for:
Sudden confusion
One-sided weakness or facial drooping
Severe headache or vision changes
Sudden speech difficulty
Chest pain or shortness of breath
These symptoms may indicate a stroke or medical emergency.
Sources
Reversal of Cognitive Decline: A Novel Therapeutic Program, Bredesen DE, 2014
Precision Medicine Approach to Alzheimer’s Disease, Toups K, Bredesen DE et al., 2022
Reversal of Cognitive Decline: 100 Patients, Bredesen DE et al., 2018
Medically reviewed by
Dr. Jessica Knape, MD, MA Board Certified in Internal Medicine and Integrative and Holistic Medicine
Healthspan Internal Medicine — serving patients in Boulder, CO
Book a Discovery Call | About Dr. Knape
This content is for educational purposes and does not replace personalized medical advice.
