What is the ReCODE Protocol?
Last Updated: November 2025
In this FAQ, Dr. Jessica Knape of HealthSpan Internal Medicine in Boulder, CO, explains that the ReCODE Protocol is a personalized, research-based program designed to identify and treat the root causes of cognitive decline. Using advanced testing, genomics, and targeted interventions, ReCODE provides a precision-medicine approach rather than a one-size-fits-all treatment.
The ReCODE Protocol (Reversal of Cognitive Decline) is a comprehensive, personalized medical program created by Dr. Dale Bredesen to identify and treat the root causes of memory loss, cognitive decline, and early-stage Alzheimer’s disease. Rather than offering a single treatment, the BrainSpan ReCODE program uses advanced testing, genomics, nutrition, lifestyle interventions, and targeted therapeutics to address the multiple biological factors that contribute to brain deterioration.
ReCODE is based on decades of published research, including clinical papers showing measurable cognitive improvement in properly selected patients. It is not a “one-size-fits-all” approach — it’s a precision-medicine framework that evaluates each person’s biochemistry, genetics, exposures, inflammation patterns, metabolic function, and lifestyle to design a personalized treatment plan.
Overview
The BrainSpan ReCODE Protocol and BrainSpan PreCODE programs are personalized and designed to identify and reverse the root causes of cognitive decline.
Combining advanced lab work, genomics, metabolic evaluations, toxin screening, brain-supportive nutrition, and targeted therapies.
Research from Dr. Dale Bredesen and colleagues shows measurable cognitive improvement in 84% of ReCODE participants.
It works best when tailored to the individual — not applied as a generic checklist.
At HealthSpan Internal Medicine in Boulder, CO, we provide the ReCODE protocol alongside clinical genomics (including IntellxxDNA) in our BrainSpan Recode and Precode Programs.
Key Points
ReCODE is built on precision medicine, not symptom-based treatment.
It evaluates multiple domains: inflammation, insulin resistance, hormone balance, nutrient status, toxin exposure, infections, vascular health, and genetics.
Published research (Bredesen, Toups, et al.) documents improvements in memory and cognitive scores in appropriately selected patients.
The protocol is highly personalized — two patients with “memory loss” may have completely different root causes.
Ongoing monitoring is essential because cognitive recovery depends on continuous optimization of metabolic, inflammatory, and genomic pathways.
It’s most effective when started early — mild cognitive impairment (MCI) or early cognitive changes respond best.
Safety monitoring includes metabolic labs, medication review, sleep evaluation, and assessment of red-flag symptoms requiring urgent care.
Let’s Break This Down Simply
ReCODE is a roadmap for understanding why someone is experiencing memory loss or brain fog. Instead of attributing cognitive decline to age or genetics, ReCODE looks for the specific imbalances that may be affecting a person’s brain — and then treats them one by one.
In simple terms:
If insulin resistance is harming the brain → fix blood sugar metabolism.
If inflammation is high → identify the triggers (gut, infections, mold, stress).
If hormones are low → balance them carefully and safely.
If toxins are present → support removal and reduce exposure.
If genetics increase risk → create a personalized prevention strategy.
At HealthSpan Internal Medicine, I (Dr. Jessica Knape) take this approach personally. I spent 10 years working in memory care and have lost several family members to Alzheimer’s disease. I know how devastating cognitive decline is — and how urgently families need more than generic advice.
This is why our clinic uses ReCODE combined with clinical genomics, including IntellxxDNA, to pinpoint what’s driving each patient’s symptoms and what will make the biggest difference for their brain health.
Who ReCODE Helps (and Who Should Avoid It)
ReCODE may help people with:
Mild cognitive impairment (MCI)
Early Alzheimer’s disease
Subjective cognitive decline
Family history of dementia
Brain fog during midlife
Metabolic problems that impair cognition (insulin resistance, low ketone availability)
Chronic inflammation or immune dysregulation
Hormone-related cognitive changes (perimenopause/menopause)
Toxin-related cognitive issues (mold, heavy metals, pollutants)
ReCODE may not be appropriate for:
Individuals with late-stage Alzheimer’s disease— consider Palliative Care and Hospice for this stage
Those unable to participate in lifestyle or treatment modifications
People with uncontrolled psychiatric or neurological conditions requiring specialized care
Individuals who cannot complete recommended safety evaluations or follow-up appointments
Every case is assessed individually to ensure the safest, most effective approach.
How ReCODE Works: Evaluation, Timeline, and Monitoring
1. Comprehensive Intake
Your history, symptoms, exposures, nutrition, stress levels, sleep patterns, and medications are reviewed in detail. Cognitive testing is used as a baseline to monitor future improvements.
2. Advanced Lab Testing
Depending on your symptoms, this often includes:
Metabolic labs (glucose, insulin, HbA1c)
Inflammation markers (CRP, homocysteine)
Thyroid and adrenal hormones
Sex hormones (estrogen, progesterone, testosterone)
Vitamin and nutrient status (B12, D, magnesium, omega-3 index)
Toxicity screening (heavy metals, mycotoxins)
Gut-immune markers
Vascular and cardiac risk markers
3. Genomic Testing (When Clinically Indicated)
At HealthSpan Internal Medicine, we use IntellxxDNA — an advanced genomics tool that identifies specific genetic patterns affecting brain inflammation, detoxification, mitochondrial function, lipid transport, methylation, and Alzheimer’s-related risk pathways (including APOE).
Genomics allow us to tailor the plan with extraordinary precision.
4. Personalized Care Plan
Your plan may include:
Medical nutrition therapy (including ketogenic or low-glycemic patterns)
Treatment of insulin resistance
Hormone optimization when appropriate
Detoxification support if toxins are contributing
Supplements chosen to match your lab/genomic patterns
Sleep optimization
Stress regulation and nervous-system balance
Anti-inflammatory strategies
Gut microbiome restoration
Targeted treatment of chronic infections if identified
5. Follow-Up & Monitoring
Most people begin noticing early improvements within 6–12 weeks, with deeper changes occurring over 3–12 months.
Ongoing assessments include:
Repeat cognitive testing
Lab follow-ups
Genomics-informed adjustments
Medication optimization
Symptom tracking
Lifestyle coaching and accountability
Risks, Side Effects & Safety
ReCODE is generally safe when supervised by a trained clinician, but patients may experience:
Temporary fatigue as metabolic patterns shift
Digestive changes during microbiome therapy
Headaches or mood changes during detoxification
Hormone-related side effects if hormone therapy is part of the plan
These are typically manageable with dose adjustments or pacing changes.
ReCODE is not a replacement for emergency care or neurologic evaluation when needed.
How We Approach ReCODE at HealthSpan Internal Medicine
At HealthSpan Internal Medicine in Boulder, CO, we provide the ReCODE Protocol and PreCode Protocol
Root-cause diagnostic methods
Clinical genomics (IntellxxDNA)
Advanced labs
Precision nutrition and metabolic therapies
Early-detection strategies for Alzheimer’s risk
Personalized hormone, sleep, and stress-regulation plans
A deep commitment to patient-centered care
If you’re noticing early cognitive symptoms, or if you have a family history of Alzheimer’s and want proactive prevention, the earlier we intervene, the more powerful the results can be.
Sources
Apollo Health – Reversal of Cognitive Decline (100 Patients)
Bredesen DE. Reversal of Cognitive Decline: A Novel Therapeutic Program
Bredesen DE et al. Reversal of Cognitive Decline: 100 Patients.
Toups K, Bredesen DE et al. Precision Medicine Approach to Alzheimer’s Disease.
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.
