Why Is There So Much Testing in the ReCODE Protocol?
Last Updated: November 2025
One of the first questions patients and families ask when beginning the ReCODE Protocol is:
“Why is there so much testing?”
In this FAQ, Dr. Jessica Knape of HealthSpan Internal Medicine in Boulder, CO, explains why the ReCODE Protocol requires comprehensive testing: cognitive decline has many possible root causes, and thorough evaluation replaces guesswork with clarity. With ReCODE 2.0 certification and over a decade of memory-care experience, she uses targeted testing to identify the mechanisms driving each patient’s cognitive changes.
It’s a fair question — especially if you’re used to brief appointments, minimal labs, and single-medication treatment models. But Alzheimer’s disease and cognitive decline are not single-cause conditions. They are complex, multi-factor processes that can arise from dozens of different biological imbalances. Because of this, the ReCODE Protocol relies on comprehensive testing to identify exactly why cognitive problems are happening — and how to reverse or stabilize them.
At HealthSpan Internal Medicine in Boulder, CO, Dr. Jessica Knape uses advanced testing not to overwhelm patients, but to replace guesswork with clarity. Missed diagnoses and incomplete evaluations lead to faster decline. Thorough testing, when done correctly, allows us to target the right mechanisms early and safely.
Below is a clear explanation of why ReCODE includes more testing than standard neurology — and why that testing is one of the reasons the program works.
BrainSpan Snapshot
Alzheimer’s is not one disease — testing determines your personal subtype(s).
Cognitive decline has many possible causes; testing reveals which ones apply to you.
Labs and genomics eliminate guesswork and allow personalized, targeted treatment.
Each test measures a different system: hormones, inflammation, toxins, vascular health, gut, infections, insulin resistance, nutrients, and more.
Genomics (IntellxxDNA) ensures personalized and safe treatment.
Without testing, the wrong interventions can delay or block healing.
Testing creates a measurable baseline to track improvement.
Many symptoms look the same on the surface, making detailed evaluation essential.
Dr. Knape uses testing to map the root causes of cognitive decline based on years of memory-care experience.
Key Points
ReCODE requires comprehensive evaluation because cognitive decline is multi-factorial.
Precision medicine demands individualized data, not assumptions.
Alzheimer’s subtypes (inflammatory, atrophic, toxic, glycotoxic, vascular, traumatic) can only be identified with testing.
Each biomarker gives insight into a different biological driver.
Advanced genomics inform safer, smarter treatment decisions.
Testing prevents trial-and-error and accelerates improvement.
Reason #1: Alzheimer’s Is Not One Disease
Traditional neurology treats Alzheimer’s as a single, uniform condition. In reality, research from Dr. Dale Bredesen and others shows there are multiple biological subtypes, including:
Inflammatory (Type 1)
Glycotoxic (Type 1.5)
Atrophic/Hormonal (Type 2)
Toxic (Type 3)
Vascular (Type 4)
Traumatic (Type 5)
These subtypes cannot be identified with a short visit or simple labs.
They require deeper investigation across inflammatory pathways, hormone levels, toxic burdens, genetics, metabolic markers, vascular health, and more.
Without this testing, you’re essentially guessing which subtype is present — and guessing leads to ineffective care.
Reason #2: The Brain Declines for Many Different Reasons
Two people may have identical symptoms (e.g., brain fog, word-finding difficulty, memory lapses), yet completely different root causes.
Common drivers of cognitive decline include:
Chronic inflammation
Insulin resistance and metabolic dysfunction
Hormone depletion (thyroid, adrenal, estrogen, testosterone)
Nutrient deficiencies
Chronic infections
Gut-immune dysfunction
Environmental toxins
Sleep disorders
Vascular problems
Mitochondrial dysfunction
Oxidative stress
Genomic vulnerabilities (APOE, detox genes, inflammatory genes)
Only testing reveals which of these drivers are present — and how severe they are.
This is why ReCODE’s testing is more comprehensive than the conventional model.
Reason #3: ReCODE Testing Replaces Guesswork With Precision Medicine
ReCODE is a personalized program, not a protocol you can follow blindly.
Every test tells us something essential:
Inflammation markers show whether the brain is under immune attack.
Hormone levels reveal if the brain is lacking critical growth signals.
Insulin resistance tests show whether poor glucose utilization is impairing brain energy.
Toxin testing identifies hidden exposures that can sabotage progress.
Nutrient panels show deficits that impair neurotransmitters and mitochondria.
Sleep studies reveal whether oxygen levels or sleep architecture are damaging the brain.
Vascular markers highlight circulation problems that compromise cognitive function.
Infection panels detect chronic stealth infections that inflame the brain.
Every lab adds a piece to the puzzle. Together, they create a map of what your brain needs to stabilize or improve.
Reason #4: Genomics (IntellxxDNA) Is Essential for Personalized and Safe Care
Genomic interpretation is one of the most powerful components of ReCODE.
At HealthSpan Internal Medicine, we use IntellxxDNA, which analyzes hundreds of relevant genomic variants that affect:
Inflammation
Detoxification
Mitochondria
Hormone metabolism
Oxidative stress
Methylation
Vascular risk
APOE-related cognitive vulnerability
Antioxidant pathways
Neurotransmitter metabolism
Genomics helps answer questions that no lab panel alone can solve:
Is this patient prone to inflammation?
Do they detoxify toxins slowly?
Should they avoid certain supplements or medications?
Will they respond better to specific nutrients, hormones, or detox strategies?
This prevents trial-and-error and improves safety — especially for patients with complex or overlapping Alzheimer’s subtypes.
Reason #5: Without Testing, the Wrong Interventions Can Delay Healing
Many people try to “DIY” cognitive support with supplements or internet advice.
But without knowing your specific drivers:
You could take supplements that don’t match your genomic profile.
You might miss a toxin exposure that is preventing improvement.
You could use hormones when detox should be addressed first.
You might follow a diet that worsens your insulin resistance or inflammation.
You could overlook vascular or oxygenation issues.
You might miss a correctable thyroid or nutrient deficiency.
ReCODE is designed to avoid these risks by ensuring your plan is biologically matched to you.
Reason #6: Testing Creates a Measurable Baseline to Track Improvement
Cognitive decline often unfolds gradually. Without objective markers, it can be hard to see whether things are improving.
Testing allows us to:
Track metabolic changes
Monitor inflammation
Measure hormone optimization
Follow toxin clearance
Evaluate nutrient repletion
Test sleep changes
Monitor cognition with validated tools
This helps us adjust your plan at each step, ensuring measurable, real-world improvement.
Reason #7: Cognitive Symptoms Often Look the Same — Even When the Causes Are Different
Memory loss, confusion, word-finding problems, or difficulty with daily tasks can stem from:
Sleep apnea
Depression or anxiety
Medication side effects
Hormone imbalance
Thyroid dysfunction
Mold exposure
Metabolic syndrome
Chronic infections
Vascular issues
Early Alzheimer’s disease
These conditions look identical on the surface.
Only advanced testing can tell them apart — and direct the right treatment.
Reason #8: Dr. Knape’s Memory-Care Experience Shows What Happens When Testing Is Missed
In over a decade working with individuals with Alzheimer’s and dementia, I’ve seen patients decline faster when:
Sleep disorders were undiagnosed
Toxic exposures went unnoticed
Thyroid or B12 deficiencies were missed
Insulin resistance remained untreated
Chronic infections were overlooked
Vascular disease was unmanaged
Comprehensive testing prevents these oversights and gives patients the best chance for stabilization or improvement.
Reason #9: ReCODE Treats Why Decline Is Happening — and Testing Makes That Possible
ReCODE is built on a simple but powerful truth:
You cannot treat cognitive decline effectively unless you identify its root causes.
Testing reveals those causes.
Personalization makes treatment effective.
Monitoring keeps you safe.
This is why ReCODE uses more testing than conventional medicine — and why it works.
When to Seek Urgent Care
Seek immediate medical attention for:
Sudden confusion
Weakness on one side
Speech difficulty
Severe headache
Vision changes
Chest pain or shortness of breath
These may indicate a neurologic or cardiovascular emergency.
Sources
1. Reversal of Cognitive Decline: A Novel Therapeutic Program
Bredesen DE, 2014
This landmark paper was the first to demonstrate that cognitive decline in Alzheimer’s disease and mild cognitive impairment could be reversed using a comprehensive, personalized therapeutic protocol. It documents case studies showing measurable improvement within months, laying the foundation for what is now known as the ReCODE Protocol.
Read the full article:
https://pubmed.ncbi.nlm.nih.gov/25324467/
2. Precision Medicine Approach to Alzheimer’s Disease
Toups K, Bredesen DE et al., 2022
This clinical trial evaluated the ReCODE/precision-medicine approach in a larger cohort, showing that most participants experienced significant improvements in cognitive testing over 9 months. The study reinforces that targeted, multi-domain interventions can stabilize or reverse early Alzheimer’s disease.
Read the full article:
https://pubmed.ncbi.nlm.nih.gov/36365455/
3. ReCODE: A Personalized, Targeted, Multi-Factorial Therapeutic Program for Reversal of Cognitive Decline
Rao RV, Bredesen DE et al., 2021
This peer-reviewed paper outlines the scientific foundation of the ReCODE Protocol and documents measurable cognitive improvements in individuals with early Alzheimer’s disease and MCI. It highlights how a precision-medicine, multi-factorial approach can stabilize or reverse decline—supporting the idea that improvements often emerge over the first several months of treatment.
Read the full article:
https://pmc.ncbi.nlm.nih.gov/articles/PMC8533598/
4. Sustained Cognitive Improvement in Alzheimer’s Disease and Mild Cognitive Impairment Following a Precision Medicine Protocol
Bredesen DE et al., 2024
This publication presents long-term follow-up data showing that many patients not only improve on the ReCODE Protocol but maintain gains for multiple years. It provides real-world evidence that cognitive benefits can emerge gradually and continue to strengthen with ongoing protocol adherence.
Read the full article:
https://www.mdpi.com/2227-9059/12/8/1776v
5. Reversal of Cognitive Decline: 100 Patients
Bredesen DE et al., 2018
This expanded case-series analysis follows 100 patients treated with the ReCODE Protocol, demonstrating consistent cognitive improvements across multiple subtypes of Alzheimer’s disease and mild cognitive impairment. The paper provides real-world evidence that a personalized, multi-domain therapeutic approach can produce measurable gains in memory, executive function, and daily performance—often within the first several months of intervention.
Read the full article:
https://pubmed.ncbi.nlm.nih.gov/30005175/
Ready to improve your Brain health?
Schedule a Discovery Call with Dr. Knape to explore your personalized options.
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.
