I’ve Just Found I Have the APOE4 Gene… What does this mean?
A Naturopath’s Guide to Staying Symptom-Free for Life
Naturopath Jennifer Harrington explains why discovering your APOE status is not a diagnosis, but an opportunity.
There’s a moment that many people remember clearly.
You weren’t looking for it.
You weren’t experiencing symptoms.
You may have been doing a genetic test, exploring your health data, or simply being curious.
And then it appears. APOE4.
It often lands heavily because APOE4 has become closely associated with Alzheimer’s disease.
But here’s the truth to really understand:
Having the APOE4 gene does not mean you will develop dementia.
And equally important…
Many people develop dementia without carrying APOE4 at all.
This is not a diagnosis. It’s a risk factor.
And in clinical practice, a risk factor is something to work with to optimise preventative healthcare.
APOE4 Is About Risk, Not Destiny
The APOE4 gene plays a role in lipid transport, inflammation and brain repair. It can be associated with an increased risk of neurodegenerative conditions.
But risk is not certainty.
It’s not simply about whether you carry the gene... it’s about whether your environment and biology activate it.
This is where the work of Dale Bredesen becomes so important. He describes cognitive decline not as a single disease, but as a protective response to multiple stressors—metabolic, inflammatory, toxic, infectious and more.
In other words:
The brain doesn’t “fail” randomly.
It responds to imbalance.
Hence we want to identify and reduce those imbalances and thus influence the trajectory.
You Can Live Your Entire Life Without “Switching On” This Gene
From a functional and naturopathic perspective, genes are not fixed outcomes.
They are instructions and those instructions are dictated by your internal environment.
This is the essence of epigenetics.
You may carry APOE4…
but whether it expresses is shaped by:
lifestyle factors
metabolic health
inflammation
toxic exposure
The Real Question Isn’t “Do I Have the Gene?”
It’s “What Is My Current Terrain?”
At Mito Core, we always come back to one principle:
You can’t personalise a plan without a baseline.
If you’ve discovered you carry APOE4, the next step isn’t panic.
It’s precision.
Because cognitive risk is not driven by one factor, it’s influenced by a network of interconnected systems.
Key Areas to Consider/Test for and Optimise
Rather than chasing a single cause, we look at the terrain as a whole.
1. Metabolic Health & Blood Sugar Regulation
Insulin resistance is one of the strongest drivers of cognitive decline.
The brain is highly energy-dependent and when glucose metabolism becomes impaired, the brain struggles.
2. Inflammation & Immune Activation
Chronic, low-grade inflammation is often silent but drives neuroinflammation.
This may be influenced by diet, stress, gut health, infections and environmental triggers.
3. Infections & Microbial Load
Research tells us certain infections may play a role in cognitive decline. This includes viral, bacterial and oral pathogens but also more persistent, harder-to-detect organisms such as spirochetes.
Spirochetes (including those associated with Lyme disease and certain oral infections) have been identified in brain tissue in some neurodegenerative conditions. These organisms:
trigger chronic immune activation
contribute to inflammation
disrupt normal neuronal function
From a functional perspective, the brain may be responding defensively to these microbial threats.
4. Dental & Oral Health
Is critically important, one not to overlook. The mouth is not separate from the brain; chronic gum disease and oral infections contribute to systemic inflammation.
5. Toxic Load & Environmental Exposure
This includes:
Heavy metals (especially excess iron, mercury and lead)
Mould exposure and mycotoxin burden
Chemicals and pollutants
Electromagnetic field (EMF) exposure
These factors can disrupt mitochondrial function and increase oxidative stress over time.
6. Nutritional Status
The brain requires specific nutrients to function and repair.
We aim to assess:
B vitamins
Omega-3 fatty acids
Antioxidants
Minerals
Deficiencies and imbalances can impair neuronal function and resilience.
7. Gut Health & Microbiome
The gut and brain are deeply connected.
Imbalances in the microbiome influence inflammation, mood, cognition and immune function.
8. Sleep Quality (Including Sleep Apnoea Risk)
During sleep is when the brain clears waste products via the glymphatic system.
But it’s not just about how long you sleep, it’s about how well you breathe during sleep.
Sleep apnoea is a major often undiagnosed contributor to cognitive decline.
Repeated drops in oxygen overnight can:
impair brain repair
increase oxidative stress
disrupt memory consolidation
drive vascular and metabolic dysfunction
If there is snoring, waking unrefreshed or daytime sleepiness, this should be investigated.
9. Movement, Exercise & Vascular Health
We all know exercise is essential as it supports:
blood flow to the brain
mitochondrial function
insulin sensitivity
neuroplasticity
But we also need to consider vascular integrity more broadly.
Compromised blood flow, whether through endothelial dysfunction, hypertension or microvascular changes, can significantly impact brain health over time.
10. Sunlight & Circadian Rhythm
Natural light exposure regulates:
sleep-wake cycles
hormone balance
mitochondrial signalling
Disruption to circadian rhythm is a massive driver of metabolic and neurological dysfunction.
11. Hormonal Balance
Hormones play a direct role in brain function and resilience.
Imbalances whether related to stress hormones, thyroid function or sex hormones would impact:
memory
mood
sleep
neuroprotection
12. Social Connection & Cognitive Engagement
The brain thrives on stimulation and connection.
Isolation is a very large risk factor. Engagement with people is highly protective.
13. Sensory Health (Vision, Hearing, Smell & Taste)
Sensory input plays a far greater role in brain health than most people realise.
Declines in vision and hearing are already well established as risk factors for cognitive decline but changes in smell and taste are also important early indicators.
The olfactory system (sense of smell) has a direct connection to brain regions involved in memory and cognition. A reduced or altered sense of smell may reflect early neurological changes, sometimes years before other symptoms appear.
Taste is closely linked and can be influenced by neurological function, nutrient status and overall metabolic health.
Supporting sensory health, and investigating changes early, can provide valuable insight into brain function and may offer an important opportunity for early intervention.
14. Head Trauma & Concussions
Even mild head injuries can contribute to long-term neurological risk.
This is an area that should never be overlooked.
15. Stress & Emotional Load
Chronic stress alters brain structure and function over time.
Finding the varied ways to regulate the nervous system is foundational. Finding ways to create joy and emotional expression is essential.
16. Trophic Support & Brain Repair Capacity
Your brain relies on trophic factors, chemical messengers that support:
neuron survival
synaptic connections
repair and regeneration
When trophic support is reduced (due to hormonal decline, inflammation, poor nutrition, stress or metabolic dysfunction), the brain shifts into a more defensive, energy-conserving state.
What Most People Get Wrong
When people discover APOE4, they often look for:
the ‘best’ supplement
the ‘best’ diet
a quick “fix”
The truth is, cognitive health has to be built on creating an internal environment where the brain can function, repair and thrive!
This Is Not a LIfe Sentence, It’s a Window of Opportunity
Discovering your APOE status, especially before symptoms, can be one of the most valuable insights into your future health. Because prevention is where the greatest impact lies.
You have time.
You have influence.
You have the ability to shift your trajectory.
Looking Ahead
At Mito Core, we help you uncover your unique risk factors and potential triggers. By identifying and addressing these, we can work with your biology to help minimise the likelihood of this gene being expressed.
In our next 2 articles, we’ll explore what to do if symptoms are already present, and how the advanced technologies at Mito Core may support brain function, resilience, and recovery.