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She diagnosed her own mother. Then found out she might be next.

A retired doctor shares her real APOE4 protocol.

T
· Reviewed by Dr. Kevin Tran, PharmD

Key takeaways · TL;DR

Dr. Gertrude Behan, a retired Australian family physician, diagnosed her own mother with Alzheimer disease, then discovered her own APOE4 status while screening for BRCA during breast cancer treatment. Her response became a do-it-now protocol: exercise, diet, social connection, and a cautious supplement stack including activated folate, B12, vitamin D, and nicotinamide riboside.

Definition

A genetic variant that impairs folate metabolism and can elevate homocysteine, a risk factor for brain and cardiovascular disease.

People with MTHFR variants often benefit from methylated (activated) folate and B12 supplementation rather than standard forms. Dr. Behan brought her homocysteine down using this approach.

Dr. Behans APOE4 Supplement Approach

SupplementReasonStatus
Activated folate plus B12MTHFR variant, lower homocysteineCurrent
Vitamin DAustralian sun-avoidance paradoxCurrent
Nicotinamide ribosideBrain energy, skin cancer preventionCurrent
Microdose lithiumEmerging neuroprotective researchOn radar
RapamycinLongevity and autophagyReserved option

Hi Phoenix friend,

Today in our latest Phoenix Member Story: Dr. Gertrude Behan — "Do It Now"

Phoenix Member Stories areraw conversations with APOE4 carriers who aren't waiting around for a cure.

Every episode, I sit down with a member of our community and dig into what they're actually doing. The wins. The doubts. The stuff nobody talks about.

Full conversation in the Youtube link below.

Today: Dr. Gertrude Behan

She diagnosed her own mother.

Gertrude is a retired family medicine physician from Australia. She spent decades treating patients. Some of them had Alzheimer's.

"I'd seen the effect of Aricept," she told me. "It was really pretty useless, to be blunt."

Then in 2016, she diagnosed her own mother.

"There's a silent screaming inside, isn't there?" she said. "I know that everyone listening would know what I'm talking about. How painful it is."

Her mother is now terminal.

Then she found out she's next in line

Two years later, Gertrude was diagnosed with breast cancer. While searching for the BRCA gene, she stumbled onto something else.

APOE4.

Her first reaction? Not panic. Validation.

"My initial thought was, well, I think these people are on to something. My mother has Alzheimer's. This gene test isn't quackery. They're right."

Then the fear set in.

What changed everything

Gertrude read that certain interventions might buy you 6 to 8 more years of healthy brain function.

That's when it clicked.

"What am I waiting for? If I'm going to do something, I should do it now."

She started exercising more. Connecting with people. Examining her diet. Not waiting for a perfect plan.

"Life is finite no matter which way you look at it. No point waiting. Do it now."

A doctor's (skeptical) approach to supplements

Gertrude doesn't rush into interventions. Especially supplements.

"The person making this supplement is doing it to make money," she said. "There might be contaminants. They might not have the amount that's on the bottle."

She's not anti-supplement. But she needs a reason.

Her current stack:

  • Activated folate and B12 (MTHFR gene variant; brought her homocysteine down)

  • Vitamin D (the Australian paradox: sunny country, everyone avoids the sun)

  • NR (nicotinamide riboside) for brain energy and skin cancer prevention

On her radar:

  • Microdose lithium (tempted by the research, watching closely)

  • Rapamycin (keeping it as an "arrow in her quiver")

Her philosophy: you don't have to do everything now. Keep options in reserve for when you need them.

The wild variant

My favorite moment from our conversation:

"Maybe we should sell APOE4 carriers as the wild variant," Gertrude said. "The tough humans. The people who had to track a mammoth for two weeks, running on ketones."

I loved that.

We're not broken. We're just not built for the modern world.

Watch the full conversation

Gertrude and I talked for almost an hour. We covered caregiving, breast cancer, supplement skepticism, the case for population-wide APOE4 testing, and why she thinks "do it now" is the only strategy that makes sense.

Your turn

If you're a Phoenix member and want to share your story, email me at kevin@thephoenix.community.

And if you're not a member yet?

Gertrude found a place where she can talk through her decisions without wearing out her friends. Where the information is evidence-based. Where she feels optimistic about the future.

You can too.

Talk soon, Kevin

P.S. Gertrude's message to anyone at the "pointy end" (older carriers): "You can't have gotten to this age without some medical or orthopedic issues. Just do what you can. And it's great." Don't let perfect be the enemy of good.

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FAQ

Frequently asked questions.

Who is Dr. Gertrude Behan?
Dr. Gertrude Behan is a retired Australian family medicine physician and Phoenix Community member who shared her APOE4 journey on Phoenix Member Stories. She spent decades treating patients, including many with Alzheimer disease, and formed a firsthand view of how limited current treatments like Aricept are. She diagnosed her own mother with Alzheimer in 2016, then discovered her own APOE4 status two years later during breast cancer screening for BRCA mutations.
How did Dr. Behan discover she has APOE4?
Dr. Behan was diagnosed with breast cancer and began genetic screening to look for the BRCA gene. During that process she stumbled onto her APOE4 status. Her initial reaction was validation rather than panic, because her mothers Alzheimer diagnosis made the genetic link feel credible rather than abstract. The fear came later, followed by the realization that intervention research suggested she could potentially gain 6 to 8 more years of healthy brain function if she acted now.
What supplements does Dr. Behan take for APOE4?
Her current stack is cautious and evidence-driven. She takes activated folate and B12 to address her MTHFR gene variant, which brought her homocysteine down to healthy levels. She supplements vitamin D due to the Australian paradox where sun avoidance leaves many deficient despite a sunny climate. She also takes nicotinamide riboside (NR) for brain energy and skin cancer prevention. She keeps microdose lithium and rapamycin on her radar as future options rather than using them now.
What is the do-it-now APOE4 philosophy?
Dr. Behans guiding principle is to start interventions now rather than waiting for a perfect plan or a cure. After reading that certain interventions might buy 6 to 8 additional years of healthy brain function, she increased her exercise, reinforced social connections, and examined her diet without waiting. Her mantra: life is finite, there is no point waiting, do it now. For older APOE4 carriers at the pointy end, she adds: do not let perfect be the enemy of good, just do what you can.
Why does Dr. Behan call APOE4 the wild variant?
In her Phoenix conversation, Dr. Behan reframed APOE4 not as a defective gene but as the wild variant, calling carriers the tough humans who had to track a mammoth for two weeks running on ketones. The framing captures a popular hypothesis that APOE4 was evolutionarily advantageous for hunter-gatherer lifestyles with high physical activity, fasting, and low modern stressors. Carriers are not broken, they are built for an environment that no longer exists, which is why lifestyle design matters so much.
What changed everything
Gertrude read that certain interventions might buy you 6 to 8 more years of healthy brain function. That's when it clicked. "What am I waiting for? If I'm going to do something, I should do it now." She started exercising more. Connecting with people. Examining her diet. Not waiting for a perfect plan. "Life is finite no matter which way you look at it. No point waiting. Do it now."
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