Discovering my APOE4/4 Alzheimer's genetic markers could have destroyed me. Instead, it became the deepest inner work of my life—teaching me to face fear, release control, and live fully present while protecting my brain health. Yes, I have a substantially higher risk of getting Alzheimer's Disease but knowing this has transformed my fear into purpose, reminding me that genetics may load the gun, but lifestyle pulls the trigger.

The Moment That Changed Everything

I remember exactly where I was when I found out—alone in a bathroom in Hawaii, scrolling through my 23andMe results, completely unprepared for what I was about to see. As someone who has always considered herself an eternal optimist, I was 100% certain I wouldn't carry the APOE4 genetic variant that increases Alzheimer's risk.

After all, my mother's vascular dementia seemed explainable: the chemotherapy that had aged her brain, her vascular issues, her significant (unhealed) childhood trauma.

And yet there it was on my screen:

🫣 APOE4/4 😱

Two copies of the "high-risk" allele.

I stepped into the shower and collapsed in tears. Though I didn't know the exact numbers at the time, I knew this was a big deal.

Later, I would learn that while the average person has about a 9% chance of developing Alzheimer's by age 85, my genetic profile pushed that risk to somewhere between 50-90%, according to several robust scientific studies.

The landmark research from the Fundació ACE in Barcelona (2019) found that APOE ε4/ε4 carriers like me have approximately a 51-68% lifetime risk of developing Alzheimer's by age 85. Another important Spanish study (2024) by Juan Fortea and Victor Montal at the Biomedical Research Institute of Sant Pau, published in Nature Medicine, found that 95% of APOE ε4 homozygotes (carry two of the ε4 alleles, aka APOE4/4) developed signs of Alzheimer's Disease in their brain or body fluids. And those physical signs were evident, on average, nearly 20 years before an Alzheimer's diagnosis. Also of note is that not everyone with two copies of APOE4 had other clinical symptoms, which usually are the trigger for an Alzheimer's diagnosis, like severe memory, mood, and thinking problems. In other words, most APOE ε4/ε4 carriers will develop signs of AD in their brain and blood but that may never manifest into actual symptomatic disease.

But in that vulnerable moment, something profound was also born—a fierce determination that would transform my relationship with health forever.

The Shadow Work of Facing My Mortality

That moment in the shower wasn't just about receiving medical information—it was about meeting the shadow I'd been avoiding my entire adult life.

The part of me that watched my mother disappear into dementia had made a silent, terrified vow: "Not me. Never me. I'll be different. I'll be smarter. I'll be more careful."

But there it was on the screen: APOE4/4. Evidence that I might not be able to think or control my way out of this fate.

This is what shadow work really looks like—not the Instagram version where we journal about our "dark side," but the raw, devastating moment when life forces us to look directly at what terrifies us most.

My ego wanted to collapse into victimhood: "This is unfair. Why me?"

But somewhere deeper, my soul whispered something different: "This is your invitation. What will you do with this information? Who will you become because of it?"

A new level of personal transformation began right there, in that shower in Hawaii—the work of transforming genetic fear into intentional living, of releasing the illusion of control while reclaiming the power I actually have.

This Knowledge Isn't Just Power—It's Liberation

Discovering my APOE4 genetic status transformed my fear into purpose, reminding me that genetics may load the gun, but lifestyle pulls the trigger.

My journey shows that facing genetic realities head-on can inspire us to rewrite our health destiny through intentional living and health empowerment.

Understanding the APOE Gene

The APOE gene (short for Apolipoprotein E) contains instructions for making a protein that helps carry cholesterol and other types of fat in your bloodstream. Think of it as a delivery service for fats throughout your body, especially to your brain where fat is needed for normal function.

APOE comes in three common variants (called alleles):

APOE2: The "protective" version. It's associated with lower risk of Alzheimer's disease and generally helps with cholesterol balance.

APOE3: The "neutral" version. This is the most common variant in the population and is considered the baseline for risk assessment.

APOE4: The "higher-risk" version. It's associated with increased risk of Alzheimer's disease and may cause the body to handle fats and inflammation differently.

You inherit one APOE allele from each parent, creating six possible combinations.

With my double APOE4 status, I inherited the higher-risk variant from both parents.

Having one or especially two copies of APOE4 increases your risk of developing Alzheimer's, though it's important to understand that:

• Many people with APOE4 never develop Alzheimer's

• Many people without APOE4 do develop Alzheimer's

• The APOE4 variant affects more than just brain health—it can influence cardiovascular health, inflammation, and how your body responds to different diets and lifestyle factors

The APOE gene isn't just about disease risk—it represents one piece of your genetic makeup that, when understood, can help guide personalized medicine and preventive health approaches.

Why I Chose to Know

People often ask why I wanted this information. Wouldn't ignorance be bliss? My husband, for instance, has no interest in knowing his genetic status.

For me, the answer is simple: I refuse to be owned by fear or uncertainty.

Actually, I refuse to be owned by anything or anyone ;)

Knowledge allows me to take action.

Information becomes empowering when coupled with agency.

Ego/Fear vs. Soul/Wisdom: Two Different Responses to Genetic Risk

Here's what I've learned about facing a high genetic risk for cognitive decline: your ego and your soul will have very different responses—and both need to be honored.

My ego's response was immediate and intense:

• Hypervigilance about every health choice

• Obsession over data points, supplements, and research

• The belief that if I just do everything perfectly, I can control the outcome

• Fear that any "slip-up" is a step toward inevitable decline

• Anxiety about the future stealing joy from the present

My soul's response emerged more slowly:

• Deep gratitude for the wake-up call while I'm still healthy

• Recognition that I'm being invited to live MORE fully, not less

• Understanding that true brain health includes joy, connection, and presence—not just protocols

• Trust that I can handle uncertainty without needing guarantees

• Freedom to make empowered choices without perfectionism

The real inner work has been learning to let my soul lead while my ego provides useful information—not the other way around.

This is the edge work I walk, sometimes moment-to-moment: staying present with both the genetic reality AND the full aliveness of this moment. Not living in future fear. Not pretending the risk doesn't exist. But finding the middle path where wisdom and presence meet.

Turning Genetic Knowledge Into Health Empowerment

When the initial shock subsided, I realized this information has given me a precious gift—motivation to (really) prioritize my health and how I want to age.

After witnessing my mother's 15-year journey with dementia, including the devastating psychosis that developed in her final years, I felt empowered to build a personalized roadmap to, hopefully, avoid that path through dementia prevention strategies and brain longevity practices.

Full disclosure, walking this path of health optimization hasn't been without its ups and downs…progress and setbacks. And some of the lifestyle changes I've implemented over the past five years initially felt like sacrifices.

I've often grappled with the internal conflict around "I just want to live my life now" and "what's best for my long term health?"

And some changes, like reducing carbs and sugar, felt too hard to bear—so I didn't start with those.

But by picking the "low-hanging fruit," and allowing myself to take small incremental steps, these lifestyle medicine practices have built upon each other.

They've become investments in a future I'm actively creating through intentional aging.

The Unexpected Gift

The most surprising aspect of this journey has been realizing that everything beneficial for brain health supports overall wellness and well-being.

There's virtually nothing on my list of brain-protective strategies that doesn't also benefit heart health, metabolic function, inflammation levels, and general vitality.

At 54, I feel more vibrant and connected to my body than ever before.

I don't strive for perfection—I still enjoy ice cream dates with my husband, popcorn when I (rarely) go to the movies, homemade birthday cake, dark chocolate, and other random indulgences.

In fact, creating a healthier baseline has given me more resilience and flexibility for occasional splurges without the guilt or harm.

I'm always learning and incorporating new healthy habits.

And sometimes, I fall right off the tracks, crash and burn, and have to find my way back.

I'm a messy human, after all.

As the poet Mary Oliver asked,

"What is it you plan to do with your one wild and precious life?"

My APOE4 status has become a daily reminder of the preciousness of my life—which means I neither live for the future, nor do I only live for this moment.

The Inner Work of Presence: Living Between Now and Later

One of the most profound challenges of knowing my APOE4 status has been learning to hold two seemingly contradictory truths:

Truth #1: I need to take my brain longevity and cognitive health seriously and make choices today that support brain health for decades to come.

Truth #2: I refuse to sacrifice the aliveness and joy of this present moment for a future that may never come.

This tension—between planning for later and living fully now—has required deep inner work around control, trust, and what it means to be truly alive.

There's a younger part of me—maybe she's 15, watching my mother's first memory slips—who believes that if she just tries hard enough, controls enough variables, and never relaxes her vigilance, she can prevent the terrifying future she witnessed.

I've had to tenderly hold that part of myself and say: "Yes, we're going to take excellent care of our brain. We're going to make nourishing choices. And also—we're not going to let fear steal our life. We're not going to live in the prison of what might happen."

This is what I mean by intentional living—not living in denial, but not living in fear either.

It's choosing the salmon over the pasta because it supports my cognitive health, AND choosing the birthday cake with my family because connection and joy are also brain-protective.

It's doing the research, implementing the strategies, tracking my progress—AND releasing my grip on outcomes I can't control.

The deepest truth I've discovered: The lifestyle changes that protect my brain also require me to be more present, more connected to my body, more tuned in to what truly nourishes me.

In other words, preventing cognitive decline and living soul-led aren't separate paths—they're the same journey of personal growth and self-discovery.

Your Genetic Journey

If you've recently received results that concern you, please know you're not alone.

If you carry one or two APOE4 alleles, understanding your genetic landscape is just the beginning of the story—not the conclusion.

As a brain longevity coach and founder of Brain Health Horizons, I've created special coaching sessions specifically designed to help people navigate these complex emotions and transform them into actionable power through emotional resilience and health empowerment.

The good news is that the science continues to evolve. We know more than ever about genetic risk factors and modifiable risk factors.

Global meta-analyses like the one by Genin et al. (2011) found E4/E4 carriers had a 60.1% risk by age 85 for women and 51.4% for men. These numbers align with the Farrer et al. meta-analysis, which reported a 52.9% risk by age 85 for E4/E4 carriers.

While these statistics might seem frightening, they also reveal that many people with APOE4/4 never develop Alzheimer's—proof that our genes aren't our destiny.

And as we learn more, we'll likely discover that addressing the proven modifiable risk factors can prevent or delay nearly half the dementia cases worldwide, as the 2024 Lancet Study suggests.

Moving Forward with Purpose: The Inner and Outer Work

Genetics may provide probabilities, but lifestyle creates possibilities—and inner work creates resilience for the journey.

The choices we make today are investments in who we'll be tomorrow. But those choices become sustainable only when they emerge from empowerment rather than fear, from self-trust rather than perfectionism.

If you're wondering whether to pursue genetic testing for Alzheimer's risk or other cognitive decline factors, ask yourself:

» "Would this information motivate positive changes in my dementia prevention strategies?"

» "Would it help me prioritize brain health and cognitive health in a way I currently struggle to justify?"

» "Am I prepared to do the inner work of holding both the information and my emotional response to it?"

» "Can I use this knowledge for health empowerment without letting fear run my life?"

If the answer is yes, knowledge might be your most powerful medicine for brain longevity.

If you know you're the kind of person who might spiral into anxiety or become obsessively controlling with this information, respect that about yourself. Emotional resilience matters as much as genetic information.

This is a deeply personal choice that only you can make.

And here's my invitation: Whether you choose genetic testing or not, consider making these preventive health and lifestyle changes anyway. The practices that support cognitive health—quality sleep, stress management, movement, nutrition, meaningful connection—benefit every aspect of wellness and intentional aging.

They help you live more fully right now, regardless of what your genetic risk factors might be.

What This Journey Taught Me About Control, Trust, and Being Fully Alive

Five years into this journey of living with APOE4/4, here's what I know for certain:

I cannot control whether I develop Alzheimer's disease. No amount of optimization, supplementation, or health obsession can guarantee a particular outcome.

AND—I have more agency than I initially believed. The research on modifiable risk factors and lifestyle medicine gives me real power to influence my trajectory.

Both of these statements are true. Holding them simultaneously is the work.

This genetic knowledge forced me to grow edges I didn't know I needed:

The edge of facing mortality without falling into despair

The edge of taking action without becoming obsessive

The edge of living presently while planning wisely

The edge of trusting myself to handle uncertainty

The edge of releasing outcomes while still doing the work

This is what personal transformation looks like in real life—not a dramatic before-and-after, but a daily practice of choosing empowerment over victimhood, presence over fear, trust over control.

My mother's journey with dementia was devastating. And it also became my greatest teacher.

Because of her, I'm doing the inner work and the outer work simultaneously—healing my relationship with control, building genuine health optimization practices, learning to be present with uncertainty, and discovering that true wellness isn't about preventing death.

It's about being fully alive while we're here.

My APOE4 status has become a daily reminder to ask myself how I want to spend precious moments—not someday, but now.

Not by living recklessly or in denial.

But by living intentionally, presently, soulfully—with both wisdom and wonder.

Life remains beautifully uncertain, regardless of our genetic makeup.

The gift lies not in changing what we can't control, but in embracing what we can—our daily choices, our mindset, and our unwavering belief that we are more than the sum of our genes.

Resources

If you're interested in learning more about APOE4 and brain health, these resources may be helpful:

• Alzheimer's Association - APOE Gene and Alzheimer's: Trusted information about genetic risk factors

• ApoE4.Info: Community support specifically for APOE4 carriers

• The Bredesen Protocol (ReCODE): Dr. Dale Bredesen's approach to cognitive decline

• National Institute on Aging - Alzheimer's Disease Genetics Fact Sheet: Detailed government resource on genetic factors

• Meta-Analysis on APOE and Alzheimer's Disease: Scientific paper showing risk percentages for different APOE genotypes

Your Roadmap for From Fear-Led to Soul-Led Living

If you're resonating with this—if you're facing genetic realities, health fears, or the weight of uncertainty about your future—The Whole Soul Way™ was created specifically for this journey.

This comprehensive foundational course (available free on my ELATE podcast on YouTube and podcast channels) guides you through 39 transformative lessons that help you navigate not just genetic information, but the profound inner work of living empowered in the face of uncertainty.

You'll learn how to:

• Reduce stress and regulate your nervous system so anxiety about your health doesn't hijack your present moment—essential for both brain health and emotional well-being

• Practice self-leadership around medical fears and choices by distinguishing between ego-driven panic and soul-led wisdom, allowing you to make empowered health decisions from a grounded place

• Heal the past patterns and childhood wounds that shape how you respond to scary information—transforming victim consciousness into authentic agency

• Release the illusion of control while reclaiming the power you actually have—learning to hold both the uncertainty and your capacity to influence outcomes

• Integrate shadow work practices that help you face mortality, fear, and vulnerability without falling apart or numbing out

• Shift from hypervigilance to presence so you can protect your health without letting health obsession steal your aliveness

• Build internal safety and self-trust so you can handle whatever comes—whether it's challenging test results, difficult health decisions, or an uncertain future

This isn't about denying genetic realities or pretending everything will be fine. It's about doing the deep inner work that allows you to face hard truths, make wise choices, and live fully—regardless of what your genes say might happen.

Because here's what I know for certain: You are not owned by your genetics. You are not defined by your risk factors. And you are far more resilient than you think.

The Whole Soul Way™ gives you the tools to prove this to yourself—not through positive thinking or spiritual bypassing, but through genuine transformation that integrates both the wisdom of your body and the truth of your soul.

So much awaits you on this adventure toward becoming the woman who can hold both genetic reality and radical aliveness—who can honor her health AND her joy, her wisdom AND her wonder.

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What would you do differently today if you knew your aliveness mattered more than your longevity? Share in the comments below.