Muhammad Ali has it. Michael J. Fox has it. It’s painful to see strong, beautiful people we admire dealing with tremors, slurred speech, and coordination problems. It’s even more painful to watch a family member struggle to cope with the symptoms of Parkinson’s disease, or to get such a diagnosis ourselves.
An estimated 1.5 million Americans have Parkinson’s disease, according to the National Parkinson Foundation. What exactly is it? Where does it come from?
Deep inside the brain is a region known as the substantia nigra. In people with Parkinson’s, the nerve cells inside the substantia nigra stop producing dopamine, an important chemical that coordinates muscular movement. If you think of dopamine as the symphony conductor and your hundreds of muscles as the musicians in the orchestra, you’ll get a clear picture of what this dopamine-conductor does.
When the muscles work in harmony, you can do all the daily tasks that most people simply take for granted—walking, talking, lifting a fork to your mouth, buttoning your jacket. But when the dopamine-conductor isn’t there to help the muscles coordinate their efforts, you get the classic symptoms of Parkinson’s. Everything that used to be automatic becomes difficult—everything from maintaining balance to carrying on a conversation to enjoying a simple meal.
The disease is progressive. That is, over time it tends to get worse. Medical researchers don’t yet know what causes it, and they don’t yet know how to stop it in its tracks. But they do know a lot about how to deal with symptoms and possibly slow the progression of the disease.
A good percentage of people who have Parkinson’s take levodopa (Sinemet, Atamet), a medication that helps the brain produce dopamine. Doctors are well aware that levodopa is more effective in controlling symptoms for the first few years it’s used. After that, unfortunately, it’s simply not as effective.
Is there anything that someone with Parkinson’s can do in terms of nutrients to make life easier and deal with health conditions related to the disease? The answer is a great big yes, says Laurie Mischley, ND, a naturopathic physician in private practice in Seattle who specializes in natural therapies for neurological diseases, such as multiple sclerosis and Parkinson’s. There are a number of dietary changes and specific nutrients that may prove helpful, she says. But before we look at those, there’s one nutrient that science is pointing to as a potentially life-changing therapy for the disease—the powerful antioxidant coenzyme Q10.
Coenzyme Q10 is not only “absolutely safe,” but the study that revealed its potential as a therapy for Parkinson’s is “historically significant,” says Dr. Mischley.
She’s referring to a scientific study led by the late Clifford Shults, MD, who was a professor of neurosciences at the University of California, San Diego. Dr. Shults and his colleagues looked into whether high doses of coenzyme Q10 were safe and whether it could slow the progression of the disease. The study found that high doses of coenzyme Q10 do, indeed, appear to be safe. What’s more, of the 80 people in the study, those who were taking the highest dose—1,200 milligrams daily—experienced a 44 percent reduction in the day-to-day symptoms of the disease, such as difficulty being able to feed or dress themselves.
Coenzyme Q10 is an antioxidant that plays a key role in the body’s energy production system. The mitochondria in the body’s cells act like little energy factories, and they need coenzyme Q10 in order to carry out their work.
The study was published back in 2002. Dr. Shults and his colleagues concluded at the time that more research is needed before this dietary supplement can be widely used as a treatment.
Some doctors, however, including Dr. Mischley, are already using this therapy with their Parkinson’s patients. “I definitely recommend high doses of coenzyme Q10,” she says.
The supplement is expensive, approximately $300 a month for such high amounts, and it’s difficult to take that much at a time, she says. Dr. Mischley has her patients take 1,200 milligrams daily in wafer form, a product that melts in the mouth, and she believes she is seeing positive results.
If you’d like to try coenzyme Q10 therapy, do be aware that it is still considered experimental and is not yet approved as a treatment for Parkinson’s. That doesn’t mean that it doesn’t work. It simply means that more research needs to be done before many mainstream doctors are willing to give it a thumbs-up. If you want to try it, do not undertake the therapy on your own. Consult with your doctor about whether high doses of coenzyme Q10 might be appropriate for you, and do make sure your doctor is on board and monitoring your response to the therapy. (If your doctor wants to look at the study, it was published in the Archives of Neurology in 2002 and is available online.)
Beyond the rising star of coenzyme Q10, there are several more tested and accepted dietary strategies that are helpful.
Keep things moving.“Constipation predates Parkinson’s disease,” says Dr. Mischley. People who get Parkinson’s often experience bouts of constipation before the disease is diagnosed. And it continues to be a problem as the disease progresses. Further, possible side effects of the medication levodopa include nausea and constipation.
Levodopa also competes with amino acids to get absorbed into the body. Amino acids are the building blocks of protein. This means that you can’t take levodopa at the same time that you have, say, a steak dinner. So lots of people with Parkinson’s tend to veer towards high-carbohydrate meals, says Dr. Mischley. Instead of pasta and potatoes, they should be looking more towards high-fiber foods—fruits, vegetables, and legumes. If you have Parkinson’s, you need lots of fiber to keep constipation at bay. Here’s one case where an apple (or more!) a day makes good sense. Oatmeal is also a good choice to help with both constipation and nausea, says Dr. Mischley.
Watch protein and fats. Because protein meals interfere with levodopa, people with Parkinson’s may sometimes cut back too far on their protein. Fish and poultry are good choices, and need to be scheduled so they don’t compete with levodopa, says Dr. Mischley. Fish is an especially good choice because it supplies healthy kinds of fat—omega-3 fatty acids—that are helpful to people with Parkinson’s.
Do discuss protein with your doctor. In some cases in which responses to levodopa fluctuate, doctors suggest low-protein diets.
For this reason, Dr. Mischley suggests keeping dairy products to a minimum.
Along with following a low-protein diet and eating lots of fiber, there are several nutrients that may be helpful for those with Parkinson’s.
“Free radicals are associated with the initiation and development of Parkinson’s disease,” says Dr. Mischley. Free radicals are naturally occurring molecules that damage the body. Excess free radicals apparently play an as-yet little understood role in the disease. It would be logical to theorize that supplements of antioxidants, such as vitamin C and vitamin E, might be helpful, but so far research has not borne that out.
“Antioxidant studies don’t show good results,” says Dr. Mischley.
A couple of small studies have shown modest benefit from vitamin E. And some population studies have shown that dietary intake of vitamin E, particularly from nuts, helps protect against getting Parkinson’s disease in the first place.
Your best bet at this point, says Dr. Mischley, is to make sure that your diet is rich in antioxidants. The best way to do that is to make sure you have lots of color on your plate—green, yellow, orange, and blue fruits and vegetables. Get acquainted with the delightful taste of pomegranate juice and blueberry juice. Green tea is also a good choice.
There are many antioxidants in foods besides vitamins E and C, Dr. Mischley explains. Researchers don’t yet know which ones might be beneficial for Parkinson’s, but in the meantime, all of them mop up free radicals and are good for your health.
The medication levodopa depletes the body’s stores of folic acid, and low levels of folic acid are associated with a more rapid course for the disease, says Dr. Mischley. Other helpful B vitamins include vitamin B12 and vitamin B6. All three B vitamins help keep homocysteine levels down, she explains. Homocysteine is an inflammatory substance that the body produces.
“Both low folic acid and high homocysteine have been associated with Parkinson’s,” says Dr. Mischley. She recommends a daily supplement that includes 400 micrograms of folic acid, 15 milligrams of B6, and 300 micrograms of B12. With her own patients, she uses Homocystrol, a product that is available only through a health-care practitioner and contains precisely this formula along with some other helpful ingredients.
If you have Parkinson’s, you need to keep your iron levels down, says Dr. Mischley. This is yet another reason to avoid red meat, she says. And if you take a multivitamin, make sure that it does not contain iron. The formulas for seniors generally don’t have iron, but do check the label to be sure.
Anyone with Parkinson’s disease should be under the care of a physician. Discuss any supplements you wish to take with your doctor. In addition, do what you can to keep your iron intake down. This means avoiding red meat and making sure that if you take a multivitamin, it does not contain iron.
Antioxidants |
Get from foods by eating a variety of colorful fruits and vegetables |
Coenzyme Q10* |
1,200 milligrams |
Folic acid |
400 micrograms |
Omega-3 fatty acids |
Eat fatty fish (salmon, tuna) a couple of times a week. |
Vitamin B6 |
15 milligrams |
Vitamin B12 |
300 micrograms |
*This is a tremendously high dose for coenzyme Q10. Consult with your doctor before trying this experimental treatment.