Although he attempted a comeback, Michael J. Fox, the television and film actor, has had his career cut short by Parkinson’s disease. He seemed to be a young, healthy, happy, and active person. How could this have happened to him? It raises all kinds of questions as to what Parkinson’s disease is and how we can prevent it. He is devoting his life now to raising awareness of Parkinson’s disease.
Dr. Michael Wald describes the condition, also known as PD: “It is characterized by tremors and muscular tightness and problems with posture and reflexes. It is one of the most frequently encountered disorders and is a predominant cause of disability in those older than fifty years of age. Its prevalence is estimated at one million to two million cases in the United States, and the incidence increases with age. There are different types of Parkinson’s, primary and secondary.
“Particular to PD is a loss of cells in the area of the brain known as the substantia nigra, locus cerleus, and substantia innominata, and a formation of abnormal bodies called Lewy bodies. Basically we don’t know the cause, but the most likely mechanism of the cellular damage is oxidation by toxic free radicals. In particular, this oxidation might break down a certain amino acid we need for normal health and normal motor function that leads to dopamine depletion.
“Someone with PD has what is called a ‘resting’ tremor or ‘pill-rolling’ tremor, as if they were rolling something between their thumb and their first finger and their hands are moving. During sleep it fades away. If you try to move their arms and legs, the muscles are very rigid, called ‘lead pipe’ rigidity, and the muscles move with a ‘cogwheel phenomenon.’ These individuals walk very slowly and often shoot forward and fall down and hurt themselves because their motor function is skewed. Infrequency of blinking is one of the early signs and a loss of overall facial expression, a loss of voice volume, with a poverty of body movement. Reflexes are diminished.”
This lack of movement is called bradykinesia, and the shuffling gait with poor arm swing is very characteristic of Parkinson’s patients. One key is that the incessant tremor disappears with intentional movement and then returns as soon as the arm is at rest. There is also a very strong association between PD and depression and eventual dementia.
These clinical signs are due to the nerves in the brain starting to degenerate and are a strong clue in the diagnosis. MRIs sometimes show atrophy, or wasting, in advanced cases, but mostly the CT scan and MRIs of the brain do not show anything. The diagnosis is usually made based on the clinical picture.
Parkinson’s is mostly a disease of the elderly, but it can sometimes be seen in younger people, such as Michael J. Fox. Younger people tend to develop the motor and muscle problems first. In the older population there is a much higher incidence of dementia. Other kinds of dementias can also have features that look like Parkinson’s disease, and many times there is an overlap of different causes for the dementia.
As mentioned above, signs and symptoms of Parkinson’s include shaking (tremors), stiffness and rigid limbs (generally asymmetric), extremely slow movement (bradykinesia), and impaired postural reflexes (extended arm tremor or trouble with handwriting). When two of these symptoms are present, it is probable that the patient is suffering from Parkinson’s. When three or more symptoms are evident, the patient is positively considered to have Parkinson’s disease.
Frequently, tremor of a hand or a leg, particularly when the person is resting, is the first indication of Parkinson’s disease. The tremor often begins on one side of the body (asymmetric). Eventually, a person’s voluntary movements become increasingly difficult. For example, a once-simple task such as walking becomes stiffer and slower. This is followed by speech difficulties (speaking in a hushed tone). Then the face becomes expressionless because of increased muscular rigidity. Because the person cannot control his or her facial muscles, there is often drooling. There may also be numbing of the hands and feet. Also, the person’s handwriting becomes small (known as micrographia) and is illegible. Although the person’s thinking processes remain normal, they are stuck inside a debilitated body. For this reason, as symptoms worsen, a great depression may set in and lead to a shortened lifespan.
The cause is unknown, but there is a lot of speculation. A current theory is that PD may be caused by a toxic environmental agent or chemical compound. This is because there were reports of greater prevalence in rural areas. The herbicide Parquat is a likely culprit. Dieldrin and DDT have also been implicated. Another study by Scheider and colleagues in 1997 found that the antioxidant lycopene (found primarily in tomatoes and related products) was not associated with higher PD risk, but intake of sweet foods, including fruit, was. They theorized that pesticide residues in the fruits and vegetables may have contributed to the development of PD.
“There have been a number of studies of pesticides and insecticides,” Dr. Wald says. “If you are genetically susceptible and are exposed to toxins in the soil or air, they can break down or oxidize the dopamine. In the Journal of Neurology they reported causing PD with pesticides, and they were able to reverse it. It is our liver that detoxifies toxins. They also say that ongoing exposure to manganese and copper of greater than twenty years will cause PD. A diet higher in monoand disaccharides, the simple sugars, is associated with a higher risk of PD.”
Dr. Jay Lombard, a neurologist who blends traditional and complementary medical approaches, has seen and treated many Parkinson’s patients. He has this to add about the causes of Parkinson’s: “Environmental toxins have been implicated in the etiology of Parkinson’s disease, particularly pesticides. It appears that patients who have Parkinson’s disease have an inability to detoxify these very common pesticides found in the environment because they lack a particular enzyme.”
It is also known that certain drugs can cause a reversible form of PD. These drugs are the phenothiazines and butyrophenones, drugs that affect the central nervous system. Carbon monoxide poisoning has been known to induce a Parkinsonism.
There is widespread belief that Parkinson’s is caused at least partially by a deficiency of dopamine, as well as free radical damage.
Parkinson’s is generally managed with drugs, physical therapy, and surgical interventions. As of now, we do not have a way to prevent the loss of nerve cells that produce dopamine or to restore those that have already been lost. Thus, effective treatment of Parkinson’s would seem to rest on the ability to halt the damage to, and death of, the nerve cells that manufacture dopamine. In fact, many individuals suffering from Parkinson’s are prescribed the drug levodopa (L-dopa), which can be converted into dopamine in the brain. Levodopa is often used in combination with other drugs that appear to have protective effects on brain cells. Treatment with these drugs, however, does not completely alleviate the symptoms of Parkinson’s, although the disease may progress slower. Long-term treatment with these drugs may result in neurotic or psychotic symptoms.
Research is ongoing on the effects of other drugs and methods of treating Parkinson’s, including a new generation of drugs that work to mimic levodopa and inhibit the enzymes that break down levodopa in the brain. Research is also progressing on surgical options, including a brain “pacemaker” that blocks brain signals that cause tremors. In late stages of the disease, some patients are treated with a surgical option called pallidotomy, in which a small section of the globus pallidus is destroyed. Some patients also undergo thalatomy, another surgical procedure that destroys a specific group of cells in the thalamus (the brain’s communication center).
Neurotrophic proteins and neuroprotective agents are also being studied, along with neural tissue transplants and genetic engineering. Obviously, Parkinson’s is a serious condition, and professional medical management and prescription drugs are crucial in staving off the progression of the disease and maintaining quality of life. Recent advances in molecular science, however, are beginning to alter the diagnostic approach to Parkinson’s and the ways in which we approach treatment of the condition. Prior to these recent developments, the chief focus—and rightfully so—was on oxidative damage. Now, other causes— mitochondrial damage, excitotoxicity, and inflammatory cytokines—are being examined for the part they play in the death of brain cells. At some point in the future, the chief cause of Parkinson’s may be determined to have come from this group. But, as of now, any of these can lead directly to Parkinson’s. Hence, the treatment modality should be multifaceted.
Although full-blown Parkinson’s can be crippling or disabling, early symptoms of the disease may be so subtle and gradual that patients attribute them to other causes. Even if your doctor is fairly certain you are suffering from Parkinson’s, there is much you can do in the early stages that may help to slow the progression of the disease. Exercises involving weight training have been linked to increasing testosterone levels that, in turn, elevate dopamine levels. Hence, exercising is crucial in fighting Parkinson’s. Exercise also reduces stress, which has been found to aggravate the symptoms of Parkinson’s. Specific exercises, such as those taught by the Alexander Technique, which focuses on ridding your body of harmful tensions through improving the mechanics of moving your body in day-to-day activities, may offer particular benefit to individuals suffering from Parkinson’s.
When a person first exhibits these symptoms, it is traumatic. From a physical perspective, doctors generally treat the problems associated with motor functioning, for they are extremely alarming to someone who has never had sluggish movement of their limbs or rigidity. Though the patient is being treated for these physical symptoms, the doctor should also address the anticipated cognitive decline, for this greatly affects quality of life.
Older adults commonly develop drug-induced Parkinson’s disease after having been prescribed antipsychotic drugs, such as Haldol, Thorazine, Mellaril, and Stelazine. These antipsychotics are used to sedate nursing home patients with dementia and chronic anxiety, two nonpsychotic disorders. When these drugs are discontinued, most newly diagnosed Parkinson’s patients return to normal.
Your diet should incorporate mostly alkaline foods, with green drinks, such as chlorella, spirulina, barley grass, or wheatgrass, once or twice a day. Eat fruits and vegetables that provide a good supply of antioxidants, which are critical for overcoming oxidative damage to the brain and slowing down progression of the disease. Research has shown that a combination of antioxidants can mimic chelating agents. (A chelating agent is a water-soluble molecule that can bond tightly with metal ions, keeping them from coming out of suspension and allowing them to be flushed from the system.) For maximum results, I suggest trying a combination of the C and E vitamins, polyphenols (found in green and black tea), bioflavonoids, proanthocyanidins (in grape seed extract and pine bark extract), and curcumin.Foods such as red peppers and onions that contain glutathione (a metabolite of the essential amino acid methionine) are thought to be beneficial, as are broccoli, cauliflower, brussels sprouts, and cabbage, which are rich in cyanohydroxybutene (a naturally occurring chemical that helps increase glutathione levels).
It is important to choose organic foods. Unheated extra virgin olive oil and herbs for flavoring should be used. Sugar and fat should be avoided, as research has shown diets high in sugar triple the risk of developing Parkinson’s, while diets high in fats result in a fivefold increase in the odds of developing Parkinson’s. You should also avoid wheat, dairy, and gluten products, margarine, fried foods, polyunsaturated oils, artificial sweeteners, processed food (e.g., deli meats), monosodium glutamate (MSG), alcohol (except red wine), and water containing chlorine or fluoride. (Remember, this not only applies to the water you drink but also the water you bathe in; for best results, purchase a water filter, or be sure to keep your mouth closed while showering.) Do not use microwave ovens to cook your foods. Individuals who are taking the prescription drug levodopa should limit protein intake to one meal per day, eaten late in the day, because protein hinders the absorption of levodopa.
Certain vitamins and minerals may be beneficial in preventing and impacting the symptoms of Parkinson’s disease.
Vitamin B6 is essential in the synthesis of dopamine. When taken with zinc, it can help stimulate the production of dopamine. While adding foods rich in B vitamins to your diet is fine at any time, when you use vitamin B supplements in combination with levodopa, the vitamin B may act to stimulate production of dopamine in other areas of the body, with less reaching the brain. Therefore, if you and your health care provider decide to try supplementing with vitamin B, you should take it either at the end of the day after the last dose of levodopa, or at intervals between doses of levodopa. I recommend increasing your daily vitamin B6 supplement from 75 milligrams to 150 milligrams. Do not exceed a daily supplement of 150 milligrams.
Vitamin C may help to slow the progression of Parkinson’s symptoms and counteract severe side effects of levodopa. It appears to be even more effective when paired with other antioxidants, such as vitamin E. I recommend increasing your daily vitamin C supplement from 500 to 1, 000 milligrams to 3, 000 mil-ligrams, taken in three divided doses. For Vitamin E, I recommend increasing your daily supplement from 268 milligrams to 536 milligrams. Do not exceed a daily supplement of 536 milligrams.
Zinc, a cofactor of vitamin B, may help with control of symptoms, such as tremors and rigidity, and may improve walking skills and bladder control. I recommend a daily supplement of 30 milligrams.
A number of other naturally occurring nutrients have beneficial impacts on the symptoms of Parkinson’s disease. Coenzyme Q10 (CoQ10) is the most important nutrient for people over thirty. Because the cells of our bodies need CoQ10 to produce energy and to combat mitochondrial free radical activity, a CoQ10 deficiency can result in a greater incidence of many degenerative diseases associated with aging. It should be taken with the fattiest meal of your day. When consumed in an oil-based capsule, the CoQ10 can be absorbed through the lymphatic canals for better distribution throughout the entire body. I recommend increasing your daily supplement from 100 to 300 milligrams to 1, 200 milligrams.
Glutathione, a metabolite of the essential amino acid methionine, is an important part of the body’s antioxidant defense system. Studies of the substantia nigra after death in Parkinson’s disease sufferers have shown the depletion of glutathione. To impact the symptoms of Parkinson’s, I recommend a supplement of 200 milligrams taken twice daily.
Melatonin, a hormone manufactured by the pineal gland in the brain, is released into the bloodstream and is involved in synchronizing the body’s hormone secretions and setting daily biorhythms. In a study conducted at Thomas Jefferson University, researchers showed that melatonin was effective in blocking the oxidative damage in dopamine-producing cells, thereby reducing or blocking Parkinsonian effects. To help ease the symptoms of Parkinson’s disease, I recommend supplementing with 300 micrograms to 1 milligram, taken a half hour before bed two or three nights per week.
N-Acetylcysteine (NAC), an important amino acid that enhances the production of glutathione, can help protect the brain from free radicals and minimize age-related deterioration of the nervous system. I recommend supplementing daily with 1, 500 milligrams taken in three doses of 500 milligrams.
Nicotinamide Adenine Dinucleotide (NADH) is an enzyme that helps improve neurotransmitter function. It helps prevent cellular degeneration, and may increase concentration and memory capacity. I recommend a supplement of 2.5 milligrams taken twice daily.
Proanthocyanidins (chemical relatives of bioflavonoids) serve to benefit the brain in a twofold manner: They are antioxidants, and they protect collagen. Research has shown that proanthocyanidins are fifty times more powerful antioxidants than vitamins C and E. Intricate tests prove that proanthocyanidins are great killers of the hydroxyl radical—the free radical that is responsible for the most damage—and lipid peroxides (rancid fats). Although proanthocyanidins can be found in the diet, the levels in food are generally insufficient to help fight the symptoms of Parkinson’s disease. I recommend increasing your daily supplement from 80 milligrams to 380 milligrams, taken in three divided doses. Do not exceed a daily supplement of 380 milligrams.
Fish oil is abundant in omega-3 fatty acids that have been shown to support neurological health in Parkinson’s patients. I recommend taking 2, 000 to 4, 000 milligrams daily of a purified fish oil concentrate. Consult with your doctor if taking anticoagulant or antiplatelet medications or have a bleeding disorder.
Some herbal extracts have properties similar to conventional medications, but are gentler and may lack the drugs’ side effects. Always inform your medical practitioner of any herbal remedies you may be taking.
The following remedies may be used for relief from the symptoms of Parkinson’s disease. When dealing with a chronic condition, homeopathic remedies must be used in conjunction with other therapies, as prescribed by a qualified health professional. Consult with your health care provider before taking any homeopathic remedy, and follow your provider’s recommendation for the appropriate dosage. Always inform your medical practitioner of any homeopathic remedies you may be taking.
Chelation therapy eliminates metals from the brain, as well as other toxic agents that encourage free radicals development. A hair analysis can determine whether high levels of metals need to be chelated out of the body. Studies indicate that to properly impact Parkinson’s disease, effective treatments must reduce oxidative stress. Chelation therapy plays an important role in eliminating iron as well as other toxins from the brain. These toxins infuse the brain with free radicals. Some think that chelation can only occur through chelation therapy. Antioxidants can also play the role of chelators, however. The C and E vitamins, bioflavonoids, polyphenols (from black and green teas), grape seed extract (specifically, the proanthocyanidins), and tocotrienols from curcumin also serve as chelators.
Essential oils can be used in baths or inhaled to provide rebalancing effects. Do not apply essential oils directly to the skin; they must be mixed with carrier oils. Though massaging with fragrant essential oils will not cure Parkinson’s, it can provide temporary relief. Experiment with various scents to see which brings you relief: clary sage, marjoram, and lavender.
Dr. Lombard follows three general strategies in attempting to prevent progression of the disease. He remarks, “These strategies are useful for other neurodegenerative conditions as well. We know the immune system is overactive in particular ways that are destructive to the brains of Parkinson’s patients. We know that patients with Parkinson’s have an inability to handle a particular metal found in our diets called iron and we know that Parkinson’s patients may have a deficiency of a part of the cell called the mitochondria that is responsible for the manufacture of ATP [adenosine triphosphate, which is involved in the storage and transfer of cellular energy]. Using these three evidences, a comprehensive program can be drawn up that addresses each of these issues separately.
“In regard to excessive inflammation, certain types of white blood cells make a compound called nitrous oxide, which is a free radical. It is very destructive to areas of the brain in Parkinson’s disease. There are certain antioxidants that are effective in quenching or inhibiting the effects of this free radical. These include an extract of green tea that has profound antioxidant properties. Dihydrolypoic acid, which is a glutathione precursor, increases brain glutathione levels and is very effective as an antioxidant. Lycopenol is another antioxidant that crosses the blood-brain barrier and inhibits excessive free radical activity.
“Second, we know Parkinson’s patients have too much iron in their brains, and iron acts as a free-radical inducer. So we try buffering the effects of increased iron with a protein called lactoferrin. This prevents excessive iron absorption from the intestinal tract into the bloodstream.
“Finally the mitochondria, the energy-producing units of the cell that make ATP, are also deficient in Parkinson’s patients. Ways of increasing the mitochondria include coenzyme Q10, serotonin, and two other compounds: NADH, which is also called ignatia, and ubiquinone, which is a coenzyme Q10 analog. They dramatically increase brain ATP levels. These three things are a very worthwhile strategy for treating a Parkinson’s patient.”
Dr. Wald has devised a detoxification program that he feels is worthwhile for PD. “Beta-carotene has been fairly well studied in PD. It is an antioxidant, and I use about 50, 000 units. It helps protect the liver and other cells and the nervous system from premature degeneration. Vitamin C helps protect dopamine, an important neurotransmitter that is low in those with PD.”
“Essential fatty acids, such as omega-3 and omega-6, are important for protecting the nervous system. Toxins in our environment known as zenobiotics are fat soluble, meaning they love to hang out in the nervous system. We need to take all the antioxidants... with essential fatty acids such as omega-3 and omega-6 So we want to get vitamin E, 400 to 800 IU a day, and vitamin C to balance tolerance. Some of the studies show PD patients have low levels of vitaminB3, niacin. There is a nonflushing form called hexaniacinite, 250 milligrams a day. Melatonin is a very important hormone not just for sleep and repair but also as an important antioxidant in the nervous system. It slows down the breakdown of dopamine. Another important amino acid is N-acetyl cysteine or NAC. It is used by the liver to convert fat-soluble toxins into water-soluble toxins so that we can excrete them in the urine. The body must be able to eliminate toxins once they are mobilized. Any detoxification program needs to focus on the liver and intestine and the lymphatic system and so on to get these things out.”
Dr. Wald adds, “Glutathione has been found to be low in PD. The most effective way to increase it is with Vitamin C. Glutathione is not only an immune booster but helps fight degenerative changes. It tends to become lower as we age.”
The following chart summarizes the supplements I recommend adding to the protocol for overall brain health from chapter 16. In some cases, I recommend increasing the dose of a particular vitamin or supplement to specifically impact Parkinson’s disease. In these cases, you should increase the daily dosage from chapter 16 to the level recommended for this specific condition. This protocol is designed for individuals who suffer from, or are specifically concerned about, Parkinson’s disease. If you are concerned about additional conditions discussed in other chapters, consult with a health professional about how you can safely impact multiple conditions. If you are taking medications, whether prescription or over-the-counter, or have any food restrictions, consult with your doctor before beginning any supplement program. Your health care provider should always be up-to-date on all vitamins, supplements, and herbal or homeopathic remedies you are taking. Supplement overdoses are rare, but possible, and certain combinations may affect individuals adversely.
| SUPPLEMENT | DOSAGE | CAUTIONS |
|---|---|---|
| Brain Shield and Cognitex | as directed | |
| black cumin seed oil | 1 tsp, three times daily | |
| coconut oil | 1 tsp, three times daily | |
| coenzyme Q10 (coQ10) | Increase daily dosage from 300 mg to 1, 600 mg. | Do not exceed a daily supplement of 2, 000 mg. Take with fattiest meal of the day. If going higher, do so under medical supervision. Dosage should be gradually increased, with 300 mg daily added over a six-week period until the daily dose reaches 2, 000 mg. Individuals supplementing with coQ10 at high doses should be monitored closely by their doctors. |
| Cytokine Suppress with EGCG | 300 mg | |
| glutathione | 200 mg two times daily | Glutathione levels may also be elevated through supplementation with cysteine, N-acetylcysteine, or L-cysteine. |
| melatonin | 300 mcg–1 mg two to three nights per week, a half hour before bed | Tolerance may develop with regular use. Long-term effects of nightly use are unknown. |
| N-acetylcysteine. | 1, 500 mg in three. divided doses | Regular supplementation increases urinary output of copper. If supplementing for an extended period, add 2 mg of copper and 30 mg of zinc daily. |
| Nicotinamide adenine Dinucleotide (NADH) | 2.5 mg twice daily | High doses (10 mg per day or more) may cause nervousness, anxiety, and insomnia. |
| proanthocyanidins | Increase daily dosage from 80 mg to 380 mg, taken in three divided doses. Do not exceed a daily supplement of 380 mg. | |
| resveratrol | 200 mg twice daily | |
| vitamin B6 | Increase daily dosage from Contraindicated for 75 mg to 150 mg. Do not exceed a daily Discuss with your supplement of 150 mg. Take with zinc (30 mg). | Contraindicated for use with levodopa. Discuss with your health care provider. |
| vitamin C | Increase daily dosage from 500–1, 000 mg to 10, 000 mg, taken in three divided doses. | |
| vitamin E | Increase daily dosage from 400 mg to 800 mg.Do not exceed a daily supplement of 1, 000 mg. | If you have high blood pressure, limit your supplemental vitamin E to 268 mg daily. If you are taking blood thinners, consult with your doctor before taking vitamin E. |
| zinc | Up to 30 mg daily | Large doses (50 mg or more) can interfere with the body’s absorption of essential minerals, impair blood cell function, and depress immune system. |
An increasing body of evidence is showing the benefits of natural modalities to overall health and well-being. Following is a sample of recent peer-reviewed scientific studies relating to Parkinson’s disease.
An article on the Life Extension website provides an in-depth look at Parkinson’s disease, citing numerous research studies on alternative treatment methods. A 2011 report published in the American Journal of Psychiatry revealed that symptoms of depression improved in 56 percent of patients with Parkinson’s disease who participated in cognitive-behavioral therapy as compared with 8 percent who were monitored clinically. A 2011 report in the European Journal of Neuroscience showed in an animal model that eighteen weeks of treadmill exercise offered neuroprotective effects, including improvement in movement and balance coordination. Mucuna seed extract was shown in a 2010 study published in Parkinsonism & Related Disorders to provide long-term relief of symptoms similar to traditional treatment, but without the side effects such as drug-induced dyskinesias (movement disorders). In 2012, a report in Neurology concluded that intake of some flavonoids may reduce Parkinson’s disease risk, particularly in men. The researchers examined five major sources of flavonoid-rich foods: tea, berry fruits, apples, red wine, and oranges/orange juice. Other useful treatments and preventive substances include vitamin B6, coenzyme Q10, carnitine, and resveratrol.