Cause - Dopamine is a transmitter substance in the brain, in Parkinson's disease (PD) the dopamine creating cells in the middle of the brain (substantia nigra) die faster than they are replaced and because they produce less dopamine, the motor part of the brain is slowed down. The cause is uncertain, there is a slight genetic tendency, but oxidative stress, cigarette smoking, possibly herbacide and pesticides, and obesity have all been implicated. Some people also suggest that the disease may originate in the gut and be transmitted through the vagus nerve.
What doctors can do
Drugs - There are a number of drugs which can be used, but these only address the symptoms, and have little effect on the longer term progression of the disease. Newer possible disease-modifying drugs are being researched, but are not yet available.
L Dopa (which is like dopamine) is the usual medication given to Parkinson's patients, usually it is combined with other drugs to reduce the side effects (carbidopa).
Dopamine agonists which directly stimulate the dopamine cells can be very effective too (bromocriptine, cabergoline), and can be used with L-Dopa or instead of L-Dopa in younger patients.
Selegiline (a MAO-B inhibitor) has a milder effect.
Anticholinergic drugs like Benztropine have a mild effect and are often used in younger patients (<70) where tremor is the major problem.
Amantadine is an antiviral drug which seems to have some benefit in patients where rigidity is a problem. Its mode of action is unknown.
Many of these drugs are effective, but with time their benefits can become less, and some doctors suggest holding back until symptoms warrant their use as there does seem to be a fixed duration of their benefits.
What you can do
- Exercise - regular exercise including walking, treadmill, balance training, and active music therapy can help reduce the symptoms of stiffness and improve
function. Being outside has a feel good effect and stretching, swimming and water aerobics all help. Unsteadiness and a feel as if you will fall forward is a common
complaint, and a stick or walker can give huge confidence. In the supermarket - grab the trolley. Using a walker may seem over the top, but a good one with wheels can
allow Parkinson's patients to buzz round without the falling fear that they often have.
- Psychological approaches - people see patients with advanced disease and project themselves into that situation. But with the therapies we talk about here
we can hugely reduce that risk, and research will soon come up with answers that we have not yet found - and that will be very soon. However Parkinson's
Disease makes people self conscious, they often do not go out as much and dont associate with old friends. Remember that the disease affects mainly the
muscle, and although speech may be slower and less easy to understand, the mind behind the words is usually as sharp and sensitive as it was before the
disease appeared. Live as normal a life as possible, go out with friends, shop, walk, boat, go to the movies enjoy life to its full. An active happy mind makes the disease less obvious and of course makes life more enjoyable.
- Speech therapy - sometimes speech can become very quiet and slurred without the patient realising it. Seeing a good speech therapist can often help. Encoursge the patient to speak up and more slowly.
- Massage, meditation, Tai Chi, Yoga, Reiki, acupuncture and similar therapies have all been shown to help some people, especially those who feel comfortable using the techniques. Mind/body interaction is very important in Parkinson's disease, and belief in a therapy and an open mind can hugely increase the degree of benefit.
- Avoid some drugs - check that you are not taking any drugs which could cause or worsen Parkinson's symptoms - antipsychotic and anti nausea drugs like chlorpromazine, haloperidol, metaclopramide, stemetil, reserpine. Discuss all of your drugs with your doctor . Perhaps even statin drugs could be stopped for a while and see if that makes any difference (there is conflicting data on whether they could worsen Parkinson's).
- Coffee, believe it or not, seems to lower the risk of developing Parkinson's disease by up to a quarter, by drinking 2-3 cups per day. How and why, no one knows.
Does it improve symptoms, we don't know (surprisingly no one has looked), but it may slow ongoing progress and may also help, so I would suggest you enjoy 2-
3 coffees daily.
- Coconut oil - the brain cells can use short chain free fatty acids found in coconut oil and it has been claimed they help with Alzheimer's disease, epilepsy and other conditions. Might it help in Parkinson's disease - we do not know, but taking 1-2 tablespoons full of coconut oil ( cooking with it, in salads, rubbing on skin or just from a spoon) can do no harm and possibly benefit.
- A good multivitamin and multimineral daily to provide the body and especially the brain cells with optimal levels of nutrients does seem logical for Parkinson's
as well as most people. The antioxidant vitamins ( A,C,E) may also slow the be brain cell damage. Make sure the supplement does not contain iron, as this has
possibly been implicated in some forms of Parkinson's. Ths USANA Cellsentials (see below) multi contains some phytonutrients which are believed to improve inter cellular communication and also in the creation of internal antioxidants; they may help with Parkinson's - worth a try.
- Omega 3 fish oils - fish oils contain 2 essential fats (DHA and EPA) which are essential in the building of brain cells and for good brain function. All Parkinson's patients
should be taking at least 1,000 preferably 2,000mg of fish oils daily - but make sure they are good ones and are mercury and other impurity free.
- Vitamin D - this is essential for many body functions and protection against disease. Patients with Parkinson's disease tend to have lower vitamin D levels. Will
vitamin D reduce or slow the disease - we dont know yet, but people are looking at this. As Parkinson's is caused by early and more rapid death of some brain
cells, and as vitamin D seems to have an essential role in controlling cell death (apoptosis) and replacement - it seems logical to have an ideal level of vitamin D in
the body. Take a good supplement - probably 5 - 8,000iu daily.
- Calcium and magnesium - both are essential for good muscle function and relaxation. Magnesium is often low in our diet and helps muscles to relax (a major
problem in Parkinson's patients). Take a regular calcium and magnesium supplement - 500-800mg of each daily.
- Coenzyme Q10 - this is an energy enzyme found in all cells and is essential for most tissues to function. It is also an antioxidant. Low levels are found in many
nerve and muscle diseases, and it is believed that low CoQ10 levels can be found in Parkinson's cells. There have been some studies looking at its benefit and
some using high doses of Coq10 (1,200mg/day) have found major benefits in the Parkinson's symptoms (click here )
- Probiotics - as mentioned above, there is a suspicion that Parkinsons disease may originate in the gut, so good gut health is a good idea. good diet, fish oils, fibre and probiotics can help make the gut work better.
- Ginkgo Biloba - an old Chinese herb is reputed to improve blood supply to the brain and may possibly help in Parkinson's.
The Nutritional supplements I use and recommend to my patients
For Parkinsons disease patients - USANA - Cellsentials *, Biomega, Active Calcium plus, ginkgo, Coquinone and vitamin D -
Other therapiesThere are a number of other therapies which you might like to look at. They have not been specifically included with this disease because some are a form of treatment which is applicable to most diseases and many focus on the mind, body, spirit, and the universe. These include - acupuncture, Ayurvedic medicine, energy healing, homeopathy, naturopathy, prayer, visualisation and some people with this condition might like to look at these topics (I have described them more fully on another page on this website click here .) With my personal experience and reading, I do not think that I can comment of whether one or a number of these might help. They fit well with most conventional and complementary treatments and I suspect some or even all of them can be extremely powerful - if performed by an experienced practitioner. My only caveat is that if in the course of one of these therapies, you are given potions or herbs, do check with your health practitioner that they will not interfere with other treatments or drugs you are receiving.
Nutritional supplementsI believe in today's world that nutritional supplements are so necessary as to be an essential component of any form of both prevention and treatment. Not only is today's food lacking in nutrients because of the way it was grown and processed, but also most of us make the wrong choices in diet. It is virtually impossible to obtain optimal levels of most of the vitamins, minerals and other nutrients although many people try to do so, and even then fresh produce is not available all year round. *There are many quality supplements available on the market, including –Thorne, NFS, Douglas Labs, Xtend Life, True Star Health, USANA, and Metagenics. There are others, but do your due diligence before choosing one. USANA Health Sciences has added a new adjunct to its multivitamin and multi mineral called CellSentials. These are a patented blend of phyto-nutrients which they believe affects cell signaling and growth, and increases the production of preventative antioxidants within the cell. These should add to the value of the multi, so these are the multivitamin/mineral preparation I recommend.