Natural Strategies for Parkinson’s Disease
Nill Family Chiropractic
Parkinson’s disease belongs to a class of conditions called movement disorders. The disease involves a degeneration of part of the brain called the substantia nigra, or “dark substance”. This part of the brain makes a chemical called dopamine. Dopamine is a neurotransmitter, meaning that it communicates messages between nerves (in this case different parts of the brain). The messages that it communicates have to do with movement and coordination. Symptoms typically begin when about 80% of the dopamine in the brain is lost.
Parkinson’s disease is chronic and progressive with no known cure. The average age of onset is 55, and Parkinson’s affects 1 in 625 people (this incidence increases with age). The commonest symptoms of the disease are as follows:
- Tremor (typically begins on only one side and involves the hands and/or feet—while this is a common symptom it does not occur in about 30% of Parkinson’s sufferers).
- Stiffness and rigidity in the muscles.
- Slowness of movement (called bradykinesia), and a lack of spontaneous movement (called akinesia).
- Poor balance.
- Problems with walking.
- Depression and fatigue occur in about 50% of people with Parkinson’s, in about 20% some level of dementia is present, ranging from slowing of thought to difficulty organizing thoughts.
Usually treatment for Parkinson’s disease involves taking either a drug called levodopa, which is a chemical precursor to dopamine, and/or a drug from a class called dopamine agonists—these drugs allow the dopamine that is present in the brain to “do more work” before it breaks down. There are two problems with levodopa therapy. First, the drug tends to lose its effectiveness over time. Second, there is some evidence that levodopa is actually toxic to the nerves that make dopamine (in the substantia nigra) and that it increases the oxidation process in these nerves.
Coenzyme Q10 (CoQ10)
The process by which the nerves in the substantia nigra begin to break down is called oxidation. Oxidation is a common degenerative process in the body and there are some nutritional strategies that can hinder the process. Specifically to Parkinson’s disease, an enzyme called CoQ10 has been studied. This is an enzyme that occurs naturally in the body and that has been found to be deficient in many people with Parkinson’s disease. Additionally, research has shown that supplementation with CoQ10 helps many people with mild Parkinson’s by slowing the progression of the disease. The greatest effects were at a dose of 1200 mg per day. CoQ10 may exert protective effects beyond it’s antioxidant properties because it also acts as an enzyme in energy production within cells. The effects of other antioxidants are less well known. I caution people against high doses of other antioxidants including vitamin C and vitamin E since these (in high doses in a non-food form) are associated with increased rates of heart disease and cancer.   
An alternative to levodopa therapy that is gaining attention is Mucuna Pruriens. This herb contains a plant form of dopamine. Interestingly, the amount of dopamine present in a dose of mucuna pruriens that is necessary to create an effect is much less than the amount of pharmacological levodopa needed. This has led to the conclusion that there are other compounds in the herb that help with the action of the dopamine.
One study showed that mucuna pruriens in combination with CoQ10 actually helped to regenerate some of the cells in the substantia nigra. In 2004, a study at the National Hospital for Neurology and Neurosurgery in London compared levodopa therapy to supplementation with mucuna pruriens. It was concluded that “The rapid onset of action and longer on time without concomitant increase in dyskinesias on mucuna seed powder formulation suggest that this natural source of L-dopa might possess advantages over conventional L-dopa preparations in the long term management of Parkinson’s disease.” Another study assessed the effect of an extract of mucuna pruriens on 60 patients with Parkinson’s. Twenty-six of the study participants had been taking synthetic levodopa before the study, the remaining 36 participants had not been taking levodopa. All of the individuals improved—this is especially significant in the group that had been on medication prior to the study.
Mucuna should be used for Parkinson’s only under the supervision of a trained health care provider. For most patients it is appropriate to start with ½ teaspoon of the seed powder two times per day. The amount is then increased every few days until a therapeutic effect is attained. Research has used up to 30 grams per day (this is nearly 3 tablespoons) . The herb has also been used as an adjunct to levodopa therapy, but this should only be undertaken under the supervision of the prescribing doctor. Most mucuna pruriens seed powders contain about 100mg of dopamine per 3 grams of seed powder. You can work with your doctor to find the best times of day to take the herb, and whether or not to take it with food.
Mucuna Pruriens is considered to be a very safe herb to use. Even at very high doses used in research, side-effects have only included stomach upset and diarrhea (these side effects are infrequent). These are usually not a concern at lower dosages. Nonetheless, people with the following conditions should not use the herb:
· Mucuna pruriens should not be used during pregnancy or while nursing.
· Mucuna pruriens should not be used with a class of antidepressants known as M.A.O. inhibitors.
· Mucuna does slighly raise testosterone levels and has been used by athletes safely for many years. People on anti-anabolic medications should check with their doctor before taking mucuna.
Even in healthy individuals a lack of exercise causes muscle wasting, decreased balance, and an increased incidence of falls. Since people with Parkinson’s have challenges with movement and coordination, it is imperative that they make a point to exercise on a regular basis. Research has shown that different types of exercise not only slow the functional decline in people with Parkinson’s, but can actually lead to improvements in coordination and movement. The following types of exercises are especially “high pay-off” for people with Parkinson’s disease:
· Weight training: one study found the following exercises especially helpful
o Leg Press
o Leg Extension
o Leg Curl
o Calf Raises
· Light to moderate cardiovascular exercise such as brisk walking
· Exercises involving mind-body coordination—examples include dance, tai’chi and other martial arts, and Yoga.
While there is no cure for Parkinson’s, the natural strategies outlined above can help to both slow the progression of the disorder and to improve the functioning and quality of life of the affected person. Due to the complexity of the disease, and its chronic and progressive nature, it is important to bring together a “team” early on so that ongoing support is easily accessible both for the Parkinson’s sufferer and his/her loved ones.
Chiropractic care can be especially helpful to people with Parkinson’s. Chiropractors are specially trained in the functioning of the joints, muscles, and nervous system (the neuromusculoskeletal system). Since Parkinson’s affects muscle function and joint movement, there is a high incidence of joint dysfunction in this population. Chiropractic treatment can help with pain associated with dysfunction and create healthier movement patterns that result in greater ease of movement. Your chiropractor can also give you specific exercises to enhance your flexibility and strength. Recent studies have confirmed that people with Parkinson’s benefit greatly from chiropractic care.
A neurologist is best trained to oversee pharmacological treatment, and should be consulted with early in the course of treatment to monitor progress and coordinate care.
Friends, relatives, counselors, and others should be brought together as a “support network” for individuals with Parkinson’s and their families. The disease can take a toll not only on the people that it directly affects, but also on family members and friends. By taking the time to establish a support network early on, support and treatment can be delivered more effective.