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http://www.wwonline.com/rona/park.htm ZOLTAN P. RONA, M.D., M.Sc. 1466 BATHURST ST. SUITE 305 TORONTO, ONT. M5R 3J3 416-534-8880; FAX:416-534-6723 ALTERNATIVE MEDICINE FOR PARKINSON'S DISEASE Parkinson's disease involves the deterioration of specific nerve centers in the brain. This deterioration changes the chemical balance of acetylcholine and dopamine. These two chemicals are both essential for transmission of nerve signals. When the balance between these two neurotransmitters is altered, the ultimate result is a lack of control of physical movements. The five main symptoms and signs of Parkinson's disease are: Tremor Rigidity Bradykinesia (slowed movement) Gait disorder Loss of Balance Symptoms appear slowly, in no particular order and some time may elapse before they interfere with normal activities. The main symptom of Parkinson&'s is tremor, an involuntary shaking of the hands, the head or both. In many cases this is accompanied by a continuous rubbing together of the thumb and forefinger. Stooped posture, a mask-like face, trouble swallowing, depression and difficulty performing simple tasks may all be seen at different stages of the disease. The tremors are most severe when the affected part of the body is not in use. There is no pain or other sensation other than a decreased ability to move. In severe cases, the person will be unable to walk smoothly due to an inability to swing the arms. Writing legibly and speaking clearly will also be affected. Parkinson's disease affects more men than women at a ratio of three to two. It is estimated that one in every one hundred persons over age 60 will contract this condition. Parkinson's occurs at the rate of 228 per 100,000 people and usually begins between the ages of 50 and 65. It is much more prevalent in the 60 to 69 age group but is sometimes seen in patients under 40 years of age, with an incidence of ten per 100,000. The specific cause of Parkinson's is not known. Predisposing factors include carbon monoxide poisoning, high body levels of noxious chemicals, brain infections (encephalitis) and certain psychiatric drugs. Medical treatment involves the use of prescription drugs such as Levodopa, Sinemet and Deprenyl all of which control symptoms for some years but eventually become ineffective. There is no medical cure for the condition, all current treatments being primarily symptom suppressive, supportive or palliative. Successes using alternative medicine for Parkinson's disease are largely anecdotal or unproven. In dealing naturally with Parkinson's, complementary health care practitioners aim to rule out toxic heavy metal excess body burdens, food and chemical allergies and chronic infections (bacterial, fungal or parasitic). These abnormalities can all have deleterious effects on the nervous system. Treating any imbalances or infections that turn up on testing with natural remedies can certainly do no harm and are well worth doing for the improvements in general health that result. Studies show that a low protein diet with most of the protein being eaten in the evening significantly reduces the symptoms of Parkinson's. Deficiency of folic acid, magnesium and the amino acids tryptophan and tyrosine, precursors to neurotransmitters, may all be involved somehow in the disease. Excess amounts of manganese, iron, mercury, aluminum and copper have all been reported connected to Parkinson's. It is thought that these excess minerals increase free radical pathology and accelerate cell death. The mercury in dental amalgams has been suggested to be involved in some cases of Parkinson's. Vitamin C and E, selenium as well as the amino acid derivative, N-acetyl-cysteine, are free radical scavengers and can remove excess mercury from the body. Lactoferrin, a naturally occurring iron-binding protein, manganese and vitamin E helps offset iron excesses in the body. Zinc supplementation can help push excessive copper out of the body. Strong antioxidants like proanthocyanidins (pycnogenols, grape seed extract, pine bark extract or bilberry) which can cross the blood brain barrier would likely be the most effective antioxidants in Parkinson's complicated by toxic heavy metal excesses. Intravenous chelation therapy is recognized to be effective against toxic heavy metal excesses. Parkinson's cases that have been treated for long periods of time with the drug Levodopa may develop deficiencies in vitamin B6, vitamin B3 (niacin), folic acid and vitamin B12. Supplementation of these vitamins may be necessary to prevent worsening of the symptoms. Many people over the age of 60 have problems in the absorption of vitamin B12 and folic acid. In these cases, taking either a sublingual form or injections is better. Other supplements effectively used in the treatment of Parkinson's include choline, octacosanol, inositol, lecithin, niacinamide, vitamin B1, vitamin C, vitamin E and Coenzyme Q10. These nutrients are all involved in the body's synthesis of acetylcholine and dopamine. Evening primrose oil supplementation has been shown to reduce the tremor of Parkinson's. Herbal remedies of potential benefit include ginseng and horsetail. A nutritional evaluation by a natural health care practitioner can pinpoint these and other potential deficiencies or toxicities. Combined with conventional medical therapy, a good nutritional supplement program will help produce optimal results. Before attempting any of these natural therapies it would be a good idea to get extensive lab testing done. This includes routine blood and urine tests, hair mineral analysis, livecell microscopy, comprehensive stool and digestive analysis including comprehensive parasitology, food and chemical allergy testing and amino acid analysis. A naturopath or medical doctor familiar with nutrition should be consulted. REFERENCES Beal, M., Flint, M.D. Aging, Energy, and Oxidative Stress in Neurodegenerative Diseases. Annals of Neurology, 1995;38:357-366. Carter, J. et al. Amount and distribution of dietary protein affects clinical response to levodopa in Parkinson's disease. Neurology 39:552-56, 1989. Clayton, P. et al. Subacute combined degeneration of the cord, dementia and parkinsonism due to an inborn error of folate metabolism. J. Neurol. Nerosurg Psychiatry 49:920-7, 1986. Critchley, E.M.R. evening primrose oil in parkinsonian and other tremors: a preliminary study, in D.F. Horrobin, Ed. Clinical Uses of Essential fatty Acids. Montreal, Eden Press, 1982:205-8. Dexter, D.T. et al. Increased nigral iron content and alterations in other metal ions occurring in brain in Parkinson's disease, other chronic neurological diseases and control brains. Can. J. Neurol. Sci. 16(3):310-14, 1989. Jimenez-Jimenez, F.J., et al, Serum and Urinary Manganese Levels in Patients With Parkinson's Disease.ACTA Neurol. Scand, 1995;91:317-320. Lohr, James, B. and Browning, John, A. Free Radical Involvement in Neuropsychiatric Illnesses. Psychopharmacology Bulletin, 1995;31(1):159-165. Logroscino, Giancarlo, M.D., M.S., et al. Dietary Lipids and Antioxidants in Parkinson's Disease: A Population-Based, Case-Control Study.Annals of Neurology, 1996;39:89-94. Pall HS et al. Raised cerebrospinal-fluid copper concentration in Parkinson's disease. Lancet 2:238-41, 1987. Penney, John, B., Jr., M.D., et al . Impact of Deprenyl and Tocopherol Treatment on Parkinson's Disease in DATATOP Patients Requiring Levodopa. Annals of Neurology, 1996;39:37-45. Singh, Ram, B., M.D., et al. Dietary Intake and Plasma Levels of Antioxidant Vitamins in Health and Disease: A Hospital-Based, Case-Control Study. Journal of Nutritional & Environmental Medicine, 1995;5:235-242. Tsui J. et al. The effect of dietary protein on the efficacy of L-dopa: a double-blind study. Neurology 39:549-52, 1989. "There can be no happiness if the things we believe in are different from the things we do." - Author Unknown