Parkinson’s Disease is a chronic degenerative condition of specific pathways within the brain in combination with a decrease in the neurotransmitter, dopamine.
It is characterised by an increasing rigidity in movement, tremors and an inability to alter a movement pattern once it has begun. Early signs can include a pill rolling motion between the thumb and index finger. As the disease progresses facial expression, swallowing and bowel motion can all be affected. The disease may progress at varying rates depending upon the person afflicted.
Should I take anti-Parkinson’s drugs?
Anti-Parkinson’s drugs (predominantly L-Dopa) can be effective however they also have significant side effects. Furthermore long term use of the drug may have the disadvantage of periodic failures in effectiveness (known as ‘On-off’ effect). For this reason an integrated approach to Parkinson’s Disease to mimimise reliance on pharmaceutical interventions can assist in slowing the decline associated with the condition and reduce the risk of pharmaceutical side effects.
Are there any Foods I should Eat?
The oily deep sea fish such as Salmon, Tuna, Mackerel, Herring and Sardines should be encouraged for brain health.
Blueberries and a variety of coloured fruits and vegetables are important to increase anti-oxidant and phytonutrient availability.
High Magnesium foods such as dark leafy greens, bananas, nuts and seeds are helpful to assist relax muscles under the stress of constant Parkinsonian rigidity.
Foods high in the amino acid, Tyrosine, should be encouraged including quality protein sources. Tyrosine is a precursor of dopamine.
What about Nutrient/Herb Supplementation?
A nutrient and herb programme should always be integrated carefully into mainstream care. The importance of a carefully networking team cannot be overstated. Complementary therapies can assist with Parkinson’s Disease but must be carefully integrated with traditional pharmaceutical medication.
Nutrients and herbs to consider include:
The amino acid, Tyrosine, is a precursor to dopamine and may be helpful. However it should be used with caution if you are using various drugs including SSRI, MAOI and TCA anti-depressants and L-Dopa, such that medical supervision is necessary. Co-factors in the conversion of Tyrosine to dopamine are important including Magnesium, Vitamin B6 and Zinc.
Increased intake of Vitamin B3 may assist in the alternative production of dopamine due to the associated biochemistry of both nutrients/neurotransmitters.
Fish Oils (EPA/DHA) are important in maintaining healthy brain function and decreasing any inflammatory component that may be contributing to the disease process. It may also be helpful in addressing the Depression many patients with Parkinson’s Disease experience.
Vitamin D may help to prevent or reduce dopaminergic neuron damage. It may also be important as many Parkinson’s patients can become house and even chairbound risking the progression of osteoporosis, coupled with an accelerating increase in fall’s risk. Further osteoporosis management and falls preventions is therefore important.
CoQ10 may be effective in slowing the progression of Parkinson’s Disease.
The herbs, Curcumin and Mucuna puriens, are both though to increase dopamine levels. The later naturally contain L-dopa.
A broad based anti-oxidant may also be of benefit.
What about the side effects of treatment? Can Nutrients/Herbs help with these?
Magnesium has an important relaxant role in the body and is critical in assisting neurotransmitter balance. Supplementation with magnesium (preferably in chelated forms and with cofactors such as the B Group Vitamins) can be important in reducing muscular tension associated with Parkinson’s Disease.
Vitamin B12 and Folate may be reduced by pharmaceutical medications used to treat Parkinson’s Disease. However supplementation needs to be monitored carefully.
Should I Exercise?
Exercise is critical in maintaining neuromuscular co-ordination, gait and balance, strength, cardiovascular health and quality of life. Physiotherapy may be of assistance in coordinating your exercise programme and in providing any walking aids that may be required if function deteriorates. The risk of a fall is a significant danger to consider and all effort should be made to minimise falls risk (see Osteoporosis)
Interestingly studies of tango dancing have also demonstrated benefit for the frail and elderly.
What if my day to day functioning deteriorates?
You may require help from Occupational Therapy and Nursing Assistance to assist with or find ways of completing tasks. Do not hesitate to ask for assistance when this becomes necessary.
...and Speech and Swallowing
If your Parkinson’s Disease deteriorates it is critical to watch for signs of deterioration in voice and swallowing. The later is particularly important as failure in swallowing control can lead to aspiration and lung infection. Ultimately this can be the most dangerous and life threatening consequence of Parkinson’s Disease.
Of course any loss in your capacity to communicate can drastically effect your quality of life and should be addressed. Both speech and swallowing control are managed by qualified Speech Therapists.
Are there any other Physical Therapies to consider?
It is suggested that acupuncture may be of benefit in coordination with pharmaceutical interventions, although no clear medical evidence exists.
Smoking...the answer’s Obvious?
Toxins associated with smoking may contribute to Parkinson’s Disease, therefore it is important that you quit smoking.
If you cannot quit without assistance, this being the majority of smokers, it may be sensible to join a multidisciplinary programme. Peer support if often essential to the success of any quit smoking plan.
Remember, or although pharmaceutical approaches that replace nicotine via chewing gum, patch or otherwise are helpful, eventually they must be weaned otherwise you may simply be trading the risk of lung cancer for other diseases.
What about Mind-Body Therapies and Stress Management?
As many patients with Parkinson’s Disease experience Depression it is important to consider Mind-Body therapies and Stress Management techniques along with Psychological interventions where appropriate. Interventions to consider include:
Psychological treatments (in particular, CBT)
Other Effects Based Stress Managements techniques
Cause Based Stress Management Techniques
Developing Emotional Intelligence
Achieving Life Balance
Developing Spiritual Intelligence
Other treatments that have been demonstrated to be effective in helping Parkinson’s patients with Depression include Music Therapy, Visualisation and the Alexander technique.
What about the Environment?
Patients with Parkinson’s Disease should be assessed for the presence of Heavy Metal toxicity. Imbalances in Manganese. Lead, Iron, Copper and Zinc have all been identified in Parkinson’s sufferers. Plasma levels, Hair Mineral Analysis and/or Comprehensive Urinary Element Profile testing can all be helpful.
Exposure to pesticides should also be evaluated.