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What
is Parkinsons Disease
Parkinson’s
disease (PD) is a chronic, progressive disease of the central nervous
system characterized by slowness and poorness of purposeful movement
and rigid muscles. Degeneration of the neurons that use the neurotransmitter
dopamine and the subsequent decline in dopamine levels occur in
the part of the brain called the substantia nigra. Dopamine is involved
in stimulating and coordinating the body’s motor movements,
so PD is initially described as a disorder of movement. It can affect
other body systems, causing problems within the nervous system such
as dementia and problems with smell.
PD normally manifests
only in persons above the age of 40. Its peak age of onset is in
the 60s (range is 35 to 85 years), and the course of the illness
ranges between 10 and 25 years. Genetic clusters of forms of PD
comprise about 5% of cases. Although most patients with PD appear
to have no strong genetic determinant, epidemiologic evidence points
to a complex interaction between genetic vulnerability and environmental
factors. Risk factors include a positive family history, male gender,
head injury, exposure to pesticides, consumption of well water,
and rural living.
Primary PD is from
an unknown cause, whereas secondary Parkinsonism refers to the symptoms
being caused by another disease toxin poisonings or drugs.
Symptoms
of PD
The main symptoms
of PD are called parkinsonism, defined as a paucity and slowness
of movement (bradykinesia), tremor at rest, rigidity, a shuffling
gait, and flexed posture.
Non-motor aspects of PD include depression and anxiety, cognitive
impairment, sleep disturbances, sensory abnormalities and pain,
loss of smell (anosmia), and disturbances of autonomic function.
Together they may contribute as much to the burden of the disease
as the more obvious motor abnormalities. Some of these (e.g., anosmia,
depression, and sleep disorders) may be present long before the
onset of motor signs. Changes in mood, cognition, and behavior are
common accompaniments of the later stages of PD may occur as a side
effect of medications.
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Diagnosis
and Pharmaceutical Interventions
A diagnosis of PD
can be made with some confidence in patients who present with at
least two of the three cardinal signs—rest tremor, rigidity,
and bradykinesia. Tremor is particularly important, as it is present
in 85% of patients with true PD; a diagnosis of PD is particularly
difficult when tremor is absent.
A unilateral and
gradual onset of symptoms further supports the diagnosis. Masked
facies- where the face becomes masklike with an open mouth and decreased
eye blinking, stooped posture, and decreased arm swing complete
the early picture. The onset may also be heralded by vague feelings
of weakness and fatigue, incoordination, aching, and discomfort.
Pharmaceutical
Medications
The goals of therapy
in PD are to maintain function and quality of life and to avoid
drug-induced complications. Most commonly used is the dopamine precursor
levodopa in combination with carbidopa (Sinemet). Levodopa is usually
effective for motor symptoms at the beginning, its effectiveness
usually begins to decline after five to seven years and over time
tends to cause increased motor fluctuations, dyskinesias, and other
adverse side effects. It should not be used with antidepressant
medications of the MAOI class or by people with a history of melanoma
(a skin cancer). Side effects include hallucinations, dizziness,
insomnia, anxiety, heart palpitations, problems with digestion and
increased problems with movement.
Amantadine (symmetrel),
a commonly used medication, releases dopamine from those remaining
neurons that have not become damaged by the progression of PD. Amantadine
can cause numerous toxic side effects including nervous system disturbances
and hallucinations and should not be used by people with a pre-existing
seizure or psychiatric disorder. Pergolide (permax) is used as an
adjunct to Levodopa for the treatment of PD, and frequently added
when levodopa starts to lose it effectiveness. It is an ergot derivative,
and should not be used by lactating women. Selegiline (apo-selegiline
or eldepreyl) is an inhibitor of monoamine oxidase-B, and can be
used with levodopa. It acts on a similar metabolic pathway as some
antidepressants of the MAOI class and it should not be taken by
people on those medications.
For some the use
of medications alone does not improve symptoms and they may wish
to have surgery, which ablates brain tissue, or deep brain stimulation
(DBS), where an electric probe is placed in the brain to provide
stimulation. Only specific patients are candidate for these procedures,
and it should be discussed with specialized medical personal to
evaluation.
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Lifestyle
and Dietary Modifications
There is substantial
preliminary evidence that exposure to certain organochlorine insecticides
(e.g., lindane [Kwell®, Kildane®, Scabene®] and dieldrin
[Dieldrite]) may contribute to the development of Parkinson’s
disease. Avoiding contact with pesticides and pesticide residues
may be an important preventive measure for Parkinson’s and
other diseases. Carbon monoxide is another compound where exposure
is implicated in PD.
Presence of heavy
metals like mercury, lead and cadmium can affect normal brain function.
For individuals with exposure to these chemicals, or for those at
risk it is advised to get testing and heavy metal chelation from
a qualified professional.
PD patients should
not consume aspartame, as it can further exacerbate the disease
(due to the excitotoxic effects of aspartame).
Exercise is beneficial,
and a program of intensive exercise has been shown to significantly
improve the signs and symptoms of PD. Athletic training including
resistance exercises in water to increase strength, as well as exercises
increasing flexibility and balance is most helpful at retaining
muscle mass. Regular weight-bearing exercise, exposure to sunlight,
and a variety of supplements and dietary changes may be helpful
in preventing osteoporosis
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Nutritional
Factors Shown to be Beneficial
N-Acetyl-L-Cysteine
(NAC)
NAC can increase the body’s production of glutathione, a powerful
antioxidant in the brain. NAC itself is a potent antioxidant shown
to reduce formation of nitric oxide, a free radical implicated for
a causative role in Parkinson’s disease, Alzheimer’s
disease, and other neurodegenerative disorders.
Dose: 400 mg a day
Phosphatidylserine
(PS)
PS can improve memory and people with Parkinson’s disease
treated with L-dopa have been reported to have reduced levels of
the neurotransmitter PS.
Dose: 100 mg a day
Coenzyme
Q-10 (CoQ-10)
CoQ-10 measurably increases the efficiency of cellular energy production.
In addition, it serves as a potent brain antioxidant.
Dose: 120 mg a day
Acetyl-L-Carnitine
Acetyl-L-carnitine enhances the energy of the neurons bringing fuel
sources into the mitochondria – the energy producing machinery
of the neuron. This particularly benefits damaged brain neurons,
which are characterized by decreased energy producing ability. In
addition, acetyl-L-carnitine acts as an effective antioxidant and
been demonstrated to protect laboratory animals from developing
parkinsonism when they are exposed to chemicals known to induce
the condition
Dose: 400 mg
Alpha Lipoic
Acid
Alpha lipoic acid provides powerful antioxidant action and regenerates
other important brain antioxidants including vitamins E, C, and
glutathione. Unlike other antioxidants, alpha lipoic acid is both
fat- and water-soluble, greatly enhancing its ability to be absorbed
from the gut and penetrate into the brain.
Dose: 300-800 mg a day
Gingko biloba
Gingko, one of the most extensively studied nutritional supplements
for neurodegenerative conditions, directly improves brain metabolism,
increases brain blood flow, and provides antioxidant action.
Dose: 60 mg of the standardized extract
5-Hydroxytryptophan
(5-HTP)
5-HTP is useful in the treatment of PD for the treatment of the
depression that frequently is associated with it.
Dose: 100 - 600 mg per day
Vitamin
D
People with PD have a higher risk of osteoporosis, and it may act
as an antioxidant.
Dose: 400 IU a day
Vitamin
C
C is benifical to those with PD who are also on Levodopa as it can
increase cellular energy while acting as an antioxidant.
Dose: 800 – 2000 mg a day
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Recommended
NaturalMeds Products for Parkinsons Disease
Brain
Sustain Powder
BrainSustain is a powdered supplement that contains N-acetyl cysteine,
phosphatidylserine, acetyl-l-carnitine, coenenzyme Q 10, alpha lipoic
acid and ginkgo extract in a great tasting drink. It also contain
nutrients such as vitamin C, D and E; the minerals calcium, magnesium
and potassium. It comes in a whey or rice protein. It is specifically
formulated to enhance brain performance and promote brain health.
Dose: 2 scoops (25 g) a day Pack size: Whey
powder -330 grams; Rice powder- 600 g
Neuroactives
Made by the makes of BrainSustain, Neuroactives is a capsule alternative.
It contains N-acetyl cysteine, phosphatidylserine, acetyl-l-carnitine,
coenzyme Q 10, alpha lipoic acid and ginkgo extract, but without
the extra vitamins. This product is useful for someone already on
a multivitamin.
Dose: 2 capsules twice a day Pack size: 60
capsules
Vitamin
C Ascorbic acid crystals
Vitamin is an astounding nutrient, as supplementation not only helps
with immune function but as an antioxidant protects against free
radical damage. Powdered forms of vitamin C are easy to take.
Dose: ½ teaspoon two to threes times
a day Pack size: 8 ounces (226.796 g)
C-1000
For those who prefer to take tablets, this vitamin C provides 1000
mg or 1 gram of ascorbic acid per tablet. It is made from tapioca,
otherwise called sago, a GMO free, corn free source.
Dose: 2 tablets two to three times a day Pack
size: 100 tablet
5-HTP
50 mg
Studies have shown that 5-HTP increases the amount and availability
of serotonin, a neurotransmitter, produced by the body.
Dose: begin with 1 capsule, gradually increasing
dosage up to two capsules daily, if needed, three times a day, away
from food Pack size: 30 tablets
Alpha-
Lipoic acid 100 mg
Alpha-Lipoic Acid is a powerful antioxidant that is soluble in both
fat and water. It directly recycles vitamin C and indirectly recycles
vitamin E, providing additional antioxidant protection.
Dose: 2 capsules two to three times a day
Pack size: 30 tablets
CoQ10
30 mg
Coenzyme Q10 is essential to human life. It plays a role in energy
production cycles that converts food into energy. It is best taken
with food, especially with a food that contains fat as it improves
absorption.
Dose: 4 capsules with meals a day Pack size:
30 and 60 capsules
Vitamin
D 1000 IU
Scientists are discovering that vitamin D is an important hormone
precursor that supports immune response and helps regulate the health
of at least 20 different tissues, including the nervous system.
Dose: 1 tablet a day Pack size: 100 tablets
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