What is Parkinson’s Disease & Steps to Slow Progression

It’s a neurodegenerative disease, meaning it damages brain cells, impairs function, and gets worse over time. Parkinson’s tends to strike earlier than Alzheimer’s (average age at diagnosis is 57) and affects nearly every system in the body. The disease is marked by increasing muscle tremors, followed by slowness of movement, stiffness, and problems walking. About one-third of people with Parkinson’s go on to develop dementia.

The hallmark of the disease is the destruction of dopamine-producing neurons (brain cells) in a small part of the brain called the substantia nigra, or SN, which controls movement. Thus, the main goal of medical treatment is getting the brain to produce more dopamine, replacing dopamine, or finding ways to keep existing dopamine around longer.

Because the disease wasn’t even described until early in the 19th century, and because its prevalence has grown in Western countries along with our own growth in industrialization, many researchers suspect that toxins in the environment contribute to its development via oxidation. However, there’s obviously something else going on, or everyone would have it. And it seems there is: People with Parkinson’s seem to have higher levels of rogue electrons that escape control when brain cells make energy. These electrons become free radicals, which damage those dopamine-producing brain cells.

Plus, studies find that the SN areas in the brains of people with Parkinson’s are abnormally low in glutathione, a powerful antioxidant needed to reduce oxidative stress in that part of the brain. In fact, glutathione is so vital to sustaining cellular life that once levels drop severely, the cell nearly always dies.

Although there’s no cure for Parkinson’s, there are medications that can help. And you can also take extra measures to slow oxidation and help retard the disease’s progression.

Our Best Advice

No matter where you are in your Parkinson’s diagnosis, follow this advice to slow further progression.

1. Begin taking 100 milligrams coenzyme Q10 three times a day, gradually increasing to 1,200 milligrams a day.
2. Also take 400 IU vitamin E and 1 to 2 grams vitamin C daily (in two to four divided doses of 500 milligrams).
3. Follow a low-fat, low-calorie diet high in fruits, vegetables, and beans.
4. Drink several cups of green tea a day.
5. Get at least 20 minutes a day of physical activity three days a week. A good option is walking back and forth in the shallow end of the pool. If you find you can’t exercise on your own, get your doctor to write you a prescription for physical therapy. Add a session of t’ai chi once a week.

Why It Works

Cells contain tiny “furnaces” called mitochondria, which produce energy for the cell. A by-product of this energy production is spare electrons. If these electrons escape the cell, they become free radicals, which cause oxidative damage in the brain. Coenzyme Q10, an antioxidant found in every cell of the body, traps the spare electrons in the mitochondria, where they are used to produce the next round of energy. Obviously, its role is important. But studies find significantly low levels of coenzyme Q10 in the mitochondria of brain and blood cells in Parkinson’s patients, which is why we recommend supplements. Animal studies find it protects dopamine-producing brain cells.

In one of the few published trials in humans, of 80 people with Parkinson’s who weren’t taking any medication yet, those who took coenzyme Q10 for 16 months (or until their condition got so bad they needed medication) became less disabled in this time period than those who got a placebo. The results were so encouraging that the government is now funding large clinical trials to evaluate the supplement as a potential treatment for early-stage Parkinson’s.

We also recommend vitamins E and C. In one study, very high doses of vitamin E (3,200 IU) and vitamin C (3 grams a day) delayed Parkinson’s patients’ need for medication by about 35 months. We don’t routinely suggest such high doses of vitamin E-it can increase the risk of heart disease-so talk to your doctor about what dosage is safe for you (we know that 400 IU is safe). You can take high doses of vitamin C on your own, but don’t take more than 500 milligrams at one time.

Your diet can help too. Fruits and vegetables provide antioxidants to minimize oxidative damage. We suggest 9 to 12 servings a day. Don’t panic! A serving is as little as a small glass of fruit or vegetable juice, a medium-sized piece of fruit, or 1/2 cup cooked vegetables or cut-up fruit or veggies. Keep your fat and calories low to reduce your risk of heart disease, which some studies suggest is more deadly if you also have Parkinson’s. Plus, eating fewer calories reduces oxidation.

The beans come into play because they can increase levels of the chemical levodopa (which eventually turns into dopamine) in the brain and reduce movement problems like shaking and stiffness, particularly in people with early or mild stages of Parkinson’s. Aim for about 8 ounces (1 cup) of beans a day.

Green tea gives you heaping doses of polyphenols, antioxidant chemicals that help sop up free iron molecules. Some research suggests these iron molecules may contribute to the oxidative damage that causes Parkinson’s. Plus, the tea contains theanine, which laboratory studies find can increase dopamine levels. Aim for three or four cups a day.

Regular exercise not only helps slow the loss of movement, but also improves mobility and mood. We recommend walking and suggest you walk to a recording of a metronome (or a very rhythmic song) to maintain a regular gait.

T’ai chi helps improve balance and prevent falls. In one study, a one-hour class once a week for 12 weeks slashed the risk of falls in half, a benefit that lasted at least a year after the class ended.

Other Medicines

Herbs and Supplements

Mucuna pruriens. Compounds in the seeds of this Ayurvedic herb act pretty much like those in the standard Parkinson’s drug. We particularly recommend this supplement for people in the early stages of the disease to delay the time until you need prescription medication.

In one small study of eight patients whose symptoms were not controlled well with medication, those who took 30 grams of this herb a day had higher levels of levodopa (L-dopa) than those who just took the medication, and the L-dopa lingered in the brain longer. The results led the researchers to suggest that this plant source of L-dopa might have some advantages over the prescription drug in long-term Parkinson’s treatment. Don’t, however, take it if you’re already taking an L-dopa medication.

B complex vitamin. L-dopa raises levels of homocysteine, an amino acid linked to heart disease. To reduce your levels if you’re taking the drug, take a B complex vitamin containing at least 800 micrograms folic acid, 400 micrograms B12, and 50 milligrams B6.

Omega-3 fatty acids. One study found that daily doses of evening primrose oil relieved tremors in people with Parkinson’s, while another found wheat germ oil could improve symptoms. Both oils are rich in omega-3s. However, because they contribute to oxidation, be sure to also take the antioxidant vitamins C and E that we already recommended. Take 1 to 2 grams of either oil every day.

Prescription Drugs

Sinemet (carbidopa-levodopa). This is the main drug used in treating Parkinson’s. It combines L-dopa and carbidopa, a drug that blocks action of an enzyme that breaks down dopamine. The carbidopa reduces some of the side effects that can result from L-dopa alone, including nausea and vomiting, and enables more of the L-dopa to get to the brain, so you can take a smaller dose. Sinemet’s use is somewhat controversial, however, because there’s some evidence it may actually contribute to damage of dopamine-producing neurons by increasing oxidation.

Eventually-after about two or three years on average-Sinemet stops working in some patients during certain times of the day. A longer-lasting form of the drug called Stalevo may get around this.

Dopamine agonists. These drugs include Parlodel (bromocriptine), Permax (pergolide), Mirapex (pramipexole) and Requip (ropinirole). They enhance the action of dopamine receptors on cells so they’re more responsive to the dopamine that’s available. The drugs can be taken alone or with Sinemet.

MAO inhibitors. These drugs do two things for people with Parkinson’s. They keep dopamine in the brain longer by inhibiting an enzyme, monoamine oxidase, that plays a role in breaking it down. They also protect neurons from further oxidative damage, which can slow the progression of the disease. The most studied drug in this class is selegiline (Carbex and Eldepryl).

Anticholinergics. These drugs, which include trihexyphenidyl (Artane and Trihexane), benztropine, and procyclidine, reduce muscle tremors.

Symmetrel (amantadine). Also prescribed for viral infections, this drug increases dopamine levels in the brain and keeps dopamine available to brain cells longer. It’s generally taken only short-term in early-stage Parkinson’s, after which it usually stops working.

Other Approaches

Deep brain stimulation. This surgical procedure involves implanting a battery-operated device into the brain to electrically stimulate areas that control movement, blocking the abnormal nerve signals that lead to classic Parkinsonian symptoms. Studies find significant improvements in the quality of life of people with Parkinson’s after the procedure, particularly in terms of movement. This procedure is very invasive, however, and is not recommended until late in the disease.

Surgery. Several surgical procedures have been developed to treat the movement disorders of Parkinson’s, including procedures that destroy small parts of the brain, stem cell transplants to replace damaged neurons, and the surgical infusion of growth factors to stimulate production of certain chemicals in brain cells.

Alexander Technique. This therapy teaches you to change how you move in order to release tension and improve your balance. A 2002 study found that combining it with medical therapy could improve symptoms in people with Parkinson’s more than medical therapy alone.

Acupuncture. Although clinical studies show no difference in benefits between acupuncture and placebo in relieving the muscle-related symptoms of Parkinson’s, they do show it can help with sleep, often a problem for those with the disease. We recommend at least one trial of acupuncture to see if it helps relieve any symptoms or improve sleep.

Medical spa therapy. Ask your doctor for a prescription for this therapy, which combines water therapy with medical massage and other physical therapy. One small study in 31 people with Parkinson’s found that three weeks of medical spa therapy significantly improved several Parkinson’s-related symptoms, as well as psychological status.

Prevention

Get your caffeine. In one study, men who didn’t regularly drink coffee were five times more likely to develop Parkinson’s than those who did. Other studies find that high tea consumption reduces Parkinson’s risk. The connection is related to caffeine, researchers say. Green tea doesn’t contain as much caffeine as coffee, but it does contain some, and it also has brain-protecting antioxidants called polyphenols.

Eat your vegetables. A diet high in antioxidant-rich fruits and vegetables reduces the risk of Parkinson’s, probably by protecting brain cells from oxidative damage.