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.
Mucuna Pruriens
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.[8]
Dosage
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.
Contraindications
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.
Exercise
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.
Conclusion
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 effectively.