Parkinson's Treatment

Diagnosis

There are no specific tests that indicate Parkinson’s, but a neurologist looks to analyze physical manifestations. Four motor symptoms are used for diagnosis:

  • slowness of movement (bradykinesia),
  • tremor,
  • rigidity, and
  • postural instability.

These symptoms typically begin asymmetrically, but progress to bilateral. Other symptoms include gait changes, forward leaning posture, small steps, speech and swallowing problems, flat facial expression, etc.

Conventional Treatment

There is no cure for PD, but there are drugs available that can help reduce some symptoms.

Drugs that increase dopamine in the brain, or mimic dopamine or prevent or slow its breakdown. However, these drugs can have side effects such as hallucination, anxiety, confusion, or mood changes, as well as teeth grinding, clumsiness, dizziness, numbness, or weakness.

Caffeine-based compounds. In a 2016 study, caffeine-based chemical compounds which contained certain nutrients including nicotine, metformin and aminoindan prevented the misfolding of alpha-synuclein, which is the protein that has been shown to be necessary for dopamine regulation.1

Drugs that affect other neurotransmitters in the body in order to ease some of the symptoms of the disease, such as tremors.

Drugs for mood that help control the non-motor symptoms of the disease such as antidepressants.

Surgery is sometimes recommended:

  • Pallidotomy and thalamotomy selectively destroy specific parts of the brain that contribute to PD symptoms.
  • Deep brain stimulation (DBS) uses an electrode surgically implanted into part of the brain (typically the subthalamic nucleus or the globus pallidus) to gently stimulate the brain in a way that helps to block signals that cause many of the motor symptoms of PD.

Complementary Support

There are no current therapies that, by themselves, stop nerve cell death, or cure Parkinson’s. It is becoming increasingly clear that neurological diseases such as PD are multi-factorial involving disruptions in multiple cellular systems.2

The following recommendations are based on the concept that PD must be addressed from the point of view of all of its constituent symptoms: neurodegeneration, mitochondrial dysfunction, motor dysfunction, inflammation, oxidative stress, apoptosis (cell death), weak blood-brain barrier, gut-brain axis imbalances, poor dopamine production, and also alpha-synuclein build-up.

Diet

A poor diet will have a negative impact on an individual’s health. Nutrition and nutrition-gene interactions affect multiple aspects of neurodevelopment, neurogenesis and the functions of neurons and neural networks.3

Epidemiological studies find that high intake of fruits, vegetables and fish are inversely associated with PD risk,4, 5 with an emphasis on foods containing carotenoids and beta-carotene,6 as well as cruciferous vegetables such as cauliflower, cabbage, and broccoli (rich in antioxidants with neuroprotective capacity).

Food choices. Reduced Parkinson’s symptoms are found in a diet high in fresh vegetables, fresh fruit, nuts, and seeds, non-fried fish, olive oil, wine, coconut oil, fresh herbs, and spices. Consumption of green tea, coffee, and blueberries as well as avoiding dairy are associated with reduced risk of being diagnosed with PD.7, 8

Mediterranean diet Studies have shown that the dietary patterns characteristic of a Mediterranean diet significantly reduce the risk of Parkinson’s. These results are emerging as a potential neuroprotective alternative for PD, and are linked to later age of diagnosis.9 Some of these foods include fresh fish, olive oil, nuts and seeds, fresh fruit, and vegetables.

Keto diet Limited studies indicate that a Keto diet improve symptoms related to PD.10 Although the mechanisms are not yet well defined, it is plausible that neuroprotection results from enhanced neuronal energy reserves, which improve the ability of neurons to resist metabolic challenges, and possibly through other actions including antioxidant and anti-inflammatory effects. It may as well have beneficial disease-modifying activity applicable to a broad range of brain disorders characterized by the death of neurons.

Note: Having protein at the dinner meal only (along with vegetables, particularly green, leafy vegetables) can keep inflammation down. Keeping protein levels moderate throughout the day has been shown to help reduce the symptoms of Parkinson’s.11

Juicing recipe. These are recommended foods for juicing for brain health. Choose some combination of these foods and add your favorite fruits and vegetables as well.

  • Green, leafy vegetables, avocado, broccoli, avocado, kale, and red beets
  • Apples, berries (especially blueberry), bilberry, black currant, blackberry, mulberry, goji berry citrus fruits (especially lemon), kiwi, grapes, pomegranate juice, and prunes
  • Garlic, ginger, chia seeds, parsley, ginseng, walnuts, yogurt, and honey
  • Coconut oil

Limit the following:

  • Limit the amount of protein. Consuming lots of beef, fish, or cheese may affect the effectiveness of certain Parkinson’s medications.
  • Limit sodium, trans fats, cholesterol, and saturated fats.

Nutrient Summary

The following nutrients support brain health. Read about them in greater detail on the prevention page.

  • Break down alpha synuclein/or prevent build-up: baicalein, alpha lipoic acid, ginseng, and melatonin.
  • Neurogenesis support: acetyl-l-carnitine, astaxanthin, omega-3 fatty acids and phosphatidylserine.
  • Improve cognition: astaxanthin, ashwagandha, curcumin, ginseng, green tea, n-acetylcysteine, omega-3s, phosphatidylserine, PQQ, vinpocetine, and vitamin E.
  • Support brain plasticity: blueberries, DHA, fisetin, ginseng, goji berry, magnesium, omega-3 fatty acids, and resveratrol.
  • Dopamine support: acetyl-l-carnitine, alpha lipoic acid, choline, bacopa monnieri, baicalein, catechins, caffeine, ginseng, glutathione, green tea, lutein, n-acetyl-cysteine, polygalae radix, pueraria thomsonii benth, red sage, SAM-e, and vinpocetine.
  • Reduce brain inflammation: alpha lipoic acid, apigenin, ashwagandha, astaxanthin, baicalein, CoQ10, curcumin, garlic, ginseng, green tea, omega-3, 6, 7 essential fatty acids, pycnogenol, reishi mushrooms, resveratrol, sage, SAM-e, vinpocetine, and zeaxanthin.
  • Reduce depression: 5-HTP, baicalein, ginger, ginseng, goji berry, n-acetylcysteine, olive leaf extract, omega-3 fatty acids, phosphatidylserine, sage, SAM-e, tryptophan, and vitamin B12.
  • Improved motor performance/reduced rigidity: Bacopa monnieri, ginger, mulberry, SAM-e, and vinpocetine.

Exercise and Movement

Exercise intervention has well-documented beneficial effects on PD symptoms and quality of life (QOL). Several forms of exercise show improvement in activities of daily living, perceived health status, fall risk, motor performance, and QOL,12 putting it in the forefront of Parkinson’s treatment.13 Though exercise can be difficult, it is essential to find exercises that can be practiced daily and to keep moving and stretching as much as possible. Since balance can become a problem, make sure you work with a professional who can provide you with the best exercises and the best and safe ways for practicing them. Some PD patients may primarily practice chair exercises.

For patients who have not developed symptoms, research suggests that vigorous midlife exercise significantly reduces the risk of both dementia and other mild cognitive impairments.14

Tai chi is an excellent exercise to learn, using slow movements to help maintain health, strength, range of motion, and balance. In one study of 195 men and women with mild to moderate PD, after six months of practice and strength exercises, two times per week, the tai chi group improved more in strength and balance than the other groups. Other studies confirm these results15 with more improvement in resistance training, stretching, incidence of falls, stride length, and functional reach.

Water aerobics is a safe and effective way to exercise. Older adults who participate in water sports have significant increases in leg strength, better recovery of balance after falls, significant improvements in gait patterns, and lower risk of future injuries from falling.16

Yoga can help with mobility, balance, strength, flexibility, mood, and sleep. Parkinson’s disease can affect walking and balance, and it is estimated that over 70% of people with PD fall within a given year. Individuals who practice Hatha yoga twice a week, for 8 weeks, show improvements in mobility, balance, and stability, which reduces the risk of falls.17

Next: Prevention

Footnotes

Note: more details about research are available in our guide to Parkinson's, Natural Parkinson's Care, or upon request.

1. Kakish J, Allen KJH, Harkness TA, Krol ES, Lee JS. (2016). Novel Dimer Compounds That Bind a-synuclein Can Rescue Cell Growth in a Yeast Model Overexpressing a-Synuclein. ACS Chem Neurosci, Sep 12;7(12):1671-1680.
2. Maher P. (2017). Protective effects of fisetin and berry flavonoids in Parkinson's disease. Food Funct. Sep 20;8(9):3033-3042.
3. Dauncey M. (2012). Recent advances in nutrition, genes and brain health. J Proc Nutr Soc. Nov; 71(4):581-91
4. Gao X, Chen H, Fung TT, Logroscino G, Schwarzschild MA, et al. (2007). Prospective study of dietary pattern and risk of Parkinson disease. Am J Clin Nutr. Nov; 86(5):1486-94.
5. Okubo H, Miyake Y, Sasaki S, Murakami K, Tanaka K, et al. (2012). Dietary patterns and risk of Parkinson's disease: a case-control study in Japan. Eur J Neurol. May; 19(5):681-8.
6. Miyake Y, Fukushima W, Tanaka K, Sasaki S, Kiyohara C, et al. (2011). Dietary intake of antioxidant vitamins and risk of Parkinson's disease: a case-control study in Japan. Eur J Neurol. Jan; 18(1):106-13.
7. Gao X, Cassidy A, Schwarzschild MA, Rimm EB, Ascherio A. (2012). Habitual intake of dietary flavonoids and risk of Parkinson disease. Neurology. Apr 10; 78(15):1138-45.
8. Hu G, Bidel S, Jousilahti P, Antikainen R, Tuomilehto J. (2007). Coffee and tea consumption and the risk of Parkinson's disease. Mov Disord. Nov 15; 22(15):2242-8.
9. Alcalay RN, Gu Y, Mejia-Santana H, Cote L, Marder KS, et al. (2012). The association between Mediterranean diet adherence and Parkinson's disease. Mov Disord. May; 27(6):771-4.
10. Wlodarek D. (2019). Role of Ketogenic Diets in Neurodegenerative Diseases (Alzheimer's Disease and Parkinson's Disease). Nutrients. Jan;11(1):169.
11. WebMD. Eating Right with Parkinson's Disease. Retrieved Jun 10 2019 from https://www.webmd.com/parkinsons-disease/guide/eating-right-parkinsons#1.
12. Herman T, Giladi N, Gruendlinger L, Hausdorff JM. (2007). Six weeks of intensive treadmill training improves gait and quality of life in patients with Parkinson's disease: a pilot study. Arch Phys Med Rehabil. Sep; 88(9):1154-1158.
13. Earhart GM, Falvo MJ. (2013). Parkinson disease and exercise. Physiol. Apr;3(2):833-848.
14. Ahlskog JE. (2011). Does vigorous exercise have a neuroprotective effect in Parkinson disease? Neurology. Jul 19;77(3):288–294.
15. Wayne P. (2013). Tai Chi improves balance and motor control in Parkinson's disease. Retrieved Jun 1 2019 from https://www.health.harvard.edu/blog/tai-chiimproves-balance-and-motor-control-in-parkinsons-disease-201305036150.
16. Kim SB, O'Sullivan DM. (2013). Effects of Aqua Aerobic Therapy Exercise for Older Adults on Muscular Strength, Agility and Balance to Prevent Falling during Gait. Phys Ther Sci. Aug; 25(8): 923–927.
17. Wei M. (2018). New Research Suggests Yoga Can Help Parkinson's Disease. Retrieved Jun 1 2019 from https://www.psychologytoday.com/us/blog/urbansurvival/201807/new-research-suggests-yoga-can-help-parkinsons-disease.