Parkinson’s disease is a common neurological condition afflicting about 1 percent of men and women over the age of seventy. Individuals with Parkinson’s disease have tremor of the hands, rigidity, poor balance, and mild intellectual deterioration. The tremor is most apparent at rest and is less severe with movement. In Parkinson’s disease, a small region in the brain, called the substantia nigra, begins to deteriorate. The neurons of the substantia nigra use the brain chemical dopamine. With the loss of dopamine, tremors begin and movement slows. Despite current drug therapies, Parkinson’s disease remains a progressive and incurable condition. Many patients with Parkinson’s disease may also suffer from age related cognitive decline or have some of the symptoms of Alzheimer’s disease.
   Although Parkinson’s disease can occur from viral infections or exposure to environmental toxins, such as pesticides, the causes of the majority of cases are not well known. Scientists suspect that oxidative damage to neurons in the substantia nigra could well be one of the major causes, particularly due to the depletion of the antioxidant glutathione. People who sustain substantial head injuries may face an increased risk of developing Parkinson’s disease years later. Middle-aged men and women who are overweight may be at increased risk of developing Parkinson's disease.
   The thinking and muscle problems commonly caused by Parkinson's disease hamper driving skills in most elderly people with the progressive brain disorder.

Additional Nutrients to Consider
Some of the following nutrients may not be directly involved in making more dopamine, but could well improve general cognitive abilities. Many patients who have Parkinson’s disease, especially the elderly, have age related cognitive decline.

Fish oils at 500 to 1,000 mg a day of EPA and DHA with meals. The role of fish oils in Parkinson’s disease is not known, but they can generally improve overall brain health.
Gingko biloba at 40 to 60 mg most days with breakfast or lunch. This herb has antioxidant properties and helps improve memory and alertness.
Replacing hormones in patients with Parkinson’s disease may be an additional option. Whether pregnenolone, DHEA, or other hormones are helpful in Parkinson’s disease is currently not known.

It’s possible that the proper use of natural supplements can reduce the necessary dose of L-dopa, selegiline, and other drugs currently used to treat Parkinson’s disease, or help slow down the progression of the condition. There’s still a great deal we need to learn about the nutritional treatment of Parkinson’s disease. Incorporate relaxation or stress reduction techniques into your daily life. Some forms of body work and massage are especially beneficial in Parkinson’s. The nutritional therapy for Parkinson’s disease and tremor is still an uncharted territory. The most promising approach appears to be the use of antioxidants to slow the oxidation and damage to the substantia nigra. It’s possible that additional nutritional approaches may be found in the future.

Food and Parkinson's disease
Large amounts of dairy products may increase in the rate of Parkinson's disease. Intake of fruits and vegetables decreases the risk.

Prospective study of dietary pattern and risk of Parkinson disease.
Am J Clin Nutr. 2007 Nov;86(5):1486-94. Gao X, Chen H, Fung TT, Logroscino G, Schwarzschild MA, Hu FB, Ascherio A. Departments of Nutrition and Epidemiology, Boston, MA.
Several studies have shown associations between Parkinson Disease risk and individual foods and nutrients with inconsistent results. We examined associations between dietary patterns and risk of Parkinson's disease in the Health Professionals Follow-Up Study (1986-2002) and the Nurses' Health Study (1984-2000). Dietary patterns with a high intake of fruit, vegetables, legumes, whole grains, nuts, fish, and poultry and a low intake of saturated fat and a moderate intake of alcohol may protect against Parkinson's disease.

Manganese and Parkinson's disease
Manganese is an essential trace metal that is widely used in industry, particularly in the manufacture of steel. Exposure to high levels of manganese can cause toxicity to nerve cells with the development of a form of parkinsonism known as manganism.

Blocking Dopamine Breakdown
Dopamine is broken down in the brain by an enzyme called monoamine oxidase (MAO). When the activity of MAO is inhibited, dopamine stays around longer and this benefits those with Parkinson’s disease. Several drugs are available that block the activity of MAO. Selegiline is the most effective and the one used most commonly. The prescribed dosage is 5 mg a day.
   No nutrients are currently known that prevent the breakdown of dopamine. However, a study conducted on rats at the College of Humanities and Sciences, Beijing Union University, in Beijing, China, indicates that the Chinese herbs codonopsis and astragalus can inhibit MAO type B and increase the activity of the antioxidant SOD. We don’t have any human trials to determine whether these two herbs would benefit patients with Parkinson’s disease. Although selegiline is a very helpful medicine, high doses may increase the risk of heart irregularities.

Medical Treatment Strategies for Parkinson’s disease
There are basically three types of drugs that are commonly prescribed for patients with Parkinson’s disease. First, doctors prescribe dopamine precursors, such as L-dopa, which converts into dopamine. A second approach is using drugs that block the breakdown of dopamine. A common medicine used for this purpose is selegiline (also known as deprenyl). And third, drugs are provided that influence dopamine receptors directly. The two most commonly prescribed are bromocriptine and pergolide. Researchers from the Mayo Clinic say that in some cases, patients taking pergolide (Permax) may experience damage to heart valves.
   Over the past few decades, doctors have made important advances in the therapy of Parkinson’s disease with pharmaceutical medicines. Yet, several nutritional strategies exist which should be explored further.

Which medication to start with?
Parkinson's disease is a degenerative brain condition in which dopamine-producing cells in the brain gradually die off or malfunction. Dopamine helps regulate movement, and as Parkinson's progresses, people have increasing difficulty walking, talking and performing simple tasks. As a treatment strategy for early Parkinson's disease, both levodopa and pramipexole appear to be similar in delaying the progression of this neurological disease.
However, Levodopa is more likely to cause dopaminergic events, whereas pramipexole is more likely to cause sleepiness and swelling from water retention. Levodopa patients experience dopaminergic motor complications more frequently than pramipexole patients. sisabling dyskinesias - involuntary muscle movements -- were uncommon with both treatment approaches. Archives of Neurology, March 9, 2009.

Tricyclic antidepressant nortriptyline versus SSRI paroxetine for depression
People with Parkinson's disease who need treatment for depression seem to do better with nortriptyline antidepressant than paroxetine, a newer medicaiton. Dr. Matthew Menza, of the Robert Wood Johnson Medical School in Piscataway, New Jersey, compared the older tricyclic antidepressant nortriptyline with the newer SSRI drug paroxetine in 52 people with Parkinson's disease diagnosed with major depression. Nortriptyline is available in generic form and under the brand name Pamelor, and paroxetine CR is known by the brand names Paxil and Seroxat. After 8 weeks, nortriptyline was more effective than paroxetine CR. Neurology, March 10, 2009.

Parkinson drug risk
Drug therapy for Parkinson's disease to replace the dopamine or reduce tremors can help some patients for a while, but symptoms eventually worsen The risk of heart valve damage with two drugs for Parkinson’s disease may be far greater than was known. The drugs are not the main treatment for Parkinson’s, but one is also sometimes used to treat restless legs syndrome. A study by Italian researchers found that roughly one-fourth of Parkinson’s patients taking pergolide or cabergoline, sold as Permax, Dostinex and other brands, had moderate to severe heart valve problems. Another study, by German doctors, found that users of either drug were five to seven times more likely to have leaky heart valves than those on other types of Parkinson’s medications.

The U.S. Food and Drug Administration in April 2010 reports it is evaluating clinical data that may suggest Parkinson's disease treatment Stalevo is linked to an increased risk of prostate cancer. Data from a long-term clinical trial, known as STRIDE-PD, unexpectedly found that a greater number of patients taking Stalevo had prostate cancer compared to those taking another drug treatment.

Parkinson's drugs can increase the odds that people develop impulse control problems such as gambling, binge eating, shopping sprees and compulsive sexual behaviors. A study of more than 3,000 people with Parkinson's disease confirms that so-called dopamine agonists, such as GlaxoSmithKline's Requip or ropinirole or Boehringer Ingelheim's Mirapex or pramipexole, can cause impulse control problems. Daniel Weintraub of the University of Pennsylvania and the Philadelphia Veterans Affairs Medical Center says dopamine agonists work by helping the brain make more dopamine, the message-carrying chemical made by brain cells destroyed by Parkinson's. Patients with the incurable disease have difficulties with movement, muscle control and balance and can eventually become paralyzed and die. Daniel Weintraub studied 3,090 Parkinson's patients. Nearly all were taking either a dopamine agonist or a levodopa dopamine replacement drug such as Bristol-Myers Squibb's Sinemet.

Levodopa induced dyskinesia
Levodopa induced dyskinesia is one of the most common motor complications in advanced Parkinson's disease. This dyskiesia involve mostly the limbs, trunk and head, but unusual locations have been reported including respiratory muscles, the face and the eyes.

Drug patch for Parkinson's disease
In May of 2007, the U.S. Food and Drug Administration approved a new patch, called Neupro, that treats Parkinson's disease symptoms. Neupro is made by German drugs firm Schwarz Pharma. Neupro is the first transdermal patch approved for the treatment of symptoms of Parkinson's disease. Neupro patch delivers a drug called rotigotine. Rotigotine is similar to other drugs used to treat Parkinson's -- it is a so-called dopamine agonist, which provides more dopamine. The Neupro patch is replaced every 24 hours and provides a continuous dose of the drug. The most common side effects for Neupro included skin reactions at the patch site, dizziness, nausea, vomiting, drowsiness and insomnia, most of which are typical of this class of drugs.

Family history and Parkinson's disease
Immediate relatives (brother, sister, mother, father, son or daughter) of patients with Parkinson's disease are at increased risk for developing depression and anxiety disorders which suggests a genetic relationship. Archives of General Psychiatry, December 2007.

Ovary removal may increase risk of Parkinson's disease
Women who have had removal of one or both ovaries prior to menopause are at increased risk of developing Parkinson's disease or similar conditions. Estrogen protects the brain's neurons and thereby may decrease the risk of Parkinson's disease.

Pesticides and insecticides as a cause
On-the-job pesticide exposure increases the risk for Parkinson's disease. French researchers found that among nearly 800 adults with and without Parkinson's, agricultural workers exposed to pesticides -- including insecticides, weed killers and fungicides -- were at greater risk of the disease. The risk climbed in tandem with the amount of time a worker was exposed, strengthening the case for a cause-effect relationship, according to the researchers, led by Dr. Alexis Elbaz of INSERM, the national French institute for health research in Paris. In men, among the main groups of pesticides -- fungicides, herbicides, insecticides -- the association was the strongest for insecticides, and among insecticides, with organochlorine insecticides, which have been frequently used in France in the past. Annals of Neurology, June 4, 2009.

Dr. Jason R. Richardson of the Robert Wood Johnson Medical School in Piscataway, New Jersey, reports that Parkinson's disease patients are more likely to have detectable levels of beta-hexachlorocyclohexane (beta-HCH) in their blood, and also had higher average levels, than healthy individuals or Alzheimer's disease patients. Beta-HCH belongs to a class of pesticides known as organochlorines, which were banned in the US in the 1970s. But these pesticides can persist in the environment -- and in people's bodies -- for decades. Archives of Neurology, July 2009.

Do NSAIDs protect against Parkinson's disease?
Some studies find that NDAIDs protect agains Parkinson's disease while others have not found such a relationship.

Nonsteroidal anti-inflammatory drugs may protect against Parkinson disease.
Neurology. 2007 Nov 6;69(19):1836-42. Wahner AD, Bronstein JM, Bordelon YM, Ritz B. Department of Epidemiology, UCLA School of Public Health, Box 951772, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA.
Markers of neuroinflammation, including activated microglia and increased levels of circulating proinflammatory cytokines, have been observed in the brains and CSF of patients with Parkinson disease. Our study contributes to the growing body of literature suggesting a protective role for nonsteroidal anti-inflammatory drugs (NSAIDs) in Parkinson disease. Given our results and the biologic plausibility of a neuroprotective function for NSAIDs there is a pressing need for further studies elucidating the protective role such drugs may play in Parkinson's disease.

Nonsteroidal anti-inflammatory drugs and the risk of Parkinson disease.
Neuroepidemiology. 2007;28(4):193-6. Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
Several lines of evidence suggest a role of inflammatory processes in Parkinson disease, although it is still unclear whether inflammation is a cause or rather a consequence of neurodegeneration. In a prospective population-based cohort study among 6,512 participants aged >or=55 years, with repeated in-person examination, we evaluated the association between cumulative use of nonsteroidal anti-inflammatory drugs (NSAIDs) and the risk of Parkinson disease. Complete information on filled prescriptions was available from automated pharmacy records. Data were analyzed by means of Cox proportional hazards regression analysis, adjusted for age, sex, smoking habits and coffee consumption. After an average 9 years of follow-up, 88 new cases of Parkinson disease were detected. No association was found between use of NSAIDs and the risk of Parkinson disease (adjusted hazard ratio for any NSAID use. Our findings do not support the hypothesis that NSAIDs might decrease the risk of Parkinson disease.

Parkinson's disease emails
Q. I've been trying to keep you aware of my condition; The Parkinsons disease I have. the mucuna pruriens has helped greatly, I've improved even more. The shaking is very much better and the memory is getting better. My DR. is surprised I showed him the product and he is considering having a mucuna bottle in his office to reccomend to patients.

Q. I have Parkinson disease and I beg you to answer to me if Mind Power Rx is right supplement for me.
   A. We cannot predict any person's response to a particular supplement, it is impossible for us to say whether a product such as Mind Power Rx will help or not, all we can do is give general research on the topic of Parkinson's Disease.

Q. I have Parkinson disease taking mucuna at present would your other supp. mind power rx be better on ltd income due to illness any info appreciated thank you.
   A. It is impossible to predict whether Mind Power would help or not help. If you do choose to use Mind Power Rx, we would suggest reducing the dose of mucuna to avoid overstimulation and have your doctor supervise you.

Q. Sir, will Mind Power Rx formula aid a person with Parkinson's disease ? Is there a special formula that may help control the symptoms of Parkinson disease ?
   A. There have not been any studies with Mind Power Rx in regards to Parkinson's disease. You may ask your doctor to read the research on this page in regards to Parkinson's disease option with natural supplements.

Q. I have severe Parkinson's disease with motor fluctuations and am on Sinemet etc. Can I use choline supplement? What should I watch for? Which preparation is the best for me to use?
   A. It is difficult to predict for each person how a supplement will interact with their medical condition or medication. We have not seen much research with Parkinson's disease and choline supplements.

Q. I am considering using natural products to supplement or replace my existing regimen of Sinemet LDOPA, Mirapex, Comtan and Selegiline. What of your products would you recommend and why. Also a byproduct of taking these meds is erectile dysfunction. I understand these natural products my help me there as well.
   A. We suggest your doctor reads this page on Parkinson's disease. We cannot make individual suggestions. If natural supplements such as mucuna pruriens are started, the dosage of the other drugs may need to be reduced since overstimulation can occur.

Q. I recently discovered mucuna pruriens product and I have been taking 3 pills daily or about a month as a secondary dopamine support to my daily prescription of Carbodopa / Levodopa. I had a stem cell treatment for
Parkinson's almost a year ago and the thought is that the stem cells will develop into dopamine producing cells as needed. My hope is to wean off of the prescription drugs and use the mucuna pruriens product to help keep my
dopamine levels more stable while this regeneration takes place. What do you consider to be the maximum mucuna dosage a person could take without risk of serious side effects or other complications? I'd like to see if I could just use the natural dopamine and get off the prescription drugs all together.
   A. Each person is different in the mucuna pruriens dosage that works for them. One dosage may work well for one person but have side effects for another. We cannot give a specific answer since each person would need to find out for themselves in consultation with their doctor. Plus, each person may have a different dosage of the other medicines they are taking for Parkinson's disease and interactions are not easy to predict.

Q. Have read your literature regarding L-tyrosine and its possible uses as a supplement. Since it is a precursor of dopa, is there any literature related to using L-tyrosine as an effective supplement during early Parkinsons in replacing dopa in the brain?
   A. Tyrosine is not an effective treatment for Parkinson's disease.

Q. I am 80 years old. I got Parkinson's disease about 3 years ago. Two Years ago I went to the Mayo Clinic in Rochester. I was diagnosed, by the doctor/s there, with Parkinson's disease. My main problems are writing very small and walking (I no longer have the coordination to play tennis, skip rope and swim) but I have no tremors. My Doctor here in Toronto recommended I take Levo Dopa (8 pills/day) which I have been taking for 2 years now. About 1 to 1- 1/2 years ago I lost quite bit of my balance and began to use a cane and at times a walker. I have fallen down quite a few times. Fortunately I am in good shape and have not broken any bones. About 6 months ago I hired a personal trainer and found him to be very capable. His training technique includes discouraging me from walking with a cane and walker. This past March 2008 I went on cruise and began taking Mucana Pruriens and slowly I stopped taking the Levo Dopa prescribed. Now I am taking 2-3 Mucana pills per day + 1-2 Curcumin Tumeric pills per day. I must tell you that since I have been taking the Curcumin Tumeric pills my skin texture has improved and my friends tell me my overall appearance has improved. In addition my eyes look better (no redness) plus my eyesight has improved. I saw a new top doctor recently by the name of Tony Lange who's specialty is movement (it took me 2 years to get this appointment). He gave me an extremely thorough examination this past June. He diagnosed me with Parkinson's disease as well and he ordered an MRI for my brain.

I just thought I would put out my thoughts on Glutathione. My husband was diagnosed with stage 4 Parkinson’s in May ’06 at age 47. We researched the current drugs available, talked to PD patients throughout the world, talked to researches that would come out with “new” PD drugs and decided to stay away from the PD medical drugs. We ended up going completely holistic and stumbled upon Glutathione. At a time when my husband could barely walk out the front door to the mailbox and back, I chose to fly him out of town to Idaho Falls, ID to a natural healer who had someone from Hawaii dispensing Glutathione in IV format. For one week my husband received 4000mgs. everyday for 6 days and then flew home. I was amazed at the results. We were able to walk for 3 miles with no problems. I then flew him back out for another 2 weeks of treatment. One day they even gave him 50,000mgs of Glutathione. (My thoughts are the body takes what it needs and dispenses the rest) They also included a small amount of magnesium. He was symptom free for 4 months. Unfortunately, this process cost us several thousand dollars. I’m not complaining because it was clear to me that GSH (Glutathione) was a powerful answer for us....no side effects & very healthy. We then spent a huge amount of time trying to find a local doctor to continue treatment at home. We couldn’t find one doctor (we’re in Cincinnati) or even a neurologist who would look at giving my husband 4000mgs a week. We finally found out about Dr. David Perlmutter in Naples, FL (he’s a neurologist) who pioneered a study on Glutathione for Parkinson’s patients. I flew my husband out to see him & I was taught how to give IV’s to my husband. We now have it shipped to our home in batches of 10 treatments @ 4000 mgs & I give him his IV’s myself.  We see a local neurologist who has told us that he really doesn’t need to go on the PD drugs because whatever we’re doing it’s working. We still get our GSH through Dr. David Perlmutter and sent to us from Wellness Pharmacy, a compounding pharmacy. It works and it keeps the major debilitating symptoms at bay. He is not cured but he is an anomaly for a typical Parkinson’s patient. He was really bad in 2006 and yet he continues to improve. He has never been as bad as he was in the beginning but he is still not 100% better. He hates getting an IV and I hate giving it to him but we both know it’s necessary to keep him as healthy as we can.

My dad has been diagnosed with Parkinson's in the last few years. He is 76 and has a shake in his hand, it has also progressed to what he calls a rattle in his teeth so sometimes he has a tremor in his face. He was on cholesterol lowering tablets but he has managed to get his cholesterol down so is no longer on meds for cholesterol. He is also on Regurin trospium and Avodart meds and takes one aspirin a day. He was in a serious accident in 2007 where he suffered a hematoma and fractures to the skull so I am not sure if this caused the Parkinsons to progress further. He was on meds for this neurological condition (half Inderal) for essential tremor and another tablet think it had ledovopa in it but he had adverse reaction to these meds. Can my father take Co-Enzyme Q10? I have heard that this can delay parkinson's in some patients. Is there anything he can take that might help the shake in his hand?
    Thus far most studies have not shown that coenzyme Q10 has a major influence on this neurological condition.

Following my diagnosis of Parkinsons, I revisited my daugter's focusing issues identified at age 5 -- termed ADD. Looking over your site most issues adress ADHD and she has no hyperactivity or bvior problems whatsoever. We tried the Ritalin drugs - very distressing. Would Mucuna Puriens, Tyrosine or Phenylanaline have a positive impact - if so which ones to take or combine or should I go in another direction?
    It's not easy to predict which supplement and at what dosage or combination would be helpful without trying them.

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