Providing resources and ideas for therapies and medical developments for Parkinson's disease:
Parkinson's does not have a single cause or an exact symptom for all patients and thus there is no single approach to treatment. Options are presented below that can be used to tailor an individual treatment. One of the most common symptoms of Parkinson's disease is constipation. Luckily constipation is easily treatable with laxatives or by adding more fiber to one's diet. Some vitamins and supplements target mental cognition (vitamin B6, B12), some support liver detox (Calcium D-Glucarate and Glycine) and toxic heavy metal detox (NAC and Glycine). Some help combat vascular Parkinson's disease such as omega-3, niacin and aspirin. There are also vitamins and supplements which research has shown to support the battle with Parkinson's such as Nicotinamide riboside, vitamin D and Magnesium.
Probiotics and changing eating intervals to induce autophagy can also be helpful for Parkinson's patients. Research has also shown that a ketogenic diet is helpful for both Parkinson's and Alzheimer's disease for non-motor symptoms. There are strong ties between the protein NLRP3, inflammation, alpha-synuclein and Parkinson's. There are supplements and foods that have inhibitory effects on this NLRP3 pathway. Research has also found various vitamins and supplements to be beneficial for Parkinson's patients as noted below.
Producers of dietary vitamins and supplements are known to be of higher quality and consistency if manufactured to third party verified standards.
Parkinson's disease (PD) is known to affect the muscles and nerves which control the digestive process thus impacting gastrointestinal mobility defined medically as "gastroparesis". Gastro-intestinal dysfunctions characterized by constipation affect almost 80% of PD patients (ref). If one has fewer than three bowel movements per week, one should consider a treatment for constipation. This is also true if the stool does not pass easily or is not moist and soft. There should be no discomfort, pain or blood associated with a bowel movement. Consider the following steps to relieve constipation:
If these remedies do not help, see your doctor. If you are experiencing a high degree of pain or any blood in your stool, also see your doctor. Other much more serious ailments are possible causes.Refereneces:
Prunes - nature's laxitive
Also known as Thiamine, vitamin B1 has been studied as a potential benefit for Parkinson's disease. Studies have suggested a theoretical benefit but unfortunately the research has not shown convincing efficacy (no placebo group), but the efforts are applauded.
Thiamine is not produced by the human body and thus it is generally obtained in ample quantity from food. Foods containing thiamine include seaweed (spirulina), sunflower seeds, macadamia nuts, peas, beans, asparagus and some whole grains.References:
There are so many forms associated with this vitamin it can get confusing fast. There are three forms of vitamin B3: niacin, nicotinamide, and nicotinamide riboside. Vitamin B3 is most often associated with niacin and can be often found in multi-vitamins and enriched flour and derived products. Nicotinamide, sometimes known as niacinamide, has a different molecular structure than niacin and avoids the flushing associated with niacin. Nicotinamide riboside is a precursor to the NAD+ vitamin and NAD-deficiency is a key-event in the pathogenesis of Parkinson's Disease as it leads to mitochondrial dysfunction leading to impaired neuronal metabolism. NAD+ also helps combat oxidative stress.
Niacin is not produced by the human body and thus it is generally obtained in ample quantity from food. Foods containing niacin include liver (beef or chicken), chicken breast, turkey, salmon, pork, avocado, green peas, mushrooms and potatoes.
Niacin has been shown to reduce neuroinflammation which is believed to play an active role in Parkinson's disease.References:
Niagen: Nicotinamide Riboside
Vitamin B12 is required by the body for red blood cell production, DNA formation, nerve function, and metabolism. Vitamin B12 has also been shown to have correlation to dementia for both Parkinson's and Alzheimer's diseases. The results of a study concluded that one's vitamin B12 blood levels aught to be more than 587 ng/L (nanograms per Liter) for only an 11% chance of developing dementia. Those with less than 587 ng/L vitamin B12 level had a 50% chance of having dementia within 5 years of a Parkinson's diagnosis. This is especially important for those on levodopa treatment which has been associated with lower levels of vitamin B12.
Vitamin B12 (along with vitamin B6 and folic acid) has been shown to improve cognition, lower oxidative stress and lower homocysteine levels, a known inflammation marker linked to Parkinson's disease and other movement disorders. Also see Inflammation and Parkinson's: homocysteine
The adult recommended daily intake (RDI) for vitamin B12 is 2.4 mcg (micrograms). Absorbption is typically 10 mcg per 500 mcg of supplement.
Warning: not to be used without professional medical supervision by those who have Leber disease, megaloblastic anemia, polycythemia vera, an alergy to cobalt or cobalamin or by those who have recently received a coronary stent (WebMD)
Foods with high levels of vitamin B12 include:
|Food||Serving Size||% Recommended Daily Intake|
|Liver and kidneys (lamb, beef, veal)||100 g||3,000+ %|
|Clams||100 g||4,000 %|
|Sardines||150 g||500 %|
|Beef||100 g||245 %|
|Fortified cereal||50 g||50+ %|
|Trout||100 g||300 %|
|Salmon||175 g||200 %|
|Milk||240 ml||46 %|
|One Egg||50 g||25 %|
Thus four, 50 gram eggs, would be required to achieve the Recommended Daily Intake of vitamin B12.
The recommended daily intake of vitamin B12 is at least 6 mcg. Measured levels of vitamin B12 in blood are healthy when in the range of 587 to 1245 pg/mL.
Most daily multivitamins have an ample dose of vitamin A, B, C, D and D as well as essential minerals.
Vitamin D deficiency has been found to be linked to an increased risk for Parkinsons disease and is based on a Finish study. Vitamin D potently induces Glial-cell-line Derived Neurotrophic Factor (GDNF) expression where GDNF has been investigated as a treatment for Parkinson's disease as the GDNF protein has been shown to support the survival of dopaminergic neurons. It is believed that a chronic inadequacy of vitamin D leads to the loss of dopaminergic neurons in the substantia nigra region to further Parkinson’s disease progression. Vitamin D is typically produced by the skin when exposed to sunlight (UV-b) but can be supplemented especially when one spends a lot of time indoors. Adequate levels as measured in blood serum are considered to be in the range of 30 to 60 ng/ml (or 75-150 nmol/L). Typically a dose of 1000 IU of vitamin D will raise the blood serum level 5 ng/ml.Vitamin D comes in two forms: D2 and D3, of which D3 is more effective at improving vitamin D levels in the body.
Warning: doses of over 4000 IU/day for the long term are not safe and may cause elevated calcium levels in the blood. Other effects of excessive use include weakness, fatigue, sleepiness, headache, loss of appetite, dry mouth, metallic taste, nausea and vomiting. Vitimin D can make atherosclerosis worse, can lead to kidney stones especially for those with kidney disease. (WebMD)References:
Foods with high levels of vitamin D include:
|Food||Serving Size||% Recommended Daily Intake|
|Salmon||100 g||84 %|
|Fortified milk||16 oz||32 %|
|Fortified yogurt||100 g||7 %|
|Pork chop||100 g||5 %|
|One Egg||large||6 %|
The recommended daily intake of vitamin D is 20 micrograms or 800 IU. Measured levels of vitamin D in blood are healthy when in the range of 30 to 100 ng/mL. The dosage to maintain a healthy blood level of vitamin D will depend on one's metabolism and size.
The liver is the body's first line of defense against toxins. The liver filters and separates toxins from the blood stream and dumps it into the bile duct which feeds into the gastrointestinal (GI) tract for evacuation. Supplementation of calcium D-glucarate has been shown to help with liver detoxification properties attributed to its ability to excrete, through the biliary and urinary tracts, potentially toxic compounds. Calcium D-glucarate is also known to have anticarcinogenic properties as studied in various animal tumor models including colon, prostate, lung, liver, skin and breast cancer. This supplement is often taken with Glycine for maximum liver detox support. Calcium D-glucarate is a substance produced naturally in small amounts by mammals and is found in many fruits (eg oranges, apples, and grapefruit) and cruciferous vegetables (broccoli, cabbage, and Brussels sprouts). Calcium D-glucarate is also known to lower estrogen and estradiol hormone levels as well as LDL cholesterol in the blood.
This supplement may be of interest to those Parkinson's patients who belive that their's was induced by toxins and thus are in need of detoxification of their liver. The liver has three detox phases of which calcium D-glucarate plays an instrumental role in phase two.Liver Detox Phases:
Also see toxins and Parkinson's.References:
Glucuronidation is the body's biological mechanism to process xenobiotic (foreign) substances (pesticides, idustrial compounds, pharmaceutical compounds, dyes, dioxins, etc) into water soluble moloecules for excretion from the body in bile or urine. Glucuronidation is also a primary pathway in the liver's phase 2 detoxification to make toxins hydrophobic (more water soluble) to enable their removal by the kidneys as urine or by the liver as bile through the gastrointestinal tract. Calcium D-Glucarate is a participant and enabler in the glucuronidation process. Calcium D-Glucarate, when ingested, is metabolised to D-glucaric acid (by HCL stomach acid), which can be further metabolised into D-glucaro-1,4-lactone or D-glucaro-6,3-lactone, all of which have important roles in detoxification. Calcium D-Glucarate also inhibits beta-glucuronidase, an enzyme which can disrupt phase 2 detoxification by allowing toxins to be released and reabsorbed rather than be excreted. Thus Calcium D-Glucarate helps the liver excrete toxins and inhibits reabsorbtion.Also see:
Glycine coupled with Calcium D-Glucarate gives the body extra support for phase 2 of the liver detoxification process. Toxins, especially neurotoxins, are often the root cause of Parkinson's disease and other neurological disorders.
Citicoline makes Levodopa more effective by increasing the density of dopamine receptors and thus allows one to use lower doses of Levodopa and thus reduce Levodopa side effects. Citicoline makes dopamine receptors more sensitive rather than directly stimulating receptors. It takes approximately 30 days for results to become fully apparent. Citicoline is pressent naturally in human tissue and can cross the blood-brain barrier.Also see:
Glutathione (GSH) is the body's first line of defense against toxins and free radicals. GSH can be released by astrocytes, glial cells and by neurons themselves to help defend neurons and within neuron cells from oxidative stress and free radicals. Glutathione is produced within the cells and is used to expel toxins from within the cell. A glutathione oral supplement is not effective for mercury detoxification as it does not survive the digestion tract to be passed into your cells. Instead, supplements which are the precursor or raw ingredients that a cell can use to generate glutathione is preferred.The three precursors to glutathione are:
Glutathione is known to help the body handle neurotoxins which may be at the root cause of Parkinson's disease and other neurodegenerative conditions. Insufficient levels of glutathione are often found in Parkinson’s disease patients. Glutathione contains sulfur components that to bind mercury in a form that the body can dispose of via bile. When glutathione binds with toxic metals or compounds, it prevents them from binding to cellular proteins and causing damage to both enzymes and tissue. Glutathione also helps prevent mercury from entering cells and causing intracellular damage by binding into a glutathione-mercury complex.
Thomas Jefferson University is conducting a trial using intravenous and oral NAC for its potential to counteract intracellular damage that leads to dopaminergic neuron death and the potential to reduce oxidative damage in Parkinson's Patients. See trial NCT02445651.
"Many health practitioners incorrectly advise chlorella, cysteine, NAC and glutathione for chelation, which are not true chelators in the chemical sense, as they do not contain two or more binding groups (dithiol groups). Instead, they contain only one thiol group making them ineffectual chelators, with the capacity to simply move metals around, and cause more problems. These compounds can make matters worse by redistributing stored metals i.e. mobilizing them from their storage sites, but failing to bind and excrete them. This is like stirring up a hornets nest."
Note that he prefers his own chelation protocol: ACCAndy Cutler also states:
"If you have elevated cysteine and you want to convert some to glutathione, take a 2:1 weight ratio of glutamine and glycine (e.g. 2,500 mg caps of glutamine with one 500 mg capsule of glycine) and your body will do the rest."
These supplements can be taken on and off rounds, often twice a day suffices. It will be problematic if one is thiol sensitive and consuming thiols. The ACC protocol book, "The Mercury Detoxification Guide", has a section dedicated to thiol food sensitivity. This is the dose Andy stated, but everyone needs to find their own dose.
Glutathione is a thiol with one binder while chelators like DMSA, DMPS and ALA have two and are known as dithiols and cling to mercury more forcefully. Note that DMSA and DMPS act extracellularly (outside the cell) without the ability to pass through the cell membrane to grab mercury from within the cell but can work with glutathione as an intracellular (inside the cell) agent to procure intracellular toxins.
A lack of magnesium can cause leg cramps, insomnia and fatigue and is also associated with Parkinson's disease. A study published in "Neuropsychiatric Disease and Treatment" found that the supplement Magnesium-L-Thorate elevates the magnesium level in the cerebrospinal fluid, attenuates motor deficits and dopamine neuron loss in a mouse model of Parkinson's disease. The type of magnesium supplement is also important as Magnesium sulfate failed to increase magnesium levels in the cerebrospinal fluid (CSF) and had no effect on neurodegeneration. The magnesium-L-threonate supplement also inhibited inducible nitric oxide synthase (iNOS)-mediated inflammation and oxidative stress.
Foods rich in magnesium include nuts (almonds, cashews, flaxseed, pumpkin seeds), avocados, bananas, beans (lima beans, black beans, Edamame, kidney beans), spinach, Swiss chard, yogurt, dark chocolate and peanuts.
The recommended daily intake of magnesium is at least 432 mg. Measured levels of magnesium in blood are healthy when in the range of 1.5 to 2.5 mg/dL.
Warning: doses greater than 350 mg/day may lead to irregular heartbeat, low blood pressure, confusion, and may build up in the body causing coma and death (WebMD)References:
Study suggests that dietary intake exerts neuroprotective actions in an animal model of Parkinsonism. Omega-3 also potentially thwarts Arteriosclerosis and the potential for Arteriosclerotic Parkinsonism caused by micro-strokes or blood vessle restriction. Omega-3 fatty acid, DHA, also has been found to reduce levodopa induced dyskinesia. A primate study found that a very high dosage of 5 g DHA/70 kg (154 lbs) per day resulted in a 50% reduction in levodopa-induced dyskinesia after 30 days. Dr. Laurie Mischley ND PhD found similar success in some of her patients using 4 g (1 tbsp)/day of fish oil supplement.
If the omega-3 oil is derived from fish, it is likely that there will be a mercury (and possibly a PCB) contamination problem unless the omega-3 oil has been molecularly distilled. It is also helpful if it was derived from short lived fish, low on the food chain, such as sardines.References:
Omega-3 sourced from vegetables or fish.
Saffron (Crocus sativus) and its active ingredients Crocin and Safranal have been shown to be neuro-protective of dopaminergic cells, improve dopamine levels and an anti-inflammatory. Unfortunaely much of the research has been on fruit flies and lab rats. Effective dosage has not been determined.
These services often require a doctor's order for a test.
These services provide a doctor's order for a test.
The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet which forces the body to burn fats rather than carbohydrates and its glucose derivative. Normally brain function is fueled by consumption of glucose. During a ketogenic diet, fats are converted to keytones and replace glucose as an energy source for the brain. When the body enters this state, it is said to be in a state of ketosis. While of primary benefit for those wanting to lose weight or suffering from epilepsy, it has been found to be helpful in non-motor functions for people suffering from neurological disorders such as Alzheimer's, ALS and Parkinson's disease. A ketogenic diet may actually lead to an "intermittent exacerbation of the PD tremor and/or rigidity". Unfortunately the study was on a small sample size.References:
Also see intermittent fasting and autophagy.
NLRP3 is a component of macrophage immune cells (white blood cells which engulf and consume foreign substances) which react to stress and generate "inflammasome" which in turn contains a receptor protein (ASC) that encourages activities (autoinflammatory and autoimmune conditions) which lead to pyroptosis (cell death) and the flood of inflammation factors. Alpha-synuclein aggregates have been shown to promote inflammasome activation in brain microglia (brain immune macrophage cells, main form of immune defense in the central nervous system). Foods which inhibit this pathway, inhibit the progression of Parkinson's.Also see:
Melatonin has been shown to be an important antioxidant and also an anti-inflammatory molecule which work against the activation of the inflammasomes and, in particular, of the NLRP3 inflammasome. While many of the current anti-inflammatory drugs have significant side effects, melatonin is an uncommonly safe molecule when taken as a supplement.
Warning: Melatonin can make depression, diabetes, blood pressure and seizure disorders worse. May also interfere with immunosuppressive therapies (WebMD)References:
Melatonin: an NLRP3 inflamation inhibitor
Foods and supplements which inhibit NLRP3:
|Foods||Active Ingredient||Technical Reference|
|EGCG: Epigallocatechin gallate||Epigallocatechin-3-gallate prevents lupus nephritis development in mice via enhancing the Nrf2 antioxidant pathway and inhibiting NLRP3 inflammasome activation|
|Chinese herb: Scutellaria baicalensis Georgi||Baicalein||Baicalein Attenuates Neuroinflammation by Inhibiting NLRP3/Caspase-1/GSDMD Pathway in MPTP-Induced Mice Model of Parkinson’s Disease (Rui et al, 2020)|
"Administration of baicalein reversed MPTP-induced motor dysfunction, loss of dopaminergic neurons, and pro-inflammatory cytokine elevation. Baicalein also inhibited NLRP3 and caspase-1 activation..."
"... baicalein decreases pro-inflammatory cytokine expression and release in the substantial nigra compact (SNc) of MPTP-treated mice by suppressing NLRP3/caspase-1/GSDMD pathway signaling, thereby attenuating neuroinflammation, SNc neuronal loss, and motor dysfunction."
|Tumeric root||Curcumin||Curcumin Represses NLRP3 Inflammasome Activation via TLR4/MyD88/NF-κB and P2X7R Signaling in PMA-Induced Macrophages|
Curcumin Suppresses IL-1β Secretion and Prevents Inflammation through Inhibition of the NLRP3 Inflammasome
|Resveratrol||Suppression of NLRP3 inflammasome by oral treatment with sulforaphane alleviates acute gouty inflammation|
Resveratrol pretreatment protects rat hearts from ischemia/reperfusion injury partly via a NALP3 inflammasome pathway
|Sulforaphane||Sulforaphane inhibits multiple inflammasomes through an Nrf2‐independent mechanism|
|Quercetin||Quercetin suppresses NLRP3 inflammasome activation in epithelial cells triggered by Escherichia coli O157:H7|
|found in the fruit of Gardenia jasminoides Ellis||Genipin||Genipin inhibits NLRP3 and NLRC4 inflammasome activation via autophagy suppression|
|Root of the Ginseng plant||Ginseng||Nonsaponin fractions of Korean Red Ginseng extracts prime activation of NLRP3 inflammasome|
Inhibition of NLRP3 is not only good for limiting the facilitation and instigation of Parkinson's disease progression but also that of Alzheimer's disease.
Baicalein: an NLRP3 inflamation inhibitor which has shown efficacy in Parkinson's mouse models.
This supplement contains vitamins and compounds claimed to have neuroprotective and restorative characteristics to help Parkinson's patients. They claim to acheive this by combating oxidative stress which causes mitochondrial dysfunction, support for mitophagy to supress Lewy body formation and free radical resistance to supress neural inflammation.Restore Gold contains the following:
Note that this product contains a substantial dose of ALA, a known chelator of mercury. Their recommended dosage of four capsules a day puts the ALA dosage at 400 mg per day. The Dr. Andy Cutler Chelation (ACC) protocol would consider it unwise to use this product if one has mercury amalgam dental fillings. Restore Gold also includes 400 mg of NAC per capsule, a precursor to glutathione which is also a chelator of mercury. If one experiences an uncomfortable brain fog or the effects of mercury toxicity, it might be wise to avoid using this product. It is clear that this product attempts to detoxify the body but this might be a dangerous endeavor for those with a high toxic metal burden. For more on mercury, chelation, dental amalgam removal and ALA see Parkinson's and mercury.Also see: