What Is Parkinson’s?
Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide after Alzheimer’s disease. PD involves the malfunction and death of nerve cells in the part of the mid-brain known as the substantia nigra. These cells produce a chemical neurotransmitter called dopamine which sends messages to other parts of the brain that control movement and coordination. As PD progresses, the amount of dopamine produced in the brain decreases, resulting in motor symptoms such as tremors, rigidity, slow movements, and difficulties with balance.
- Presently, the reason for this cell death is still poorly understood but PD does involve the buildup of proteins into Lewy bodies in the midbrain and other areas including the brain stem and olfactory bulb. The presence of Lewy bodies in these other areas may explain the non-motor symptoms experienced by some people with PD before any motor sign of the disease appears, as these areas of the brain correlate with non-motor functions such as sleep regulation and sense of smell.
- The intestines also have dopamine cells that degenerate in PD, and this may account for the gastrointestinal symptoms, such as constipation, that are part of the disease. A study found that 60-80 percent of PD patients have constipation (less than one bowel movement in three days) which seems to appear between 10-20 years prior to the onset of symptoms.
- As the signs and symptoms of PD worsen over time, it may eventually lead to cognitive problems including dementia, depression, and anxiety.
Current Treatments For PD
There is currently no cure for PD. Since most symptoms of PD are caused by a lack of dopamine in the brain, many PD drugs are aimed at either temporarily replenishing dopamine or mimicking the action of dopamine. In early stages of PD, they generally help reduce muscle rigidity, improve speed and coordination of movement, and lessen tremor.
But as PD progresses, the effects of the drugs may wear off and higher dosages may be required, raising the risk of developing additional side effects.
In PD, the brain cells that produce the chemical transmitter dopamine are damaged and lost. However, there is a lag between the time when the loss of nerve cells begins and the time when PD motor symptoms start to show. In fact, by the time most people are diagnosed, nearly 80 percent of their dopamine nerve cells are already gone.
However, scientists found that the brain is extremely neuroplastic, which is the potential to change and compensate. At the molecular level, exercise has the ability to improve the efficiency of how brain cells utilize dopamine even though the amount of dopamine remains unchanged. Studies found that high intensity exercises that are more difficult and complex, are noticeably more effective than low intensity balance and stretching exercises. These are exercises that move opposite sides of the body in rapid succession like using a treadmill or an elliptical machine.
– Speech Therapy
Approximately half of all PD patients experience communication problems, such as slurred speech. A speech and language therapist can help with the use of language and speech. Patients with swallowing difficulties may also be helped by a speech therapist.
– Deep Brain Stimulation (DBS) Surgery
This type of surgery is for patients with motor complications that cannot be adequately controlled by medications. In DBS, surgery is performed to insert electrodes into a targeted area of the brain. A second procedure is performed to implant an impulse generator (similar to a pacemaker) under the collarbone or in the abdomen. The devise provides an electrical impulse to the part of the brain involved in motor function. Those who undergo DBS surgery are given a controller to turn the device on or off. DBS is not a cure and it does not slow PD progression.
What Causes PD?
To date, despite decades of intensive study, the exact causes of PD remain unknown. Nevertheless, experts generally agree that the disease is largely caused by a combination of genetic and environmental factors. A simple way to describe it is that “genetics loads the gun and environment pulls the trigger”.
Statistically, people with a first-degree relative who has PD, such as a parent, child or sibling, have a 4-9 percent higher chance of having PD as compared to the general population. There are two categories of genes that are linked to PD:
– Causal genes (alpha-synuclein)
Theseare genes that actually cause the disease. A causal gene alone, without the influence of other genes or environmental factors, guarantees that a person who inherits it will develop PD. This kind of genetic PD is very rare, accounting for only 1-2 percent of people with PD.
– Associated genes (LRRK2)
These genes do not cause PD on their own but increase the risk of developing it. For LRRK2, there is great variability in the mutations that occur in the gene as well as in their effects. Some people with LRRK2 mutations develop PD in their 30s or 40s, while others develop the disease in their 80s, and others never develop PD at all. In some cases, people with LRRK2 gene mutations develop dementia, while others develop a form of PD that shares features with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease.
Epidemiological research has identified a number of factors that may be linked to PD. In North America and Europe, early onset PD appears to be associated with rural residence. Factors associated with this include vegetable farming, well water drinking, as well as wood pulp, paper, and steel industries. In China, living in industrialized urban areas increases the risk of developing PD. Many studies have demonstrated that prolonged exposure to certain chemicals and heavy metals are associated with an elevated risk of PD. They include:
- Pesticides, herbicides, and fungicides,
- Heavy metals such as manganese, lead, and copper,
- Solvents and Polychlorinated Biphenyls (PCBs).
Risk Factors For PD
Although scientists have yet to determine the exact mechanism that leads to PD, a number of factors are highly associated with the disease. Therefore, by addressing these factors, you may be able to lower your risk of developing PD.
– Toxic Environmental Exposure
As mentioned above, toxins and heavy metals are strongly correlated with PD. As we now live in a rather toxic world, the following are some preventive steps that your can take to reduce the risk:
- Always buy organic produce and grassfed/organic meats to avoid eating pesticides. If the label of the meat says 100 percent grass-fed or certified organic, that means the animal feed is also organic.
- Choose wild caught fish over farmed fish which are usually contaminated with PCBs and other harmful chemicals. Smaller ocean fish are better than big fish because they have less mercury.
- Invest in a good water filter that removes heavy metals.
- Do not use aluminum or teflon-type non-stick cookware. The best is glass, stainless steel, and ceramic non-stick pots and pans.
- Opt for all natural personal care and household products. Conventional brands are often loaded with noxious chemicals.
- Use an indoor air filtration system if you live in a polluted area.
– Vitamin D Deficiency
Vitamin D deficiency is prevalent in PD patients. Vitamin D has numerous beneficial health effects, in particular for the brain which has many vitamin D receptors. Get a blood test for 25-hydroxyvitamin D or 25(OH)D to monitor your vitamin D status. For healthy people, you want to have your level at around 50-70 ng/ml. If you currently have PD, you want to keep your level in the range of 70-100 ng/ml to help fight the disease. Unless you manage to get regular sun exposure without using sunblock on your skin, most people will need to supplement with vitamin D to attain this level. If so, you want to choose the natural form of vitamin D supplement – D3, not the synthetic D2.
– Omega-3 (DHA) Deficiency
Animal-based omega-3 fats (found mainly in fatty fish and grass-fed beef) contain two fatty acids that are crucial to health – DHA and EPA. DHA is especially important because it is one of the major building blocks of the brain. About half of the brain is made up of fat, much of which is DHA. Studies found that DHA deficiency is a risk factor for developing PD. DHA has many neuroprotective capabilities:
- Protect the brain against inflammation,
- Stimulate growth of nerve cells and repair of synapses or nerve junctions,
- Reduce apoptosis or death of cells that make dopamine,
- Increase glutathione (an antioxidant) activity that results in decreased accumulation of oxidized proteins in the brain.
– Small Intestinal Bacterial Overgrowth (SIBO)
Ongoing research continues to support the link between SIBO and PD. PD patients with SIBO, by and large, have much worse motor function than PD patients without it. Eradication of SIBO in PD patients generally results in an improvement in motor function. This is probably due to the bidirectional connection between the gut and the brain via the vagus nerve. If you have unresolved gastrointestinal symptoms such as gas, bloating, abdominal pain, diarrhea/constipation, ask your doctor to order a non-invasive lactulose breath test to see if you have SIBO.
– Gluten Intolerance
Numerous research studies have tied gluten to neurological disorders including PD. If one has an intolerance to gluten, eating gluten on a regular basis can cause havoc to the body. First, it creates inflammation in the gut and subsequently, the inflammation spreads to other parts of the body including the brain. People who have gluten intolerance may or may not have gastrointestinal symptoms. The best and most accurate way to determine whether you are gluten intolerant is to get a Cyrex Lab Array 3 blood test, which tests for reactions against the full wheat proteome, not just gluten, but also other proteins in wheat.
– Excess Iron
Scientists agree that iron is absolutely essential for the brain, but too much of it can be dangerous or deadly, especially to nerve cells in the substantial nigra, the area that deteriorates with PD. Dopamine may team up with excess iron to form a toxic compound that destroys nerve cells. Dopamine has a number of breakdown products, and one of these produced by interactions with iron can become very damaging to nerve cells.
Iron levels tend to increase with age, especially in elderly men and women after menopause. If a blood test for iron markers like serum transferrin saturation and serum ferritin indicate elevated iron levels, it is best to look into an iron reduction protocol, such as blood donation. Removal of blood is the most effective way to reduce excess iron in the body. Bear in mind that vitamin C significantly increases iron absorption. So you definitely do not want to take in a lot of vitamin C together with iron-rich foods like organ meats and shellfish if you have high iron levels.
– Poor Diet
Since nutrients affect how cells produce energy and provide vital antioxidant functions against free-radicals, a poor diet may lead to increased oxidative stress, which can impede the antioxidant defense system. Hence, to cut down on your risk of developing PD, you want to eat a well-balanced diet that is neuroprotective, including foods like:
- Copious amounts of vegetables which are excellent sources of antioxidants, vitamins, minerals, and fiber,
- Some fruits (watch out for excessive sugar),
- Foods rich in omega-3 fats like fatty fish (that are mercury and toxin-free) and grass-fed beef and its full-fat dairy products,
- Fermented and cultured foods that are rich in good bacteria to enhance gut health, eg. sauerkraut, kimchee, tempeh, miso, and unsweetened kefir and yogurt.
- Prebiotics are foods with high non-digestible fiber compounds that feed the good bacteria. Examples include unripe banana, jicama, garlic, leeks, onions, dandelion greens, asparagus, and artichoke.
- Tea and coffee (organic is preferred as coffee is heavily sprayed with pesticides).