(also referred to as...) Juvenile Parkinsonism, Paralysis Agitans, PD, Postencephalitic Parkinsonism,
Primary Parkinson's Disease, Secondary Parkinsonism, Shaking Palsy
Description Parkinson's disease is a progressively debilitating central nervous system (CNS) disorder that affects approximately 1 out of 100 people over sixty five years of age. Approximately 80,000 Canadians have Parkinson's disease and it is the fourth most common neurodegenerative disease of the elderly. Parkinson's usually begins to develop after forty years of age. Though it is a chronic, progressive disorder that increasingly hinders motor function, Parkinson's can be controlled and the life expectancy of most people with the disease commonly matches the statistical norm. Currently, there is no cure for Parkinson's disease. However, a number of preventative measures can be taken in addition to Western/Allopathic forms of treatment.
Juvenile Parkinsonism Parkinson's disease can begin in childhood or adolescence and, in this case, is referred to as Juvenile Parkinsonism.
Symptoms and Signs: Symptoms and signs may begin gradually and become more apparent over time as they increase in frequency.
Tremors One of the more defining symptoms of Parkinson's is the presence of tremors, though it is important to note that one third of Parkinson's cases do not involve tremors as an initial symptom while others do not develop tremors at all. In addition, tremors alone may indicate an entirely different disorder. If a tremor is present, it usually begins in one hand when at rest. This particular tremor diminishes when the hand is intentionally moved and can also completely stop when at rest. Over time, tremours will progress to the other hand, arms, and legs, in that order. The eyelids, forehead, jaw, and/or tongue may also be affected. The voice is not. As mentioned, you may also be symptom free when at rest, but experiences shakes or tremors when emotionally distressed or experiencing stress. Tremors are absent during sleep and decrease as the disease progresses.
Additional Symptoms In addition to tremors, you will likely experience difficulty initiating movement (akinesia), slow movement (bradycardia), decreased movement (hypokinesia), arm, leg, and general muscle rigidity and stiffness, and a feeling of aching or cramped muscles (due to rigidity and hypokinesia). Steps are generally short and sluggish and there is a lack of arm motion when moving. You may also fatigue quickly. Posture is often stooped and a loss of balance and stability occurs when walking where you may fall forward (propulsion) or backward (retropulsion) due to a loss of postural reflexes. Speech is often slurred, stuttered, of low volume, and monotone. Handwriting is small and cramped. There are reduced facial expressions due to facial-muscle impairment and decreased blinking. Muscle stiffness in the face and throat can also make swallowing difficult and cause drooling or choking. Within seven to ten years, a lack of mental acuity can also occur. At a chemical level, those with Parkinson's are seriously deficient in the neurotransmitter dopamine. For more information, see Causes, below. NOTE: As there is no definitive test for Parkinson's, all other conditions associated with the above symptoms (other degenerative brain conditions, side effects of antipsychotic drugs, et cetera) must be ruled out before an accurate diagnosis can be made. Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) tests can be conducted to rule out disorders that mimic Parkinson's. Reflex, coordination, muscle strength, and mental function tests can also be performed to ensure an accurate diagnosis.
Causes: Primary Parkinson's Disease This scenario is the most common form of Parkinson's and is experienced in the majority of cases. In the early stages of Primary Parkinson's Disease, brain nerve cells located at the substantia nigra, locus caeruleus, and other brain stem dopaminergic cell groups are lost. The decreased number of substantia nigra neurons results in depletion of the chemical neurotransmitter dopamine, which transmits nerve signals as electrical impulses along and between nerve pathways, from and to muscles. The basal ganglia, located deep within your brain, is responsible for smooth movement and posture coordination. The main neurotransmitter of the basal ganglia is dopamine, which is used to communicate with the thalamus and relays the processed information back to the cerebral cortex, resulting in a coordinated movement. Under Parkinson's disease, nerve cell degeneration is localized in this area, leading to lower dopamine production and a reduced number of connections between nerve cells and muscles. With the connections severed, the above-mentioned symptoms and signs occur. As degeneration continues and muscle control is lost, symptoms increase. The exact cause of nerve cell degeneration and resulting decreased dopamine production is not known. A number of theories hold that excess nerve cell exposure to free radicals and their damaging effects can lead to the development of Parkinson's (making antioxidant supplementation an essential component of any Parkinson's healing protocol). Once the disease is established, it generates peroxynitrite, a highly toxic free radical in the body. This results in an unfortunate positive feedback where degeneration leads to additional degeneration, accelerating the cumulative effect of damage.
Secondary Parkinsonism Under Secondary Parkinsonism, the action of dopamine on nerve cells is interfered with and dopamine receptors are blocked, resulting from the administration of antipsychotic drugs used to treat schizophrenia and severe paranoia. N-MPTP (n-methyl-1,2,3,4-tetrahydropyridine), a street-form of opium synthesized from meperidine can lead to severe and irreversible Parkinson's in intravenous drug users.
Postencephalitic Parkinsonism Postencephalitic Parkinsonism is caused by viral encephalitis -- a rare and sever flu-like infection that causes brain inflammation and results in forced, sustained deviation of the head and eyes, among other effects.
Other Causes Other causes of Parkinson's disease include blood-vessel disorders such as atherosclerosis and stroke, carbon monoxide or manganese poisoning, hydrocephalus, hypoparathyroidism, Shy-Drager syndrome, and other degenerative brain diseases or conditions that lead to reduced dopamine production.
Genetics Though it is not believed that genetics play a significant factor in developing Parkinson's disease, it does tend to run in families. One third to one quarter of people dealing with Parkinson's have a family history of the disease. The risk is further increased if the father had Parkinson's. Keep in mind that risk factors merely statistically increase the risk and are not a cause in themselves.
What to Expect: Parkinson's progresses in five stages:
Stage 1: Symptoms appear on only one side of the body. Functional impairment is minimal or non-existent. Stage 2: Symptoms appear on both sides of the body. Balance is not impaired. Stage 3: Posture may be off-balance. Some activities become restrictive. Stage 4: Inability to walk or stand without assistance. Stage 5: Individual requires wheelchair unless assisted and may become restricted to bed.
As previously mentioned, symptoms will increase in frequency and severity as the disease progresses. Though your muscle strength may be normal, useful power may be diminished and it is difficult to perform rapid, successive movements. Initiating movement (such as walking) and coordinating muscle control becomes more difficult over time and you will find it increasingly difficult to walk and perform other motor functions. Drooling and choking often occur as the stiff muscles in the face and throat make swallowing difficult. Falls are common and can lead to further complications, such as a broken hip. You will need to learn new strategies for accomplishing daily tasks as the disease progresses. Depression may accompany Parkinson's in some people, though this may be confused with the open mouth, reduced blinking, blank stare, and mask-like expression accompanying the loss in facial muscle control. Dementia occurs in fifty percent of cases.
Remedies GENERAL NOTE: All remedies listed below are not to be used as substitutes for any medications Prescribed by your physician or other health practitioner. Medication dosages and combinations are very specific and time-sensitive and cannot be interfered with. The following remedies will help compensate for free radical damage and promote increased dopamine availability in your body. You must discuss all remedies you are considering for use with your naturopath, physician, or other health practitioner.
Conventional Approaches Supplementation through Western/Allopathic medicine is often the most effective method of restoring dopamine levels and there are a variety of medications that are often, but not always, required. Regardless of your approach, drug therapy should involve close observation by your naturopath or other health practitioner and medications should be adjusted as needed. As is the case with the alternative remedies listed below, conventional approaches do not cure Parkinson's, but slow the deterioration process and allow you to maintain greater control over motor functions for an extended period of time. Amino Acids L-dopa (L-dihydroxyphenylalanine), or levodopa, acts as a precursor to dopamine. Supplementation with this nutrient is the most common approach to dealing with Parkinson's and forms the basis of most pharmaceutical drugs used to threat this condition. It is typically available in a variety of forms through prescription. This strategy must be combined with a low-protein diet, outlined under Lifestyle, below. Glutathione, or GSH, is a powerful antioxidant produced by the liver that protects against free radical damage and detoxifies harmful compounds. Those with Parkinson's typically have lower levels of this amino acid in their body and supplementation should be considered. GSH is available as part of a multi-amino acid complex and can also be found in isolated form. Antioxidants Antioxidants are essential to help deal with free radical damage, particularly to nerve cells, caused by toxins and chemical exposure. In this case, one goal should be due to reduce peroxynitrite concentrations in the body and this can be achieved through the use of antioxidants. It is also believed that symptoms become worse in the absence of antioxidants. Supplementation, therefore, is essential. Antioxidants can be used in combination for greater effect. Alpha-lipoic acid is known as the "antioxidant's antioxidant" or the "universal antioxidant". In addition to being a powerful coenzyme, this antioxidant enhances the effectiveness of several antioxidants, including vitamins C and E, glutathione, and coenzyme Q10. Alpha-Lipoic acid regenerates and recycles these antioxidants so they continuously neutralize free radical damage in the body. Take 60 to 100mg daily. Grape seed extract is a nutrient primarily derived from the seeds of grapes but is also found in the skin and stems. It has powerful antioxidant properties and has protective compounds known as flavonoids. These include oligomeric proanthocyanidins (OPCs), anthocyananins, quercetin, catechin, ellagic acid and reveratrol, which is also found in red wine. If supplementing, take 25 to 100mg daily, in divided doses. The beneficial compounds are also found in red wine, purple grape juice, and red grapes. NOTE: Discuss with your nutritionist, naturopath, or other health practitioner the appropriateness of consuming red wine, where the alcohol content may interfere with certain medications. Green tea can be taken daily to help cleanse toxins from the body. Place 2 teaspoons of green tea leaves in one cup hot (not boiling) water and steep for 3 to 4 minutes. The longer the infusion, the more bitter green tea becomes. Boiling water destroys some of the beneficial elements of green tea. Allow the water to stop boiling before adding the leaves. Use a ceramic, glass, or earthenware mug. Drink 1 to 2 cups daily Pycnogenol is extracted from the bark of French maritime pine trees grown in the south of France. The resulting extract contains approximately forty antioxidants and a number of flavonoid compounds, making pycnogenol one of the most potent antioxidant preparations currently available. One particular flavonoid of note is OPC, which may be as much as fifty times more potent than vitamin E and twenty times more potent than vitamin C in terms of its bioavailable antioxidant ability. OPCs are also found in grape seed extract (see above). Pycnogenol is exceptionally bioavailable and absorbed in the body. Take 25 to 100mg daily, in divided doses. NOTE: Some people may experience allergic reactions to pine bark extract. Consult with your naturopath or other health practitioner to determine the appropriateness of supplementation with this antioxidant. See also Selenium under Minerals, below, and vitamins Co-Q10, C, and E under Vitamins, below. For more information on Antioxidants, see the dedicated section on Antioxidants. Foods Fava beans are an ideal source of L-dopa. Add to soups, stews, and use as a side dish with rice. Constipation is common among those with Parkinson's and inhibits the elimination of toxins from the body. Increase your fibre intake to avoid this problem by consuming more raw fruits and vegetables and whole grains. Supplemental fibre is also available. For more information, see the dedicated section on Fibre. Food Supplements Evening primrose oil is rich in gamma linolenic acid (GLA), which acts as a precursor to prostaglandin (particularly PGE1) in the body. Prostaglandins are hormone-like substances that act as neuronal messengers in the body, facilitating proper nervous system, immune system, and cardiovascular function. You may also use borage and black currant oils, which have higher GLA levels than evening primrose. Evening primrose oil may also reduce tremors. Take 1,000mg daily. Herbs Gingko biloba promotes brain activity by increasing oxygen availability to the brain and stabilizing nerve cell membranes, preventing the breakdown of inter-nerve communication. NOTE: Do not take this herb if you have high blood pressure. If supplementing, take 120 to 160mg daily. If using a tincture, take 10 drops three times daily. Licorice root is a very good liver botanical and promotes the elimination of toxins from the body. It works as well as milk thistle (see below) in protecting and repairing the liver and both herbs often have improved results when used together. Licorice tea is rather sweet tasting. Gently boil 1/2 tsp. powdered root with 1 cup of water for 10 minutes. Drink up to 2 cups daily. Milk thistle promotes liver function and helps cleanse the body of toxins. It is most effective if taken at night and works very well if taken with licorice root (see above). Take 2 tablespoons ground powder daily, sprinkled on food. If using capsules, take 280 to 420mg daily. Look for supplements containing silymarin, considered the active ingredient. Milk thistle takes time to act and, being nontoxic, is safe to use over the long-term. Lifestyle A low protein diet should be established to ensure L-dopa can breach the blood-brain barrier. This large, neutral, amino acid must compete with isoleucine, leucine, methionine, phenylalanine, tryptophan, tyrosine, and valine for passage across the barrier. Low protein diets will help reduce "competition", as it were. In addition, a low protein diet reduces tremors and improves overall function. It is important to remain active and perform daily activities as much as possible. Routines should be adjusted as the disease progresses and range and ability of motion becomes more difficult. Physical conditioning, though, is key. By keeping active, you ensure longer-term mobility and ability to accomplish tasks. Lift your feet with intention when walking. This diminishes shuffling and reduces the possibility of falling. Avoid rubber-soled shoes, as they can stick to the floor and may cause tripping. Use smooth-soled shoes instead. You will have to learn new strategies to compensate for the decline in movement ability. Take advantage of solid supports, such as bars and railings, which you may need to install in your place of residence. Use a walker or other assistive device for additional stability and ease of motion. Canes are generally not recommended as they do not supply enough control and can cause further problems when walking. Discuss this matter with your naturopath or other health practitioner to determine the most appropriate strategy for your needs. A positive attitude is also important, as this will go a long way in maintaining your independence and improving the quality of your life. As you adapt to change, be proud of what you have accomplished. In keeping with the theme of the above item, support from family and friends is essential when dealing with Parkinson's disease. Your family can assist you in planning strategies for dealing with change and help accomplish tasks that may become increasingly difficult over time. Discuss concerns with friends and/or join a support group focused on this disease. Minerals Selenium is a powerful antioxidant. One Brazil nut contains enough selenium to satisfy your daily requirement. However, you may wish to have a few more. If supplementing, take 100 to 200mcg twice daily. Miscellaneous Reduce pesticide exposure. A number of theories hold that increased toxin exposure leads to susceptibility to Parkinson's, again, due to free radical damage, progressive cell death, and various other degenerative effects. Avoid and eliminate all sources of toxic chemical exposure to prevent additional free radical damage in the body. Common household cleaners containing poison symbols should be eliminated. If you cannot drink it, why would you expose yourself to it? Long term toxic exposure is a silent and potentially deadly threat. And viable alternatives are readily available. Natural alternatives are available in health food stores, while vinegar or baking soda and water clean just about anything. Companies such as Nature Clean, Simply Clean, and Ecover sell viable alternatives that work just as well, if not better, than their toxin equivalents. Do not spray your lawn with toxic chemicals. Lawn spraying is an acutely North American habit whose consequences are far greater than the trivial, aesthetic gains. Think about it. You are poisoning your lawn, pets, children, and yourself to satisfy a social norm. Again, follow the above rule of if you cannot drink, why would you exposure yourself to it? Instead, welcome the diversity of life a natural lawn brings. Your children will be able to enjoy the outdoors while playing on the grass. You could even tear up the lawn and plant a natural garden with native plant species. This is a welcome trend in humanizing our urban areas. Butterflies, birds and beautiful planted bulbs make for a welcome replacement to a toxic expanse of empty space... Therapies, Healing Aids, and More Exercise helps keep muscles strengthened and active, encourages coordination and nervous system response, and promotes circulation and proper bowel function. Moderate exercise also decreases the likelihood of falling. Exercises should be performed when you feel well rested and movement is most easy. Range-of-motion exercises also prove helpful. As previously mentioned, support from family and friends is very important. You may also wish to join a discussion group or other community group to share your experience and strategies. This form of community and connection allows you to share your thoughts and feelings with others, as opposed to internalizing what you experience. Vitamins Coenzyme Q10 is a powerful antioxidant that also increases tissue oxygenation. Broccoli and spinach are two non-protein-based foods that contain this vitamin. If supplementing, take 50 to 100mg daily. Vitamin C helps inhibit dopamine oxidation and has general antioxidant properties. Take 1,000 to 4,000mg daily. Increase dosage up to bowel tolerance. A number of studies have shown that vitamin E supplementation is beneficial if taken during Stage 1 or 2, before Parkinson's sets in. Its role as an antioxidant will also prove beneficial in inhibiting neurotransmitter oxidation and preventing further free radical damage from peroxynitrite. Take 400 to 800 IU daily. Higher doses may be used; however, you must be under the supervision of your naturopath or other health practitioner.
Actions and Remedy Listings
For More Information ... Parkinson Foundation of Canada
390 Bay Street, Suite 710
Toronto, Ontario
M5H 2Y2 Tel.: 416.366.0099
Toll-free: 1.800.565.3000
Fax: 416.366.9190 Web: www.parkinson.ca
See also Aging, Depression
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