New Hope for Parkinson’s

Parkinson’s strikes people at younger ages than ever before, but powerful treatments are on the horizon

At first, Sally Sweeney’s hands trembled just enough to make holding the morning newspaper tough. Then, on long walks, her right arm would stop its natural swinging. Her always-precise handwriting suddenly looked a little off. The active, 52-year-old mother of four figured she had a pinched nerve or something. Finally, she began having trouble knitting: Her fingers felt slow and tangled, like wearing mittens to play Pick-Up Sticks. She couldn’t ignore the pesky symptoms any longer.

That was 1995, the summer Sweeney was diagnosed with Parkinson’s disease, a chronic and progressive neurological disorder. The neurons had already started dying in the part of her brain called the substantia nigra. This area produces dopamine, a vital neurotransmitter responsible for smooth motor skills. People have likened Parkinson’s to a thief that gradually and unexpectedly robs you of movement, control, and energy. “Parkinson’s makes you want to sit in your chair and not get up,” Sweeney says. “It makes you feel awkward and uncoordinated, achy and tired.” As the disease progresses, the incremental loss of dopamine results in tremors, muscle rigidity, slowness of movement, impaired balance, and eventually incapacitation. But Sweeney, now 65 and a self-employed kitchen designer in rural Kansas, remains undeterred: “From the very beginning, I did everything I could to stave it off.”

Beyond Drugs
No cure for Parkinson’s disease exists. Instead, medications attempt to replace or mimic the brain’s dopamine. While the drugs do curb the symptoms up to a point, their effectiveness diminishes over time, so dosages often must increase dramatically. But at this point, no level of drug therapy can stop the destruction of brain cells in the substantia nigra, explains David Perlmutter, MD, a board-certified neurologist in Naples, Florida, who is recognized for his innovative approaches to neurological disorders. Medications come with side effects as well, such as depression, extreme daytime drowsiness, involuntary jerky movements, insomnia, dizziness, and hallucinations.

Like almost all Parkinson’s patients, Sweeney started on medication to reduce symptoms right after she was diagnosed. Wanting to take as few drugs as possible, however, she also searched for alternative solutions to slow the disease. She began getting acupuncture, taking antioxidant supplements, practicing yoga, lifting weights with a trainer, and volunteering each week at a Parkinson’s foundation office where she could stay on top of new research. Today, almost 13 years after her diagnosis, Sweeney says her Parkinson’s disease, remarkably, isn’t that bad … I am way ahead of most people after 13 years.

She credits her strong health to having melded the medications and expertise of conventional medicine with holistic treatments, diet, and exercise. She’s not alone in her adoption of alternative therapies. More and more patients, practitioners, and researchers are beginning to understand the huge role environment and lifestyle play in this disease and the power this duo has to help treat or prevent it.

Rising Tide
A degenerative disorder of the central nervous system, Parkinson’s first surfaced in 1817 when James Parkinson, a British physician, published a paper on what he called “the shaking palsy.” Almost 200 years later, no single test exists that definitively diagnoses the disease; instead, doctors rely on results from an in-depth neurological exam that tests motor skills and brain functions. A gradual appearance of symptoms is what usually sends patients to a neurologist for help. The condition manifests itself differently in each patient and can take anywhere from a few short years to as long as 20 to progress. “I learned that this is a very unpredictable disease; the symptoms cycle,” Sweeney says.

Currently, at least a million people in the US and an estimated 6 million worldwide live with Parkinson’s, making it the second most common neurodegenerative disorder (Alzheimer’s ranks first). The apparent cause: long-term exposure to low levels of toxins in people who are genetically susceptible to the disease, says Dan Lukaczer, ND, associate director of medical education at the Institute for Functional Medicine in Gig Harbor, Washington.

The disease doesn’t discriminate sexually, racially, or geographically, and its prevalence is rising partly because people live longer than they used to. That doesn’t tell the whole story though. In fact, the National Parkinson Foundation reports that 15 percent of those diagnosed are younger than 50. They should be resistant to the disease, says Perlmutter, but “our increasingly toxic environment is lethal to the nervous system, so it is no surprise that we are seeing a surge in neurological disorders.”

Risk Factors
Scientists have pinpointed several of the toxins that increase risk of the disease. One culprit is pesticides. Research shows that the more pesticides you’re exposed to, the higher your risk of developing Parkinson’s whether you’re a farmer or recreational gardener, or someone who just happens to drink well water near pesticide-treated land. A 2006 study published in the Annals of Neurology, for example, looked at more than 143,000 men and women, all of whom started out symptom-free and who completed extensive lifestyle questionnaires from 1992 through 2001. The researchers found that those individuals regularly exposed to pesticides had a 70 percent higher incidence of Parkinson’s. Animal studies reveal that the pesticides actually destroy the dopamine-producing neurons. Other triggers now emerging include long-term exposure to industrial chemicals and heavy metals, says Lukaczer.

Researchers believe these toxins may damage mitochondria; the energy-producing part of cells. Once damaged, the mitochondria churn out unstable molecules called free radicals that react with the rest of the cell. A domino effect destroys neurons in the brain, halting production of critical dopamine.

The first step, then, in preventing or slowing Parkinson’s is to limit your exposure to these toxins. You can do that by choosing organic produce, drinking purified water, and living in an area with low pollution levels (for example, away from industrial plants or fields where crops are sprayed). Not everyone has that luxury, of course, so people have to work collaboratively in their communities to reduce environmental contaminants.

Secondly, it’s important to support and strengthen your liver, which is the body’s main organ for detoxification. People whose livers don’t function optimally are more likely to get Parkinson’s, says Perlmutter.

The Food Connection
Along with avoiding the toxins that ignite the free-radical fire, you should eat foods and take supplements that put that fire out. Growing research shows that diets rich in antioxidants, as well as free radical-fighting supplements, help keep Parkinson’s patients functioning better with fewer symptoms. For specifics on which foods to eat and which to avoid, see “The Holistic Approach” below.

One antioxidant in particular, coenzyme Q10, has been studied intensely as a means to improve mitochondrial function. Two pilot studies, published in 2002 and 2004 and conducted at the University of California at San Diego, as well as subsequent clinical trials, have shown that oral Co-Q10, in doses of up to 3,000 mg a day for more than a year, dramatically slows the progression of Parkinson’s symptoms. The prestigious Parkinson’s Study Group will soon conduct a large-scale, 16-month study on Co-Q10?s effects on 600 Parkinson’s patients.

Movement Therapy
People with Parkinson’s, like all of us, should keep their bodies moving. Exercise helps the muscles run smoothly and staves off the rusting and rigidity Parkinson’s induces. A 2006 study published in the journal Obesity found that exercise actually helps protect the nervous system by promoting neuron growth, increasing your ability to process information, and fine-tuning your motor skills. T’ai chi, qigong, yoga, and Pilates have all delivered positive effects for Parkinson’s patients. So has music therapy, a treatment that uses music to stimulate movement and emotional responses via different sensory pathways. Music therapy helps Parkinson’s patients initiate movement of great benefit, since freezing-up is a common Parkinson’s challenge.

“There’s a direct connection between how you learn to dance and Parkinson’s movement,” says Olie Westheimer, founder of the Brooklyn Parkinson’s Group and instigator of the Mark Morris Parkinson’s dance program. “When you learn how to do a pirouette, you learn how and where to focus, where to hold your arms. Your brain is telling your body what to do.” That path of movement, Westheimer explains, is what Parkinson’s patients need to relearn. The dopamine no longer fires regularly, telling them how to move naturally. But dance therapy offers ways to retrain the brain not just for pirouettes, but for daily challenges like stepping through doorways or walking with a smooth gait.

Yoga also seems particularly effective. Claire Henchcliffe, MD, director of the Parkinson’s Disease and Movement Disorders Institute at the New York Presbyterian Hospital Weill Cornell Medical Center, conducted a 10-week study in which Parkinson’s patients took hour-long yoga sessions twice a week. She found a gentle yoga practice increased energy, balance, and coordination. “How much of that was placebo effect? At this point we don’t know,” Henchcliffe says. “Medicines get a clinical trial, testing the medicine against a placebo. You can’t really do placebo yoga.”

Nonetheless, the results are encouraging, and Parkinson’s-specific yoga classes are popping up around the country. Suzette Scholtes, who teaches one of those classes at The Yoga Studio of Johnson County in Kansas, recommends poses like forward bends that cool the nerves and strengthen the body. But, she says, steer clear of overly strenuous moves, such as too many Downward Dogs, since they can sometimes agitate the nervous system in Parkinson’s patients. The aim is to calm and balance the nerves while countering fatigue. Scholtes also uses sand weights on hands and legs to still the tremors, and props like blocks and blankets to help open the chest for deep breathing. Props are fundamental to therapeutic yoga, students need to feel supported and comforted, especially because they’ve received such a pessimistic diagnosis. Anything you can do to calm the nervous system helps.

Two-Pronged Approach
Most MDs and even NDs agree that we can’t toss Parkinson’s medications by the wayside yet. The drugs are critical for improving people’s functioning as Parkinson’s advances. But the ever-widening range of complementary therapies that help slow or ease the disease excites many doctors. “I would absolutely recommend working with an ND and an MD in tandem, as I think they both bring something important to the table,” says Lukaczer.

Some physicians remain stuck in an exclusively conventional approach.

“Neurologists seem to be drawn to the latest and greatest medications,” says Perlmutter. He sees such reluctance among his peers to use nutritional supplements, especially antioxidants, to slow Parkinson’s. “I marvel at this because this is published in very good, peer-reviewed journals,” he says. Perlmutter believes that just treating symptoms while ignoring the underlying disease process is like treating the smoke and not the fire.

Nonetheless, things are changing. People are coming in a lot more with information about alternative therapies, wondering what they should do. The interest has mushroomed. A 2001 study published in Neurology, for instance, reported that 40 percent of American Parkinson’s patients were using at least one complementary therapy, and 33 percent were using three or more, including vitamins, massage, and acupuncture. This is stuff we never used to talk about. By combining medications with holistic remedies, people can get the best of both worlds.

“I am very hopeful. I feel that scientists are getting closer and closer,” Sweeney says. For now, she keeps up her exercise regimen, her antioxidants, a moderate work schedule, and minimal Parkinson’s drugs. She also has learned, happily, to knit like a snail.

It’s an adjustment. It’s a nuisance. You have to learn to do things at a different pace, she says. I don’t know what’s helping, so I have to keep doing everything.?

Jennie Lay is a freelance journalist who writes from her home in Steamboat Springs, Colorado.