Nutritional Status Matters in Parkinson’s Disease

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Parkinson’s disease (PD) impacts 10 million people worldwide, and each year, 60,000 Americans are diagnosed with it. Men seem to be more likely to develop the condition. According to a new prevalence study, as the population ages, the number of people diagnosed with PD increases with age, regardless of sex.

I looked at a prevalence map and Montana and North Dakota have the fewest number of people (about 1,400 and 2,000 people respectively), whereas California and Florida top the list with the most people with Parkinson’s disease (85,000 and 64,000 people respectively).

There are websites that offer much more detail regarding symptoms of Parkinson’s disease but a few telltale signs include tremor in the hands, slowed movements, muscle rigidity, poor balance, fatigue, or a distorted sense of smell. Among the cognitive signs and symptoms are disturbing dreams, restless sleep, confusion at night, anxiety, dementia or difficulty with comprehension.

I could write a book on the medications and how to use them properly, but that is not the focus of my article today. I’m planning to give you nutritional options and some understanding of vitamin deficiencies, and how that impacts your prognosis. Nevertheless, I would be remiss if I did not mention the most common medications used for Parkinson’s disease. These include Carbidopa-Levodopa (Sinemet, Atamet, Dhivy), MAO inhibitors such as Azilect, Eldepryl and Xadago, and of course, the newest class of meds called the COMT Inhibitors like tolcapone and entacapone. Those COMT inhibitors are used to help with tremor, stiffness and muscle rigidity/cramps, dizziness, and sudden freezing of gait… all of these are termed “motor” symptoms of Parkinson’s disease.

Speak to your physician or local pharmacist about the medications and which combination is right for you. There are, of course, many others not listed here.

During my research, I found some interesting findings about nutrients that might be useful for you. As a pharmacist, I can tell you that most if not all of these vitamins are okay to use in combination with medications, however, to be 100 percent sure they don’t interact with the specific medication you take, I want you to ask your own practitioner about taking these. Here are some nutrients which may play an important adjunctive role in your Parkinson’s disease protocol: 

Vitamin B12 or Methylcobalamin Helps Parkinson’s Disease

We know that the B complex family of vitamins is important for proper nerve health. There is an important relationship between B12 specifically and Parkinson’s. We know that people with peripheral neuropathy are often deficient in B12. And it’s not just peripheral, there was a study in 2014 that found that B12 deficiency is one cause of SNF (Small Fiber Neuropathy).

A lack of B12 can affect thin-myelinated A-delta fibers and unmyelinated C fibers thus affecting the small fibers. If you do not know what SNF is, but you have diabetes or any kind of neuropathy please read THIS ARTICLE. Small fiber neuropathy occurs in Parkinson’s disease sometimes too. 

You can test yourself to determine levels of B12 easily. One popular test is a “Serum B12,” but I would also recommend the MMA (Methylmalonic Acid) test. I feel that this test will give you more information. An MMA test is most often used to diagnose vitamin B12 deficiency.  You can also test your homocysteine while they’re sticking you because knowing those two levels will explain whether or not you have B12 deficiency. If both the MMA and the homocysteine are elevated, you have B12 deficiency in your tissues. And if it’s low in the tissues, it’s low in your myelin which protects your nerve fiber.

In summary, B12 could be very important for muscle health, and sensations of pain and neuropathy in a Parkinson’s disease patient. Furthermore, B12 is important for sleep as it makes melatonin in the body. Finally, B12 levels reflect your probiotic status. It is your microbiome that manufactures B12 for you, so if that is low, your gut needs some work.

By the way, if you’d like to go to a lab and self-order your own blood tests (to later share with your doctor at your next appointment), you can do that nowadays. Read THIS ARTICLE on how to self-order lab tests.

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Vitamin D.
A 2019 STUDY was among several others that determined vitamin D deficiency could impact the outcome for people with Parkinson’s disease. Keeping levels of D up high enough is difficult for the elderly too, it’s hard to get enough sunlight, and even if they do, their body doesn’t sulfate it, or convert it properly due to mild liver or kidney compromise. 

But the study concurs with others in that chronic D deficiency will cause loss of dopaminergic neurons (the brain cells that you want more of if you have Parkinson’s disease). Low D translates to fewer of these brain cells, which then hastens symptoms of PD, especially cognitive function. Research does confirm that people with PD have significantly lower levels of D compared to those people who do not have the condition.

I could leave it here, but since I love to study genetics and as a teenager wanted to become a geneticist, I’ll delve a little deeper and tell you this:

We have many tight studies that show there are millions of cells in the brain (in the substantial nigra) and all of them have doorways for Vitamin D. The doorways that allow D into the cell are termed “receptors” as you probably know. These vitamin D receptors (VDR) are not working well in patients with Parkinson’s disease, and it has to do with genes. If you are born with a heterozygous or homozygous SNP (polymorphism) in your VDR gene, it will impact your risk for PD.

VDR is also highly prevalent in the putamen and caudate nucleus. This is proven. Remember, VDR is what grabs hold of vitamin D in the brain, and takes it into the cell. If you don’t get the D into the cell, you’ll have symptoms of clinical deficiency. You can find out about your own VDR on certain genetic tests widely available these days. Even if you have a VDR SNP, you can still benefit from taking vitamin D in proper doses, but do not overdo it because it will raise calcium and impact your heart rhythm. Be very careful not to overdo it.

Fish Oil. 
Sometimes tremors respond to DHA fish oil, and this could be a promising strategy to slow down the progression. Remember, even if our drugs are useful, they don’t cure it, so this natural omega 3 fatty acid is probably safe and might be slightly effective for the management of tremors and other symptoms in the early stages.

Ask your doctor of course, because fish oils are blood thinners. These work by improving synaptic development and functionality. Fish oils are useful at making things more ‘slippery’ in the sense that the signals travel faster in the body, thus communication between neurons will improve. Research confirms that essential fatty acids contribute to improving cognitive activity and more neuroplasticity. You may be interested in this article entitled, Are Fish Oils Your Only Option.