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Parkinson’s Disease Nutrition: Why is it Relevant?

Monday March 03, 2014

Humans are parasites of the planet. We need the planet, but it doesn’t need us. In order to survive, we must take in minerals, molecules and organisms from the environment. Nutrition is the study of this human dependence.

The goal of nutritional medicine is to see that the body’s needs are being met. How do we know what we need?  Dietary Reference Intakes (DRI) provide guidance for most healthy people, but not for individuals with disease. Just as burn and trauma victims require additional protein, so are the nutritional needs different in individuals with Parkinson’s disease.

When we can’t make enough of a nutrient to supply our needs, the nutrient is labeled “essential.” (Gk vitamin: essential, life)  We’re slow learners when it comes to nutrition.  It took us about 3500 years and approximately 2 million dead sailors before we figured out vitamin C deficiency caused scurvy. 3 million Americans were walking around with skin rashes, dementia, and diarrhea in the early 1900’s until we figured out niacin cures pellagra.

Conditionally essential nutrients in PD

Are there nutrients that, if provided, would prevent the onset and/ or progression of Parkinson’s disease? In my own research, we are studying deficiencies of glutathione, coenzyme Q10, and lithium in people with PD. Other researchers are working on other nutrients, such as uric acid, alpha lipoic acid, NADH, creatine, curcumin, flavonoids, and vitamin D. 

Nutritional epidemiology of Parkinson’s disease

Does what you eat as a young adult influence your risk of getting PD?  Apparently, yes. Across multiple studies, the more dairy a person consumes, the more likely the risk of developing PD. Green tea and coffee, on the other hand, are protective against PD, delaying the onset of symptoms by several years!

Integrative Medicine

How does nutritional medicine work with conventional medicine? Beautifully. In fact, conventional medicine doesn’t work without it. Think of nutritional medicine as your offensive line and symptom management (pharmacotherapy, DBS) as your defense. If you want to win, you need both your offensive and defensive lines to be in good shape, and you need them to be able to work well together.

Nutritional medicine can be considered an upstream, pragmatic, preventative approach to PD prevention and treatment. If you have PD, imagine you are sitting on a row boat that is very slowly sinking.  Dopaminergic therapies are like a bucket that allows you to relieve some of the accumulating water. Nutritional medicine strives to find the holes and patch them up.

Drug-Nutrient Interactions

Levodopa is prescribed to treat a dopamine deficiency and is an excellent example of nutritional medicine. Unfortunately, levodopa interferes with folic acid uptake, raising homocysteine levels, which have been associated with an increased risk of dementia. Don’t fret! The fix is easy- if you’re on levodopa, be sure to supplement with enough folic acid to keep your blood homocysteine levels below 10 micromoles/liter.

Not all drug-nutrient interactions are negative!  DHA (fish oil) seems to reduce levodopa-induced dyskinesia and CDP-choline extends the activity of levodopa. When nutritional medicine and conventional medicine work together, you can have your cake and eat it, too.

PD nutrition is a growing field, with promising research emerging in biochemical abnormalities (metabolomics), gene-nutrient interactions, and gut organisms (microbiome).

And then there is food: What should you eat? Should you take supplements? Well, that depends on if you are overweight, constipated, on medication, where you live, what other conditions you have, and what you can afford.

Each of these topics will be explored in greater detail in upcoming blogs, so stay tuned….

Laurie K. Mischley, ND, MPHLaurie K. Mischley, ND, MPH
NWPF Blogger

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