Category Archives: Nutrition, Vitamins and Supplements

Is natural dopamine better than Sinemet?


Mucuna PrurienMucuna pruriens or cowhage seeds are a natural source of Levodopa and its use to treat Parkinson’s symptoms can be traced over 4500 years ago when it was first used by Indian physicians practicing traditional Ayurvedic medicine. The benefit of cowhage seeds is due to the fact that these seeds contain 3-4% levodopa, the standard medical treatment for Parkinson’s. Interest in Mucuna pruriens has grown especially amongst individuals searching for a natural treatment.

Because cowhage seeds contain the dopamine precursor levodopa, clinical studies have been preformed to study its use in Parkinson’s disease. One study showed that Mucuna helped Parkinson’s patients with on-off fluctuations and dyskinesia[1]. Motor symptoms improvement was faster with Mucuna 30 grams (Phytrix, manufacturer) than carbidopa/levodopa 50/200. However only eight patient’s were studied and more research needs to be done.

At present, there is no recommended dose as further clinical trials are needed.

The following general principles must be understood when investigating the use of Mucuna pruriens:

1.       The proposed active compound, levodopa, found in these seeds is chemically the same as that in standard medicine. Mucuna, therefore, can have the same side effects that are seen with levodopa.

2.      Mucuna pruriens seeds, like other natural substances, are made up of more than just levodopa. Proposed benefits could be due to other biologically active compounds not yet determined that are present in the seed. Although these compounds may add benefit they can also have additional side effects and drug interactions.

3.      Supplements are not regulated by the FDA so any single brand may not have the purity or strength claimed on the manufacturing label. Supplements are big business and you may not always be buying what you think you are buying. Toxic side effects from impurities in supplements have been observed. Look for supplements with the label ‘USP verified’ to insure potency, purity and bioavailability is appropriate.

4.      Natural supplements can interact with you medicines. Talk to your healthcare provider before beginning a supplement.

5.     The amount of levodopa present in beans can vary dramatically from on bean to the next based on age, where it is grown, etc; so it may be difficult to standardized a dosage.

Other names for Mucuna pruriens are: velvet bean and cowhage seed.

As always, it is important that you talk with your healthcare provider before changing your medical therapy.

 


[1] Journal Neurology Neurosurgery Psychiatry 2004. 75: 1672-1677.

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Does glutathione help Parkinson’s disease


Glutathione (GTH) is a molecule and potent antioxidant found inglutathione our cells. Glutathione is produced by our bodies and levels decrease with aging, many diseases and Parkinson’s disease.  The role of glutathione is to eliminate these free radicals; in essence, putting out a fire. It is unclear whether the low glutathione content in the PD substantia nigra is due to impaired production, or because the burden of free-radicals is excessive.

IV glutathione is a popular complementary and alternative medicine (CAM) therapy for Parkinson’s yet the benefits are not clear, it is costly and side effects do exist.

In 2009, researchers in Florida conducted a study to determine whether IVGTH showed benefit compared to placebo. Over the four weeks of the study, individuals receiving IV glutathione had a mild improvement in symptoms, while those receiving the placebo did not. This benefit was lost when glutathione was stopped. (Hauser RA, et al. 2009). It is important to note that the differences between these two groups were not significant. While the study is small and only provides preliminary data, it is promising non-the-less.

Mechanism of Action

Continued interest in glutathione  explores this molecules anti-oxidant properties.   The loss of glutathione in the substantia nigra precedes PD symptoms by more than a decade, and occurs prior to the formation of Lewy bodies, considered a PD precursor. Just because low glutathione levels correlate with PD severity, doesn’t mean that the loss of glutathione causes the disease. This is highlighted by the fact that glutathione is decreased in many diseases including cancer, vascular disease and other diseases of aging. We have no idea whether glutathione has the potential to retard disease progression, as the study has not yet been done.

Future Research

More information is needed to determine if glutathione is helpful in Parkinson’s disease. Although studies to date showed no statistically significant difference between placebo treatments and  glutathione many questions are still unanswered such as the optimal dose, timing of treatment in relation to disease severity, and duration of treatment. Studies are on going and investigating other ways of delivery such as intra-nasal spray.

Caution about pills

Since GTH is made up of amino acid precursors (similar to proteins),it is broken down in the gut prior to absorption and therefore little is available for use. It is for this reason that treatments focus on intravenous or IV (administered directly into the bloodstream through the vein.

Safety and ADverse Events

  • Expense of treatment
  • Bruising and Infection at IV site
  • Rare cause of liver damage

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What do I need to know about vitamins?


Medication Assistance is availableThe vitamin and supplement industry is a multibillion dollar business. If you search the internet, browse your pharmacy aisle or read a magazine you will discover many claims about a supplement treating a multitude of symptoms, cure disease, or increase vitality. Watch out for these claims, especially the wonder pill that treats so many problems that it sounds too good to be true- it most likely is. Is there true benefit or is it marketing hype? Ask you healthcare provider or nutritionist about the evidence if any that exist behind these claims. Here are some common claims or statements you may have heard.

So why do we take vitamins? When asked, most people say they are taking vitamins to stay healthy, ward off disease and colds and to make up for a healthy diet.

There is no data to support the claim that vitamin supplements will keep you healthy and in the absence of deficiency will not treat disease. Expecting your vitamin pill to take the place of a well balanced vitamin and nutrient rich diet is like trying to make a full course dinner by tossing together a few key ingredients. If health is your aim, remember diet, exercise, stress reduction, emotional and social health are the key ingredients. Nonetheless, there may be a place for vitamins such as B vitamins in people with stroke, vitamin D  in MS and Parkinson’s and vitamin B12 and folate for people with cognitive disorders and depression. Ask your doctor if vitamins a right for you and be sure to read about the good and the bad…

It is just a vitamin so it can’t hurt me (or substitute it is just an herb or natural supplement). Yes it can! The following examples illustrate this point:

  • Vitamin A, D, E and K are fat soluble vitamins. These vitamins are stored in our body’s fat cells and high doses can accumulate to toxic levels.
  • Vitamin E is a powerful antioxidant, helping the body reduce damage caused by free radicals. Although the evidence is inconsistent, one met analysis (review of the effect based on examining outcomes of many studies) found higher rate of mortality from all causes in people on high dose vitamin E. High dose vitamin E has multiple toxic consequences. Miller 2005. Ann Intern Med. Jan 4 2005;142(1):37-46
  • Over ingestion of vitamin D may be associated with calcification of blood vessels in elderly and African Americans.
  • High dose preformed vitamin A, known as retinol (found in animal foods) can cause headache, seizures, muscle aches, osteoporosis, skin and stomach problems. Provitamin A such as beta carotene found in fruits and vegetables such as carrots is safer than preformed vitamin A so read your vitamin label carefully.
  • Excessive doses of vitamin C are used by some during cold and flu season. Very high doses of vitamin C can cause kidney stones from uric acid, diarrhea and increase iron absorption (this is a problem if iron is stored in excess).
  • Excessive iron can be deposited in our body’s tissues leading to problems liver, skin, joint and intestinal symptoms. Iron is used to treat certain types of anemia. Many postmenopausal women and men do not need iron so talk to your doctor about whether you need iron.

So should I take a multivitamin?

Few Americans are vitamin deficient. In part because the processed foods we buy off the shelf are fortified with vitamins and minerals. A multivitamin will never substitute for the health benefits of a balanced diet that includes 8-10 servings of fruits and vegetables, whole grains, vegetable protein, omega 3 fats such as in certain fish, and high fiber (20-30G). Turn to food and vitamins to be sure you get a variety of vitamins and minerals in your diet.

However, some people are at higher risk for deficiencies:

  • Vegetarians- may be deficient in B12, iron, calcium depending on diet
  • Elderly
  • Intestinal Malabsorption problems  such asCeliac,Sprue.
  • Long-term users of stomach acid depleters ,
  • Alcoholics
  • Pregnancy

There is no simple answer as to whether a vitamin is needed for you. Talk with your doctor before choosing a vitamin.   Specific questions to ask include:

  • Do I need iron?
  • Should I take a calcium supplement?
  • What about vitamin D or B vitamins?
  • What dose of vitamin E and A is safe for me?
  • How much B vitamins, calcium and D should I take?

Steps you can take if you do take a vitamin

  • Read the label on your vitamin bottle.
  • Avoid mega-doses unless recommended by your doctor. This is especially true for vitamin E and A.
  • Take iron only, ie. restless leg syndrome, premenopausal women on doctor’s advice
  • Pay attention to how much calcium you are getting in your diet and vitamin. Does it add up to the recommended dose given you by your doctor (1000-1200mg is the average daily requirement for older adult needs).
  • Look for 100% RDA of vitamin C, B12, folate,B2,  B6, thiamin, niacin, A (preferable in provitamin beta-carotene form). Gender specific or other specialty vitamins may differ slightly but the true value of these costly formulas is unknown.

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Absorption of Sinemet requires optimal GI health. Is anyone working on a sublingual delivery of the medication?


Medication Assistance is available Carbidopa/Ldopa is one of the most commonly used medicines for Parkinson’s disease. Ldopa chemically resembles the amino acids or building blocks that make up protein. Because of this, Ldopa ‘competes’ with protein for absorption through the intestines and into the brain.

As the question suggests, optimal absorption of ldopa is important to avoid fluctuations in motor response. A dissolvable form of carbidopa/ldopa does exist but unfortunately it does not absorb through the mouth and still requires swallowing of medicine into the intestine for absorption. An infusion form of Ldopa gel was developed to deliver Ldopa directly to the intestine. This allows precise changes or titration of  the  amount delivered by using a pump to match the needs of the patient. This form of the medicine and pump delivery is still being studied in clinical research trials and requires that a feeding tube be placed by a surgical procedure into the stomach and advanced through to the small intestines where Ldopa is absorbed. Researchers are also studying different ways to deliver Ldopa using special techniques such as a patch formation. This mode of delivery is not currently available because Ldopa does not easily absorb through the skin requiring special technology to enhance its absorption.

The following tips can help:

  • Treat constipation and bloating
  • Be sure to get plenty of water, fiber and exercise to help transit of food through the GI tract
  • Separate timing of Ldopa dosing from meals
  • Eat the majority of your day’s protein when you are less active such as the endo of day
  • Eat plant sources (nuts, beans, soy) over animal sources of protein

Click here to read more on this topic is available

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Top 10 Foods for Parkinson’s (and counting!)


The following are a list of top 10 foods for PD and the reason(s) why:

1. Water – Be sure to get your fluids to prevent dehydration, low blood pressure and improve constipation- all potential problems in PD.

2. Prunes – “Not just for grandma”. High in antioxidants, fiber, vitamin A and potassium plus effectively treats constipation.

3. Salmon, sardines and tuna – Packs a “big punch” for protein plus high in heart healthy omega 3s. Eating sardines with the bones adds calcium. Be careful how much tuna you eat in one week due to accumulation of mercury.

4. Berries – Pomegranates, cranberries, blueberries, blackberries. All high in antioxidants.

5. Broccoli – “Your mom was right- eat your broccoli”. Source of antioxidants and a high source of fiber, vitamin C, calcium, iron and magnesium for a vegetable.

6. Green Tea – Great source of phytochemicals that serve as antioxidant and a way to get your fluids too. A source of anti-oxidants for those wanting low (no) calorie options.

7. Chocolate! – Cocoa, rich in flavinoids and other antioxidants, may reduce the risk of cardiovascular and stroke disease. Dark chocolate is highest in cocoa (choose brads with >70% cocoa). Cocoa may also increase brain serotonin a chemical that modulates mood. Beware that processed chocolate is high in fat and processed sugars so not good for everyone. Moderation is key!

8. Ginger – Ginger has been used for centuries to treat nausea and research is proving its value for treatment of nausea during chemotherapy or with motion sickness. Ginger can help the nausea caused by dopaminergic medicines to treat PD. Using ginger root or candied ginger is one way to insure you are getting the real product as the purity of supplements is not regulated.

9. Papaya – Fruit not only high in antioxidants but may also contains an enzyme papain that can thin thick saliva. (Meat tenderizer made from papaya root mixed with water also helps).

10. Oatmeal – Easy to swallow, easy to prepare, high in fiber, and low in calories. This food is a low protein option for breakfast (high protein can reduce Ldopa absorption) also promotes heart health, may reduce cholesterol.

Submit your own Top Foods and the reasons why to expand this list!

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Should I take Coenzyme Q10 for my Parkinson’s?


Coenzyme Q (CoQ10) is and over the counter dietary supplement.  Our body’s cells produce Coenzyme Q 10 but this decreases with age and some diseases like Parkinson’s. CoQ10 plays a key role in our cell’s energy production in a specific part of the cell, referred to as the electron transport chain, in our mitochondria. Portion of this electron transport chain is deficient in people with Parkinson’s;  hence CoQ10 may play a role in maintaining the integrity of this process and cell health.

Recent studies did not support original research suggestion a potential benefit of CoQ10 in patients with early Parkinson’s.  A double-blind placebo controlled clinical trial was stopped in 2011 when it was noted that 1200mg or 2400mg for 16 months did not improve symptoms and so is not routinely recommended for treatment.  The following questions are unanswered and situations that may pertain to you serve as a point of discussion with your provider as to whether you should take CoQ10.
  • Would a longer period of use (over 16 months) yield positive results?
  • Will results differ if taken at different stages of disease?
  • Supplements can have side effects even if they are naturally occurring in the body. CoQ10 side effects are minimal but could include bleeding risk, interaction with the blood thinner warfarin.  CoQ10 may reduce blood pressure and interact with some blood pressure medicines.
  • As with all anti-oxidants, do not take if you have cancer unless it is approved by your doctor.
  • CoQ10 is expensive. Can this money be spent on alternative treatment with noted and proven benefits like weight loss, exercise, stress management, personal trainer or health coach.
  • Do not use in place of recommended medicines.
  • As a supplement, CoQ10 is not regulated by the FDA. Be sure any supplement you take is tested to prove it is pure, has the potency that and absorbability that is claimed oon the label and marketing.  One way to do this is to look for the statement USP verified on the label. USP  is an independent laborary that tests for these qualities.

Learn more about CoEnz Q10 on the Wellness Center.

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Coffee reduces risk of Parkinson’s. What about other foods?


A recent report at the 2012 American Academy Meeting suggested that greater than 3 large cups of coffee could protect against development of brain Lewy body disease. Lewy bodies are abnormal cell deposits associated with Parkinson’s disease.  Results come from research conducted as part of the Honolulu-Asia Aging Study (HAAS), a prospective analysis of more than 8000 Japanese American men who were living on the island of Oahu at the initiation of the study in 1965.

Coffee (caffeine) is an A2a adenosine antagonist thought to play a role in motor control which could be beneficial in PD.

It is not known if drinking coffee after a person has PD alters the course of the disease.  Whether caffeine is neuroprotective is unknown and will be a subject for future.

Other foods found to reduce the risk of developing PD

  • Mediterranean diet- high in fruits vegetables, vegetable protein, fish, grains, nuts, beans, olive oil.
  • Vitamin B6 foods (cheese, mild, eggs, beans/legumes, potatoes, fish, meat, flour, grains, carrots, and peas)
  • Vitamin E rich foods (olive oil, nuts, seeds and leafy green vegetables)
  • Beer
  • Berries- blackberry, blueberry, raspberry (high in flavinoids)
  • Green tea
  • Omega 3 Fish oil such as that found in cold water fish like salmon (reduced Parkinson’s in animal studies)
  • Peppers- high and antioxidants and nicotine both potentially helpful for PD

Increase risk of developing Parkinson’s was found with

  • Saturated fat- diet high in animal protein over vegetable protein)
  • Milk consumption in men

What nutrition research is clear about is that no single vitamin or food leads to ideal health.  Healthy meal patterns are your best best.  Talk to your healthcare provider before making any change in your diet. Find out more about diet, health and Parkinson’s disease at the Wellness Center.

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Coconut Oil


I am wondering about coconut oil.  A friend has been encouraging me to take it.  Since I haven’t heard any headlline news about it I wonder if it would really help my Parkinsons. 

Cocunut oil is being tauted as a treatment for Alzheimer’s disease and epilepsy.  No well controlled study is available to test its effect on Parkinson’s.  This oil is high in medium chain triglycerides which are broken down by the body to ketones. Ketones are an alternative fuel for the brain (brain’s primary source of fuel is glucose). The idea is that ketones are more readily used by some nerve cells providing much needed energy for cell activity.

You should not use coconut oil unless recommended by your doctor.  True benefits of the oil are not yet proven, not all coconut oils are the same as many contain blends of oil (some that can be harmful), and the effect of coconut oil on cholesterol and lipid levels is not yet clear.

More information on Parkinson’s diet, vitamins and supplements can be found at the NWPF Wellness Center.

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Protein’s effect on medicine


I heard that protein interferes with my medicine. Should I be restricting protein?  Eating a healthy diet is one of the most important lifestyle changes you can make for yourself.   Protein does delay the absorption of levodopa into the bloodstream and across the blood brain barrier. However, protein is an important part of a healthy diet and can not be eliminated from your meals. Learn more

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