Parkinson’s disease is a common neurological condition afflicting about 1 percent of men and women over the age of seventy. Individuals with Parkinson’s disease have tremor of the hands, rigidity, poor balance, and mild intellectual deterioration. The tremor is most apparent at rest and is less severe with movement. In Parkinson’s disease, a small region in the brain, called the substantia nigra, begins to deteriorate. The neurons of the substantia nigra use the brain chemical dopamine. With the loss of dopamine, tremors begin and movement slows. Despite current drug therapies, Parkinson’s disease remains a progressive and incurable condition. Many patients with Parkinson’s disease may also suffer from age related cognitive decline or have some of the symptoms of Alzheimer’s disease.
   Although Parkinson’s disease can occur from viral infections or exposure to environmental toxins, such as pesticides, the causes of the majority of cases are not well known. Scientists suspect that oxidative damage to neurons in the substantia nigra could well be one of the major causes, particularly due to the depletion of the antioxidant glutathione. People who sustain substantial head injuries may face an increased risk of developing Parkinson’s disease years later. According to the Parkinson's Action Network, more than one million Americans have Parkinson's disease and 60,000 new cases are diagnosed each year.

Improving the Antioxidant System
Of all the nutritional strategies available for Parkinson’s disease, antioxidants appear to be the most promising choices to prevent or slow the progression of this condition. Individuals whose diets include plenty of healthy foods containing antioxidants are less likely to develop Parkinson’s disease. Patients should consume foods, such as fruits and vegetables, that contain glutathione or can help produce it. Cyanohydroxybutene, a chemical found in broccoli, cauliflower, Brussels sprouts and cabbage, is also thought to increase glutathione levels. High intake of dairy products may lead to a higher incidence of Parkinson's disease.
   The following antioxidants may be helpful in addition to standard pharmaceutical therapy.

Providing Dopamine Precursors
L-dopa, the immediate precursor to dopamine, is a nutrient available by prescription. L-dopa (often combined with carbidopa) is the most commonly used medicine to treat Parkinson’s disease. It is possible that the use of L-dopa for prolonged periods causes oxidation and toxicity to brain cells. If this turns out to be true, it would further justify the recommendations that antioxidants be added to standard Parkinson’s disease therapy. There is, as of yet, no clinical proof that taking antioxidant supplements help those with Parkinson’s disease live longer but all indications point to the possibility that the course of the disease can be slowed by providing adequate antioxidant support.
   Tyrosine is an amino acid that can be converted into L-dopa. But there is no reason to take tyrosine if L-dopa is available. Another way to increase dopamine levels is with the use of B vitamins, particularly NADH. Preliminary studies have shown some benefit with NADH in the therapy of PD. Although more research is needed, for the time being, it would seem reasonable to add NADH at a dose of 2.5 mg. NADH can be taken every other morning on an empty stomach. NADH may also help regenerate the antioxidant glutathione which could be beneficial. Be careful when you add NADH when you are already taking L-dopa or other medicines that treat Parkinson’s disease, since the effects could be cumulative. The long-term effectiveness of NADH in patients with Parkinson’s disease is currently not known. Taking between one to three times the RDA for the B vitamins seems to be a reasonable option.

Blocking Dopamine Breakdown
Dopamine is broken down in the brain by an enzyme called monoamine oxidase (MAO). When the activity of MAO is inhibited, dopamine stays around longer and this benefits those with Parkinson’s disease. Several drugs are available that block the activity of MAO. Selegiline is the most effective and the one used most commonly. The prescribed dosage is 5 mg a day.
   No nutrients are currently known that prevent the breakdown of dopamine. However, a study conducted on rats at the College of Humanities and Sciences, Beijing Union University, in Beijing, China, indicates that the Chinese herbs codonopsis and astragalus can inhibit MAO type B and increase the activity of the antioxidant SOD. We don’t have any human trials to determine whether these two herbs would benefit patients with Parkinson’s disease. Although selegiline is a very helpful medicine, high doses may increase the risk of heart irregularities.

Additional Nutrients to Consider
Some of the following nutrients may not be directly involved in making more dopamine, but could well improve general cognitive abilities. Many patients who have Parkinson’s disease, especially the elderly, have age related cognitive decline.

Fish oils at 500 to 1,000 mg a day of EPA and DHA with meals. The role of fish oils in Parkinson’s disease is not known, but they can generally improve overall brain health.
Gingko biloba at 40 to 60 mg most days with breakfast or lunch. This herb has antioxidant properties and helps improve memory and alertness.
Replacing hormones in patients with Parkinson’s disease may be an additional option. Whether pregnenolone, DHEA, or other hormones are helpful in Parkinson’s disease is currently not known.

It’s possible that the proper use of natural supplements can reduce the necessary dose of L-dopa, selegiline, and other drugs currently used to treat Parkinson’s disease, or help slow down the progression of the condition. There’s still a great deal we need to learn about the nutritional treatment of Parkinson’s disease. Incorporate relaxation or stress reduction techniques into your daily life. Some forms of body work and massage are especially beneficial in Parkinson’s.

Treatment Strategies for Parkinson’s disease
The nutritional therapy for Parkinson’s disease and tremor is still an uncharted territory. The most promising approach appears to be the use of antioxidants to slow the oxidation and damage to the substantia nigra. It’s possible that additional nutritional approaches may be found in the future.
   There are basically three types of drugs that are commonly prescribed for patients with Parkinson’s disease. First, doctors prescribe dopamine precursors, such as L-dopa, which converts into dopamine. A second approach is using drugs that block the breakdown of dopamine. A common medicine used for this purpose is selegiline (also known as deprenyl). And third, drugs are provided that influence dopamine receptors directly. The two most commonly prescribed are bromocriptine and pergolide. Researchers from the Mayo Clinic say that in some cases, patients taking pergolide (Permax) may experience damage to heart valves.
   Over the past few decades, doctors have made important advances in the therapy of Parkinson’s disease with pharmaceutical medicines. Yet, several nutritional strategies exist which should be explored further.

Statin drugs and Parkinson's disease, is there a link?
January 2007 - There may be a link between Parkinson's disease and low levels of low density lipoprotein (LDL), the "bad" cholesterol. Researchers at the University of North Carolina are planning clinical trials involving thousands of people to see whether statin drugs, which lower low LDL levels, might actually trigger Parkinson's in some people. Other research has for several years suggested that people with abnormally low levels of LDL might be at higher risk of Parkinson's disease. Xuemei Huang and colleagues found that patients with low levels of LDL cholesterol are at least 3 times more likely to develop Parkinson's disease than those with higher LDL levels. Reporting in the journal Chemistry & Industry, the investigators said they plan a bigger study of patients taking statins, the biggest-selling drugs in the world. "I am very concerned, which is why I am planning a 16,000-patient prospective study to examine the possible role of statins," Huang said in a statement.

Do NSAIDs protect against Parkinson's disease?
Some studies find that NDAIDs protect agains Parkinson's disease while others have not found such a relationship.

Nonsteroidal anti-inflammatory drugs may protect against Parkinson disease.
Neurology. 2007 Nov 6;69(19):1836-42. Wahner AD, Bronstein JM, Bordelon YM, Ritz B. Department of Epidemiology, UCLA School of Public Health, Box 951772, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA.
Markers of neuroinflammation, including activated microglia and increased levels of circulating proinflammatory cytokines, have been observed in the brains and CSF of patients with Parkinson disease. Our study contributes to the growing body of literature suggesting a protective role for nonsteroidal anti-inflammatory drugs (NSAIDs) in Parkinson disease. Given our results and the biologic plausibility of a neuroprotective function for NSAIDs there is a pressing need for further studies elucidating the protective role such drugs may play in Parkinson's disease.

Nonsteroidal anti-inflammatory drugs and the risk of Parkinson disease.
Neuroepidemiology. 2007;28(4):193-6. Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
Several lines of evidence suggest a role of inflammatory processes in Parkinson disease, although it is still unclear whether inflammation is a cause or rather a consequence of neurodegeneration. In a prospective population-based cohort study among 6,512 participants aged >or=55 years, with repeated in-person examination, we evaluated the association between cumulative use of nonsteroidal anti-inflammatory drugs (NSAIDs) and the risk of Parkinson disease. Complete information on filled prescriptions was available from automated pharmacy records. Data were analyzed by means of Cox proportional hazards regression analysis, adjusted for age, sex, smoking habits and coffee consumption. After an average 9.4 years of follow-up, 88 new cases of Parkinson disease were detected. No association was found between use of NSAIDs and the risk of Parkinson disease (adjusted hazard ratio for any NSAID use. Our findings do not support the hypothesis that NSAIDs might decrease the risk of Parkinson disease.

Levodopa induced dyskinesia
Levodopa induced dyskinesia is one of the most common motor complications in advanced Parkinson's disease. This dyskiesia involve mostly the limbs, trunk and head, but unusual locations have been reported including respiratory muscles, the face and the eyes.

Chemical cause of Parkinson's disease
Parkinson's disease occurs when a protein in the brain, called alpha-synuclein, or AS, clumps together. This causes brain cells that produce dopamine to die or stop working properly, which in turn triggers the symptoms of Parkinson's disease. Dopamine itself plays a role in destroying the neurons that produce it. The mediating factor is a chemical by-product of dopamine known as 3,4-dihydroxyphenylacetaldehyde, or DOPAL. DOPAL causes alpha-synuclein to clump together. Acta Neuropathologica, October 27, 2007.