Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Categories
Subscribe to the Magazine for free
Subscribe for free to keep reading! If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.

4 Possible Causes Of Parkinson's And 5 Things That Make It Worse

Medically reviewed by 
 
4 Possible Causes Of Parkinson's And 5 Things That Make It Worse

Parkinson's disease affects an estimated 4% of people over the age of 50 - a number that exceeds 10 million people across the globe each year. It is the second most common neurodegenerative disorder - behind only Alzheimer's disease in its incidence.

There is an abundance of research about what works to help manage symptoms and slow progression in PD, from pharmaceuticals to the foods we eat. This article will review a Functional Medicine Approach to Parkinson's Disease, including nutrition, lifestyle interventions, pharmaceuticals, physical medicine, and more.  

[signup]

Signs & Symptoms of Parkinson's Disease

Parkinson's disease is a neurological disorder characterized by tremors, slowed movements, changes in writing and speech, and (at times) cognitive impairment. Parkinson's used to be thought of primarily as a motor disorder (disorder affecting the muscles and nervous system), but it is now known that it affects every system in the body.

  • Tremor (shaking in a limb at rest or with movement)
  • Bradykinesia and slowed movements
  • Muscle rigidity
  • Stooped posture and impaired balance (trouble with walking and more)
  • Autonomic dysfunction (impaired body temperature control, salivation, etc.)
  • Sleep issues
  • Changes in voice (softer voice and difficulty speaking)
  • Changes in writing (micrographia)
  • Gastrointestinal problems like constipation and trouble with swallowing
  • Urinary issues
  • Loss of smell (anosmia)
  • Mood issues like depression and anxiety

Symptoms of Parkinson's can develop gradually. They often begin on one side of the body, and some symptoms (like tremors) can temporarily worsen with stress. The diagnosis of Parkinson's disease is generally made by a neurologist after physical examination and testing. It is sometimes confirmed by testing to see if PD symptoms improve after L-DOPA administration.

Possible Causes of Parkinson's Disease

Parkinson's disease is generally defined as the loss of dopamine-producing neurons in a particular part of the brain called the substantia nigra. Additionally, it involves the accumulation of alpha-synuclein (or Lewy bodies) in the cytoplasm of other neurons. Our understanding of the pathophysiology of Parkinson's is still evolving, but research has shown that a variety of factors - including genetics, oxidative stress, inflammation, viral infections, dysbiosis, microglial activation, environmental exposure, and more - can play a role in the development of Parkinsonian symptoms.

Toxic Metals

Toxic metal exposures can cause nervous system symptoms that look very much like Parkinson's disease. The most famous heavy metal linked to Parkinson's is manganese. High levels of manganese can cause a disorder called manganism which mimics PD closely and includes tremors, bradykinesia, cognitive impairment, and more.

Environmental Exposure

Certain pesticides, herbicides, fungicides, rodenticides, and fumigant exposures are linked with the development of Parkinson's disease. This is because many of these chemicals are neurotoxic and - in large amounts - can damage cellular mitochondria, the brain, and other tissues. While Parkinson's disease existed long before the invention of these chemicals, we know that exposure to them makes a person more likely to develop PD today. The most famous example of pesticide-related Parksinsons' is Paraquat, a pesticide first introduced in the 1960s in the United States. Some studies showed that Paraquat caused a loss of up to 30% of the dopaminergic neurons in the substantia nigra in mice, and it is shown in the literature to be related to several cases of the development of Parkinson's symptoms after exposure.

Viral Infections

Viral infections like influenza, Epstein-Barr virus (EBV), and herpes viruses have also been associated with PD development. It's thought that viral infections may trigger immune system changes that lead to inflammation and neurodegeneration.

Genetics

Many genetic factors are thought to be associated with an increased chance of developing PD. Much of the research in PD is devoted to understanding the genetic underpinnings of Parkinson's disease due to its perceived heritability - or likelihood of occurring in families.

Possible Causes of Increased Severity of Symptoms of Parkinson's Disease

Hormone Imbalances

Males are about 1.5 times as likely to experience Parkinson's disease as women.

Abnormalities in hormones like estrogen, progesterone, testosterone, DHEA, and neurohormones like serotonin, dopamine, and norepinephrine are linked with Parkinson's disease symptoms.

Evidence suggests that DHEA - an adrenal hormone that is also the precursor to testosterone and estrogen - is involved in the muscle wasting process in Parkinson's. Studies have demonstrated that supplemental DHEA can help reverse some muscle atrophy in the lower limbs of mammals with Parkinson's.

Thyroid Hormone

People with Parkinson's are more likely to have a thyroid disorder than those without PD? Research is still evolving as to why the link exists. Many scientists theorize that it may have something to do with dopamine production and thyroid hormone sharing many of the same biochemical precursors and are linked by certain enzymatic and hormonal pathways processes.

Thyroid hormone abnormalities are correlated with subtypes of Parkinson's disease and can make symptoms worse if they are not controlled.

Oxidative Stress

Dopaminergic neurons in the substantia nigra are particularly vulnerable to oxidative stress. An emerging body of research connects mitochondrial dysfunction, oxidative stress, DNA changes, and alterations in cell signaling with the progression of Parkinson's disease.

Along with this research is a renewed focus on preventive measures for neurodegenerative disorders to maximize cellular health and antioxidant capacity in the body. These strategies are called "neuroprotective" and involve lifestyle, nutrition, and other changes discussed below.

Micronutrient Deficiencies

Specific deficiencies of vitamins like cobalamin (B12), folate, and vitamin D are common in PD patients and can increase symptom severity. These vitamin deficiencies are related to the rise in homocysteine (a neurotoxic chemical).

Manganese Toxicity

Manganese (Mn) is an essential trace element necessary for physiological processes that support development, growth, and neuronal function. Overexposure or decreased ability to excrete manganese can cause an accumulation in the basal ganglia region of the brain and may cause a parkinsonian-like syndrome, referred to as manganism.

Functional Medicine Labs to Find the Root Causes of Parkinson's Disease

Your doctor is the best person to determine which of the root causes of Parkinson's could be playing a role in your symptoms. In pursuit of understanding your root cause(s) and developing a plan to help you optimize your health with PD, they may order some of the following tests.

Heavy Metals and Environmental Toxins

Screening for manganism is a high-yield way to rule out heavy metal contributors to Parkinson's disease. To detect heavy metal abnormalities, practitioners can check hair, blood, and urine to ensure none are above the reference range.

If findings are normal, but you still suspect you may have heavy metal toxicity, you can do a provocation challenge test, where you take a small dose of a heavy metal chelator and then check how much of that metal is excreted into the urine. To screen for exposures to chemicals like those found in pesticides, organic acids testing is a great option that avoids the blood draw and uses urine to screen for elevations.

Viral infections

Four common viral infections involved in neurodegenerative, inflammatory disorders such as Parkinson's are Epstein-Barr virus (EBV), Cytomegalovirus (CMV), Herpes Simplex Virus 1 (HSV-1), and Herpes Simplex Virus-2 (HSV-2).

Microbiome

Gut microbiome testing is made easy with collect-at-home kits that can be sent away and quickly analyzed in a lab.

Genetic Testing

Genetic testing can be a powerful tool to uncover biological pathways that cause Parkinson's disease (PD), and this understanding can lead to improved treatments and care for all people with Parkinson's

Mapping the Future of Parkinson's Disease is a national initiative that offers genetic testing for clinically relevant Parkinson's-related genes and genetic counseling at no cost for people with Parkinson's disease.

Hormones

A Complete Thyroid Panel should include at least TSH, Free T4, Free T3, and Reverse T3 to get a comprehensive overview of how well the thyroid is functioning. With The Dutch Plus Test, your practitioner can measure various sex hormones in the urine and saliva, including progesterone, testosterone, DHEA, cortisol, and estrogen. Your primary care practitioner can also run all of these tests at your annual physical.

Micronutrient Testing

If your doctor suspects you have a nutrient deficiency, they can run blood tests to determine which ones may be affecting you.

Specifically, markers like homocysteine and methylmalonic acid can be used to determine the functional status of vitamins like B12 and folate in the body.

A standard CBC and CMP that your doctor runs every year at your check-up can detect some B vitamin and iron deficiencies.

Additionally, a trained practitioner can help you evaluate your diet to see if your typical eating pattern has nutrient gaps that may impact the progression rate of your Parkinson's symptoms.

[signup]

Parkinsons Symptoms Management

The proper treatment protocol for any individual's Parkinson's disease will depend on their unique history, genetics, lifestyle, preferences, and symptoms. This is because functional medicine practitioners don't treat symptoms - they treat people! Standard functional medicine approaches to treating Parkinson's disease usually contain a combination of the following approaches.

Dopamine Replacement and Pharmaceuticals

L-dopa containing or modifying medications and herbs are the first step in PD treatment. This is because low dopamine levels in the brain can result in severe symptoms (like slow movements, trouble swallowing, impaired balance, etc.), making it challenging to implement the rest of the treatment approaches in this article. Replacing dopamine allows people with PD to improve their functioning to the point where they can adopt the lifestyle changes needed to keep them well.

L-dopa is available in pharmaceutical form as levodopa and herbal formulations of mucuna pruriens. There are issues using herbal preparations of L-dopa because manufacturing processes vary, which can make dosing tricky. For most people, using pharmaceutical forms of L-dopa is the best option.

In addition to dopamine replacement, there are other pharmaceutical options for improving symptoms in PD. These include dopamine agonists, MAO-B inhibitors, anticholinergics, and even some antiviral drugs. Choosing and dosing these pharmaceuticals usually requires specialist-level expertise, and it's recommended that everyone with Parkinson's disease see a neurologist as part of their care team to manage these medications regularly.

Diet and Supplements

Research suggests that diet, supplements, and lifestyle changes have a massive impact on Parkinson's symptoms. The Mediterranean diet effectively reduces many of the symptoms of Parkinson's disease. Also there is now mounting evidence that the beneficial effects of probiotics could suppress inflammation partially through the production of anti-inflammatory cytokines. The use of probiotics or synbiotics appears to be prophylactic agents against neurodegeneration, ultimately reestablishing a balanced gut-brain axis.

Additionally, several dietary supplements have been found to improve outcomes in PD.

  • Glutathione
  • DHEA
  • Low dose lithium
  • CoQ10
  • Fish oil
  • Quercetin
  • Turmeric/curcumin
  • Ginkgo biloba
  • Resveratrol
  • Vitamin D
  • Alpha-lipoic acid
  • 5-MTHF
  • NADH
  • Multivitamins

Supplements are not one-size-fits-all, and a trained functional medicine provider is the best person to help someone with Parkinson's determine which supplements may or may not benefit them as part of their treatment plan.

Exercise and Physical Therapy

Exercise and therapeutic exercise can improve motor symptoms, gait, balance, and strength in people with Parkinson's disease. It's recommended that people with Parkinson's work with a medical professional like a physical therapist to devise a safe and effective exercise program geared towards improving their mobility and strength. Additionally, because of the risk of falls and injuries in movement disorders like Parkinson's, it's important to exercise in an environment that is safe and staffed by trained professionals depending on the severity of motor impairment a person with Parkinson's experiences.

Hormones

If hormone disorders play a role in PD symptoms, a clinician can prescribe hormone replacement or work to eliminate the barriers to normal hormone production using a combination of lifestyle, nutrients, herbs, and pharmaceuticals.

Heavy Metals & Toxicity

If heavy metal toxicity is making PD symptoms worse, many chelation therapies are available that range from gentle and mild to more intensive supplemental or prescription chelation therapy.

If pesticide toxicity or exposure aggravates PD symptoms, a clinician may refer to a toxicologist or work to eliminate sources of exposure to naturally lower body levels of pesticides over time.

Multidisciplinary Approach

The best approaches to Parkinson's are multidisciplinary and involve a team. Usually, this team combines a primary care doctor, neurologist, physical therapist or exercise specialist, nutritionist, occupational therapist, functional medicine doctor, therapist, supportive friends and family, and more.

Caregivers for people with chronic and neurodegenerative disorders also need support. If you're a caregiver or close family member of someone with Parkinson's, make sure you're caring for yourself, as well!

[signup]

Summary

It's possible to thrive with Parkinson's disease, and it is your absolute right to use every tool available to get there. A skilled practitioner who knows your history can help you develop a multidisciplinary, multifaceted plan to get back to feeling happy, healthy, and in love with your life. Work with a provider who can help you build your multidisciplinary team to get the best care and the best outcomes possible.

Articles That May Interest You

The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.
Learn More
No items found.

Lab Tests in This Article

No items found.
  1. “Analysis of Levodopa Content in Commercial Mucuna Pruriens Products Using High-Performance Liquid Chromatography with Fluorescence Detection | the Journal of Alternative and Complementary Medicine.” The Journal of Alternative and Complementary Medicine, 2021, www.liebertpub.com/doi/abs/10.1089/acm.2017.0054. Accessed 12 Apr. 2022.
  2. Bus, Christine, et al. “Human Dopaminergic Neurons Lacking PINK1 Exhibit Disrupted Dopamine Metabolism Related to Vitamin B6 Co-Factors.” IScience, vol. 23, no. 12, Dec. 2020, p. 101797, www.ncbi.nlm.nih.gov/pmc/articles/PMC7702004/, 10.1016/j.isci.2020.101797. Accessed 30 Mar. 2021.
  3. Cacabelos, Ramón. “Parkinson’s Disease: From Pathogenesis to Pharmacogenomics.” International Journal of Molecular Sciences, vol. 18, no. 3, 4 Mar. 2017, p. 551, www.ncbi.nlm.nih.gov/pmc/articles/PMC5372567/, 10.3390/ijms18030551. Accessed 12 Apr. 2022.
  4. Caputi, Valentina, and Maria Giron. “Microbiome-Gut-Brain Axis and Toll-like Receptors in Parkinson’s Disease.” International Journal of Molecular Sciences, vol. 19, no. 6, 6 June 2018, p. 1689, pubmed.ncbi.nlm.nih.gov/29882798/, 10.3390/ijms19061689. Accessed 12 Apr. 2022.
  5. Centers for Disease Control and Prevention, et al. CDC’s Second Nutrition Report: A Comprehensive Biochemical Assessment of the Nutrition Status of the U.S. Population Report Measures 58 Indicators of Diet and Nutrition New Report Uses NHANES Results. 2012.
  6. Cerri, Silvia, et al. “Parkinson’s Disease in Women and Men: What’s the Difference?” Journal of Parkinson’s Disease, vol. 9, no. 3, 30 July 2019, pp. 501–515, www.ncbi.nlm.nih.gov/pmc/articles/PMC6700650/, 10.3233/jpd-191683. Accessed 12 Apr. 2022.
  7. Choe, Myoung-Ae, et al. “Effect of DHEA on Recovery of Muscle Atrophy Induced by Parkinson’s Disease.” Journal of Korean Academy of Nursing, vol. 41, no. 6, 2011, p. 834, pubmed.ncbi.nlm.nih.gov/22310868/, 10.4040/jkan.2011.41.6.834. Accessed 12 Apr. 2022.
  8. Cilia, Roberto, et al. “Mucuna Pruriens in Parkinson Disease.” Neurology, vol. 89, no. 5, 5 July 2017, pp. 432–438, www.ncbi.nlm.nih.gov/pmc/articles/PMC5539737/, 10.1212/wnl.0000000000004175. Accessed 30 Mar. 2021.
  9. Corcos, Daniel M., et al. “A Two-Year Randomized Controlled Trial of Progressive Resistance Exercise for Parkinson’s Disease.” Movement Disorders, vol. 28, no. 9, 27 Mar. 2013, pp. 1230–1240, www.ncbi.nlm.nih.gov/pmc/articles/PMC3701730/, 10.1002/mds.25380. Accessed 27 Mar. 2021.
  10. Dong, Bao, and Rongrong Wu. “Plasma Homocysteine, Folate and Vitamin B12 Levels in Parkinson’s Disease in China: A Meta-Analysis.” Clinical Neurology and Neurosurgery, vol. 188, Jan. 2020, p. 105587, pubmed.ncbi.nlm.nih.gov/31733593/, 10.1016/j.clineuro.2019.105587. Accessed 12 Apr. 2022.
  11. Dorszewska, Jolanta, et al. “Molecular Effects of L-Dopa Therapy in Parkinson’s Disease.” Current Genomics, vol. 15, no. 1, 31 Mar. 2014, pp. 11–17, www.ncbi.nlm.nih.gov/pmc/articles/PMC3958954/, 10.2174/1389202914666131210213042. Accessed 30 Mar. 2021.
  12. Ellis, Terry, and Lynn Rochester. “Mobilizing Parkinson’s Disease: The Future of Exercise.” Journal of Parkinson’s Disease, vol. 8, no. s1, 18 Dec. 2018, pp. S95–S100, www.ncbi.nlm.nih.gov/pmc/articles/PMC6311359/, 10.3233/jpd-181489. Accessed 30 Mar. 2021.
  13. Elstner, Matthias, et al. “Single-Cell Expression Profiling of Dopaminergic Neurons Combined with Association Analysis Identifies Pyridoxal Kinase as Parkinson’s Disease Gene.” Annals of Neurology, vol. 66, no. 6, Dec. 2009, pp. 792–798, www.ncbi.nlm.nih.gov/pmc/articles/PMC4034432/, 10.1002/ana.21780. Accessed 30 Mar. 2021.
  14. Enzinger, C., et al. “Risk Factors for Progression of Brain Atrophy in Aging: Six-Year Follow-up of Normal Subjects.” Neurology, vol. 64, no. 10, 23 May 2005, pp. 1704–1711, pubmed.ncbi.nlm.nih.gov/15911795/, 10.1212/01.wnl.0000161871.83614.bb. Accessed 30 Mar. 2021.
  15. Fereshtehnejad, Seyed-Mohammad, et al. “Evolution of Prodromal Parkinson’s Disease and Dementia with Lewy Bodies: A Prospective Study.” Brain, vol. 142, no. 7, 20 May 2019, pp. 2051–2067, pubmed.ncbi.nlm.nih.gov/31111143/, 10.1093/brain/awz111. Accessed 30 Mar. 2021.
  16. Giardini, Marica, et al. “Instrumental or Physical-Exercise Rehabilitation of Balance Improves Both Balance and Gait in Parkinson’s Disease.” Neural Plasticity, vol. 2018, 2018, pp. 1–17, www.ncbi.nlm.nih.gov/pmc/articles/PMC5863303/, 10.1155/2018/5614242. Accessed 27 Mar. 2021.
  17. Guilarte, Tomas R. “Effect of Vitamin B-6 Nutrition on the Levels of Dopamine, Dopamine Metabolites, Dopa Decarboxylase Activity, Tyrosine, and GABA in the Developing Rat Corpus Striatum.” Neurochemical Research, vol. 14, no. 6, June 1989, pp. 571–578, pubmed.ncbi.nlm.nih.gov/2761676/, 10.1007/bf00964920. Accessed 30 Mar. 2021.
  18. Hackney, ME, and GM Earhart. “Effects of Dance on Movement Control in Parkinson’s Disease: A Comparison of Argentine Tango and American Ballroom.” Journal of Rehabilitation Medicine, vol. 41, no. 6, 2009, pp. 475–481, www.ncbi.nlm.nih.gov/pmc/articles/PMC2688709/, 10.2340/16501977-0362. Accessed 27 Mar. 2021.
  19. HATCHER, J, et al. “Parkinson’s Disease and Pesticides: A Toxicological Perspective.” Trends in Pharmacological Sciences, vol. 29, no. 6, June 2008, pp. 322–329, www.sciencedirect.com/science/article/pii/S0165614708000825?casa_token=-fq1PZ_5Rs8AAAAA:yVRC08Bbkpsnl5t6K_tOYHdF7XdZcp6XRHk-R2rUu-MBmfd8mci6X5hLNs9aqkzRnmz8LYLD6w#bib16, 10.1016/j.tips.2008.03.007. Accessed 12 Apr. 2022.
  20. Hunter, Randy L., et al. “Intrastriatal Lipopolysaccharide Injection Induces Parkinsonism in C57/B6 Mice.” Journal of Neuroscience Research, vol. 87, no. 8, June 2009, pp. 1913–1921, www.ncbi.nlm.nih.gov/pmc/articles/PMC2692550/, 10.1002/jnr.22012. Accessed 30 Mar. 2021.
  21. Islam, Md Shahidul, et al. “Pesticides and Parkinson’s Disease: Current and Future Perspective.” Journal of Chemical Neuroanatomy, vol. 115, Sept. 2021, p. 101966, pubmed.ncbi.nlm.nih.gov/33991619/, 10.1016/j.jchemneu.2021.101966. Accessed 12 Apr. 2022.
  22. Kim, Ji Hee, et al. “Association between Thyroid Diseases and Parkinson’s Disease: A Nested Case-Control Study Using a National Health Screening Cohort.” Journal of Parkinson’s Disease, vol. 11, no. 1, 2 Feb. 2021, pp. 211–220, pubmed.ncbi.nlm.nih.gov/33104041/, 10.3233/jpd-202265. Accessed 11 Apr. 2022.
  23. Kraemer, William J, and Nicholas A Ratamess. “Hormonal Responses and Adaptations to Resistance Exercise and Training.” Sports Medicine, vol. 35, no. 4, 2005, pp. 339–361, pubmed.ncbi.nlm.nih.gov/15831061/, 10.2165/00007256-200535040-00004. Accessed 5 Apr. 2021.
  24. Lin, Tsu-Kung, et al. “Nutritional Status Associated with Molecular Biomarkers, Physiological Indices, and Clinical Severity in Parkinson’s Disease Patients.” International Journal of Environmental Research and Public Health, vol. 17, no. 16, 7 Aug. 2020, p. 5727, pubmed.ncbi.nlm.nih.gov/32784774/, 10.3390/ijerph17165727. Accessed 11 Apr. 2022.
  25. Mao, Cheng-jie, et al. “Serum Sodium and Chloride Are Inversely Associated with Dyskinesia in Parkinson’s Disease Patients.” Brain and Behavior, vol. 7, no. 12, 9 Nov. 2017, p. e00867, www.ncbi.nlm.nih.gov/pmc/articles/PMC5745246/, 10.1002/brb3.867. Accessed 30 Mar. 2021.
  26. Marogianni, Chrysoula, et al. “Neurodegeneration and Inflammation—an Interesting Interplay in Parkinson’s Disease.” International Journal of Molecular Sciences, vol. 21, no. 22, 10 Nov. 2020, p. 8421, www.ncbi.nlm.nih.gov/pmc/articles/PMC7697354/, 10.3390/ijms21228421. Accessed 12 Apr. 2022.
  27. Mischley, Laurie K. “Nutrition and Nonmotor Symptoms of Parkinson’s Disease.” International Review of Neurobiology, 2017, pp. 1143–1161, pubmed.ncbi.nlm.nih.gov/28805567/, 10.1016/bs.irn.2017.04.013. Accessed 11 Apr. 2022.
  28. Mohammadi, S., et al. “Shedding Light on Thyroid Hormone Disorders and Parkinson Disease Pathology: Mechanisms and Risk Factors.” Journal of Endocrinological Investigation, vol. 44, no. 1, 4 June 2020, pp. 1–13, pubmed.ncbi.nlm.nih.gov/32500445/, 10.1007/s40618-020-01314-5. Accessed 11 Apr. 2022.
  29. Morissette, Marc, et al. “Estrogen and SERM Neuroprotection in Animal Models of Parkinson’s Disease.” Molecular and Cellular Endocrinology, vol. 290, no. 1-2, Aug. 2008, pp. 60–69, pubmed.ncbi.nlm.nih.gov/18515001/, 10.1016/j.mce.2008.04.008. Accessed 12 Apr. 2022.
  30. Muthukumaran, Krithika, et al. “Orally Delivered Water Soluble Coenzyme Q10 (Ubisol-Q10) Blocks On-Going Neurodegeneration in Rats Exposed to Paraquat: Potential for Therapeutic Application in Parkinson’s Disease.” BMC Neuroscience, vol. 15, no. 1, 2014, p. 21, www.ncbi.nlm.nih.gov/pmc/articles/PMC3917573/, 10.1186/1471-2202-15-21. Accessed 31 Mar. 2021.
  31. NHANES - National Health and Nutrition Examination Survey Homepage. 2021, www.cdc.gov/nchs/nhanes/index.htm. Accessed 30 Mar. 2021.
  32. O’Neal, Stefanie L., and Wei Zheng. “Manganese Toxicity upon Overexposure: A Decade in Review.” Current Environmental Health Reports, vol. 2, no. 3, 1 July 2015, pp. 315–328, www.ncbi.nlm.nih.gov/pmc/articles/PMC4545267/, 10.1007/s40572-015-0056-x. Accessed 12 Apr. 2022.
  33. “Office of Dietary Supplements - Vitamin B6.” Nih.gov, 2017, ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/. Accessed 30 Mar. 2021.
  34. “Office of Dietary Supplements - Vitamin B12.” Nih.gov, 2017, ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/. Accessed 30 Mar. 2021.
  35. Oguh, O., et al. “Back to the Basics: Regular Exercise Matters in Parkinson’s Disease: Results from the National Parkinson Foundation QII Registry Study.” Parkinsonism & Related Disorders, vol. 20, no. 11, Nov. 2014, pp. 1221–1225, pubmed.ncbi.nlm.nih.gov/25258329/, 10.1016/j.parkreldis.2014.09.008. Accessed 30 Mar. 2021.
  36. Ou, Zejin, et al. “Global Trends in the Incidence, Prevalence, and Years Lived with Disability of Parkinson’s Disease in 204 Countries/Territories from 1990 to 2019.” Frontiers in Public Health, vol. 9, 7 Dec. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8688697/#:~:text=In%20recent%20years%2C%20PD%20has,million%20in%202017%20(3)., 10.3389/fpubh.2021.776847. Accessed 11 Apr. 2022.
  37. Petzinger, Giselle M, et al. “Exercise-Enhanced Neuroplasticity Targeting Motor and Cognitive Circuitry in Parkinson’s Disease.” The Lancet Neurology, vol. 12, no. 7, July 2013, pp. 716–726, www.ncbi.nlm.nih.gov/pmc/articles/PMC3690528/, 10.1016/s1474-4422(13)70123-6. Accessed 27 Mar. 2021.
  38. Ramya KB;Thaakur S. “Herbs Containing L- Dopa: An Update.” Ancient Science of Life, vol. 27, no. 1, 2019, pubmed.ncbi.nlm.nih.gov/22557260/. Accessed 30 Mar. 2021.
  39. Renaud, Justine, et al. “The Sweet Road to Parkinson’s Disease.” Aging, vol. 11, no. 3, 1 Feb. 2019, pp. 853–854, www.ncbi.nlm.nih.gov/pmc/articles/PMC6382427/, 10.18632/aging.101806. Accessed 30 Mar. 2021.
  40. Rusch, Carley, et al. “Mediterranean Diet Adherence in People with Parkinson’s Disease Reduces Constipation Symptoms and Changes Fecal Microbiota after a 5-Week Single-Arm Pilot Study.” Frontiers in Neurology, vol. 12, 2021, p. 794640, pubmed.ncbi.nlm.nih.gov/35002935/, 10.3389/fneur.2021.794640. Accessed 13 Apr. 2022.
  41. ---. “Mediterranean Diet Adherence in People with Parkinson’s Disease Reduces Constipation Symptoms and Changes Fecal Microbiota after a 5-Week Single-Arm Pilot Study.” Frontiers in Neurology, vol. 12, 2021, p. 794640, pubmed.ncbi.nlm.nih.gov/35002935/, 10.3389/fneur.2021.794640. Accessed 13 Apr. 2022.
  42. Seppi, Klaus, et al. “Update on Treatments for Nonmotor Symptoms of Parkinson’s Disease—an Evidence‐Based Medicine Review.” Movement Disorders, vol. 34, no. 2, 17 Jan. 2019, pp. 180–198, www.ncbi.nlm.nih.gov/pmc/articles/PMC6916382/, 10.1002/mds.27602. Accessed 30 Mar. 2021.
  43. Sergi, Domenico, et al. “Diabetes, a Contemporary Risk for Parkinson’s Disease: Epidemiological and Cellular Evidences.” Frontiers in Aging Neuroscience, vol. 11, 8 Nov. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6856011/, 10.3389/fnagi.2019.00302. Accessed 30 Mar. 2021.
  44. Sivandzade, Farzane, et al. “NRF2 and NF-ҚB Interplay in Cerebrovascular and Neurodegenerative Disorders: Molecular Mechanisms and Possible Therapeutic Approaches.” Redox Biology, vol. 21, Feb. 2019, p. 101059, www.ncbi.nlm.nih.gov/pmc/articles/PMC6302038/, 10.1016/j.redox.2018.11.017. Accessed 30 Mar. 2021.
  45. “Statistics.” Parkinson’s Foundation, 2020, www.parkinson.org/Understanding-Parkinsons/Statistics. Accessed 11 Apr. 2022.
  46. Subramaniam, Sudhakar Raja, and Marie-Francoise Chesselet. “Mitochondrial Dysfunction and Oxidative Stress in Parkinson’s Disease.” Progress in Neurobiology, vol. 106-107, July 2013, pp. 17–32, pubmed.ncbi.nlm.nih.gov/23643800/, 10.1016/j.pneurobio.2013.04.004. Accessed 12 Apr. 2022.
  47. Tan, Yinyin, et al. “Thyroid Hormone Levels and Structural Parameters of Thyroid Homeostasis Are Correlated with Motor Subtype and Disease Severity in Euthyroid Patients with Parkinson’s Disease.” International Journal of Neuroscience, vol. 131, no. 4, 24 Mar. 2020, pp. 346–356, pubmed.ncbi.nlm.nih.gov/32186220/, 10.1080/00207454.2020.1744595. Accessed 11 Apr. 2022.
  48. Tomic, Svetlana, et al. “Hyperhomocysteinemia Influenced Malnutrition in Parkinson’s Disease Patients.” Neurological Sciences, vol. 39, no. 10, 30 June 2018, pp. 1691–1695, pubmed.ncbi.nlm.nih.gov/29961201/, 10.1007/s10072-018-3480-5. Accessed 11 Apr. 2022.
  49. Vicente Miranda, Hugo, et al. “Glycation in Parkinson’s Disease and Alzheimer’s Disease.” Movement Disorders, vol. 31, no. 6, 4 Mar. 2016, pp. 782–790, pubmed.ncbi.nlm.nih.gov/26946341/, 10.1002/mds.26566. Accessed 30 Mar. 2021.
  50. “What Is Parkinson’s?” Parkinson’s Foundation, 2020, www.parkinson.org/understanding-parkinsons/what-is-parkinsons. Accessed 12 Apr. 2022.
  51. Wu, Pei-Ling, et al. “Effectiveness of Physical Activity on Patients with Depression and Parkinson’s Disease: A Systematic Review.” PLOS ONE, vol. 12, no. 7, 27 July 2017, p. e0181515, www.ncbi.nlm.nih.gov/pmc/articles/PMC5531507/, 10.1371/journal.pone.0181515. Accessed 27 Mar. 2021.
  52. Yang, Lichuan, et al. “Combination Therapy with Coenzyme Q10and Creatine Produces Additive Neuroprotective Effects in Models of Parkinson’s and Huntington’s Diseases.” Journal of Neurochemistry, vol. 109, no. 5, June 2009, pp. 1427–1439, www.ncbi.nlm.nih.gov/pmc/articles/PMC2866530/, 10.1111/j.1471-4159.2009.06074.x. Accessed 31 Mar. 2021.
  53. Zhou, Zonglei, et al. “The Association between Vitamin D Status, Vitamin D Supplementation, Sunlight Exposure, and Parkinson’s Disease: A Systematic Review and Meta-Analysis.” Medical Science Monitor, vol. 25, 23 Jan. 2019, pp. 666–674, pubmed.ncbi.nlm.nih.gov/30672512/, 10.12659/msm.912840. Accessed 12 Apr. 2022.

Subscribe to the Magazine for free to keep reading!
Subscribe for free to keep reading, If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.