1. Medications you might anyway need, may have a beneficial effect!
1. Statins (e.g. Atorvastatin):
Statins are medications that are given to decrease “bad” cholesterol. Some examples of statins are Atorva-statin, Rosuva-statin, Simva-statin, Fluva-statin etc.
Since patients with Parkinson’s disease can have decreased physical activity, it is very important to check cholesterol and sugar levels to make sure they are well controlled. Diet and increased physical activity can help to control cholesterol levels. If medications are needed, statins are probably the best medication for cholesterol.
No one knows how Statins help in Parkinson’s disease, however this neuroprotective effect is not believed to be due to lowering of cholesterol. Statins, in a yet-undiscovered way, may prevent damage to Dopamine-cells. In Mice, statins have can neutralize chemicals that otherwise would cause Dopamine-cell damage (Selley 2005). Studies in humans indicate that patients who use statins may be less likely to develop Parkinson’s disease (Wahner 2008).
But, confusingly, high levels of cholesterol possibly protect against Parkinson’s disease! Some researchers have suggested that patients on statins have a lower risk of Parkinson’s disease, but it is not due to the statin but because they have high cholesterol!
The jury is still out when it comes to statin use for slowing Parkinson’s disease. But, there is absolutely no doubt that if your doctor has told you to take a statin for controlling your cholesterol, you should do so.
- Mice study: Protective effect of Statins (Selley 2005)
- Patients on statins may be less likely to develop PD (Wahner 2008)
2. Vitamin D:
It is critical to make sure your vitamin D levels are normal in Parkinson’s disease.
At a very basic level, this is because normal Vitamin D levels are required for strong bones. Parkinson’s disease patients are likely to fall, and a fracture of the hip or the spine can be extremely disabling. Therefore, make sure your Vitamin D levels are normal. If you tend to fall often, you should also do a test to check the density of your bones, called DEXA. If the density of your bones is low, you may require additional medications (in addition to Vitamin D) to make them dense again.
But, guess what, Vitamin D may actually help relieve Parkinson’s disease as well!
- People with low levels of Vitamin D may be at a higher risk for Parkinson’s disease (Knekt 2010).
- It may decrease inflammation and may be neuroprotective in Parkinson’s disease (Calvello 2017)
- In patients with Parkinson’s disease, Vitamin D may prevent falls, especially in younger patients (Hiller 2018). It does this by improving the postural corrections that prevent falls.
- In patients with Parkinson’s, Vitamin D may prevent thinking and memory problems (Peterson 2013).
- Although the evidence for this part is weak: Some studies indicate that low levels of vitamin D can be associated with worse motor function / movements as well (Soliman 2019)
- Most tantalizingly, preliminary research indicates that Vitamin D supplements may slow the progression of Parkinson’s disease!=This effect may be more prominent for some patients than others, based on genetics (Suzuki 2013).
Unfortunately, Vitamin D does not seem to have received the attention it deserves when it comes to the treatment of Parkinson’s disease. Thankfully, as demonstrated by the studies mentioned above this is rapidly changing. This requires thorough research. But will the money to conduct research on a low-cost treatment be made available? Time will tell.
At this point, it is not possible to recommend Vitamin D supplementation if your levels are normal. What is very easy to recommend is that most patients with Parkinson’s disease should have their Vitamin D levels measured. If low, you should certainly try to bring them back to normal. This can be done by taking Vitamin D supplements, by eating foods rich in vitamin D or by increasing exposure to sunlight.
If you do start taking Vitamin D supplements, you should recheck your Vitamin D levels after a few weeks to make sure they are normal / increasing.
- Low vitamin D levels may place you at higher risk of Parkinson’s disease (Knekt 2010)
- Vitamin D may reduce inflammation and protect Dopamine-producing cells (Calvello 2017)
- Vitamin D may reduce falls (Hiller 2018)
- Vitamin D may help with balance – Study no.2 (Peterson 2013)
- Vitamin D may protect against thinking & memory problems associated with PD (Peterson 2013).
- Vitamin D may help both thinking and movement in Parkinsons disease (Soliman 2019)
- Vitamin D supplementation may slow progression of Parkinson’s disease (Suzuki 2013)
2. Herbal therapies for Parkinson’s disease:
Herbal remedies don’t fall under Modern (also called Allopathic) medicine, which is the branch of medicine that I practice. Although they are sometimes treated with derision, these ancient forms of medicine need to be treated with respect. Many modern medications including some antimalarials, antiseptics and even some anticancer medications have their roots in ancient (or “traditional”) forms of medicine.
These herbal therapies are un-monitored, and the quality of these preparations is not standardized. Even the US FDA does not require thorough testing for substances marked as “nutraceuticals” or “natural supplements” – which is the term under which these are usually marketed.
Therefore, my standard recommendation to you is to AVOID all such medications. At this stage, these represent tantalizing possibilities that need to be researched much more thoroughly before they can be recommended as treatment for Parkinson’s Disease.
A few important research studies on these substances are listed below:
Ginseng is a herb whose roots are very favorably regarded in Chinese traditional medicine.
Some chemicals in this plant may protect Dopamine-producing cells against damage. Most studies have been done outside animal bodies, but a few studies done in Mice indicate that ginseng could neutralize poisons (in this case MPTP) that may damage Dopamine-Producing cells and hence prevent Parkinson’s disease.
There are no human studies, and hence the effect of Ginseng on human Parkinson’s disease is not known. I feel this is an easy one to make a recommendation on – because of the lack of human data, do not take Ginseng even if you have Parkinson’s disease, at least at the present time. We just don’t know what effect it will have.
Curcumin (Turmeric, Haldi):
In contrast to Ginseng which is popular in Chinese traditional medicine, Curcumin (also called Turmeric or Haldi) is a popular ingredient in Indian traditional medicine.
It is also proposed to act by preventing damage to the Dopamine-cells by clearing out a toxic waste product called Alpha-synuclein in these cells. Although studies in some Mice models have been encouraging, there are no animal studies.
Haldi is a common everyday ingredient in Indian food, and some of my Parkinson’s disease patients do drink half a tablespoon of Haldi in warm water daily. Although there is no clear evidence that it is beneficial, I do not have a good reason to warn them against doing so either.
Dr. Kharkar is a Neurologist, Epilepsy specialist & Parkinson’s disease specialist in Mumbai, Maharashtra, India.
He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, University of California at San Francisco (UCSF), USA & Kings College in London.
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