PARKINSON's DISEASE

Symptoms, Causes, Diet, Exercise, Herbal & Homeopathic Remedies for PARKINSON's DISEASE

What Is Parkinson's Disease?

Parkinson's disease results from a gradual degeneration of nerve cells in the portion of the mid-brain that controls body movements. The first signs of the onset of the disease are a feeling of weakness or stiffness in one limb, and/or a fine trembling of one hand when it is at rest (activity causes the tremor to disappear). Eventually, the shaking will worsen and spread, muscles will tend to stiffen, and balance and coordination will deteriorate. Depression and other mental or emotional problems are common.

The four primary symptoms of Parkinson's Disease are tremor or trembling in the hands, arms, legs, jaw, and face; rigidity or stiffness of the limbs and trunk; bradykinesia or slowness of movement; and postural instability or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. Over 40% of patients develop a dementia syndrome that is largely distinct from Alzheimer's disease. Depression is common, also occurring in more than 40% of patients with Parkinson's Disease. Careful evaluation is necessary to help distinguish Parkinson's disease from second causes of parkinsonism.

The disease is both chronic, (it persists over a long period of time) and progressive (its symptoms grow worse over time). It is not contagious nor is it usually inherited-that is, it does not pass directly from one family member or generation to the next.

Parkinson's Disease affects about 1 in every 250 people over 40 years old and about 1 in every 100 people over 65 years old. It is slightly more common in men than in women. Medication can treat its symptoms, and the disorder is not directly life-threatening. Mostly it is a quality of life issue. About half of all patients treated with drugs have no major disabilities 10 years after the onset of the disease.

Symptoms

Parkinson's disease is clinically characterized by four main features:

• Resting tremor (shaking back and forth when the limb is relaxed)
• Bradykinesia (slowness of movement)
• Rigidity (stiffness, or resistance of the limb to passive movement when the limb is relaxed)
• Postural instability (poor balance).
  

Tremor. The tremor associated with Parkinson's disease has a characteristic appearance. Typically, the tremor takes the form of a rhythmic back-and-forth motion of the thumb and forefinger at three beats per second. This is sometimes called "pill rolling." Tremor usually begins in a hand, although sometimes a foot or the jaw is affected first. It is most obvious when the hand is at rest or when a person is under stress. In three out of four patients, the tremor may affect only one part or side of the body, especially during the early stages of the disease. Later it may become more general. Tremor is rarely disabling and it usually disappears during sleep or improves with intentional movement.

Rigidity. Rigidity, or a resistance to movement, affects most parkinsonian patients. All of our muscles have an opposing muscle. When we try to move a muscle, it becomes active, and the opposing muscle relaxes. In Parkinson's disease, this delicate balance of opposing muscles is disturbed. The muscles remain constantly tensed and contracted so that the person aches or feels stiff or weak. The rigidity becomes obvious when another person tries to move the patient's arm, which will move only in ratchet-like or short, jerky movements. This is known as "cogwheel" rigidity.

Bradykinesia. Bradykinesia is the slowing down and loss of spontaneous and automatic movement. It is particularly frustrating because it is unpredictable. One moment the patient can move easily. The next moment he or she may need help. This may well be the most disabling and distressing symptom of the disease because the patient cannot rapidly perform routine movements. Activities once performed quickly and easil, such as washing or dressing, may take several hours.

Postural instability. Postural instability, or impaired balance and coordination, causes patients to develop a forward or backward lean and to fall easily. When bumped from the front or when starting to walk, patients with a backward lean have a tendency to step back wards, which is known as retropulsion. Postural instability can cause patients to have a stooped posture in which the head is bowed and the shoulders are drooped. As the disease progresses, walking may be affected. Patients may halt in mid-stride and "freeze" in place, possibly even toppling over. Or patients may walk with a series of quick, small steps as if hurrying forward to keep balance. This is known as festination.

Resting tremor, bradykinesia, and rigidity are relatively early signs of Parkinson's disease. It is often apparent in the first-affected extremity. Postural instability is a late symptom typically emerging ten or more years into the disease. Other common signs include shuffling gait, stooped posture, difficulty with fine coordinated movements, and micrographia (small handwriting) . Secondary features include autonomic dysfunction (constipation, sweating), cognitive symptoms (dementia), affective disturbances (depression) , and sensory complaints including pain in muscles.

The symptoms of Parkinson's disease include:

• Slowness of voluntary movements, especially in the initiation of such movements as walking or rolling over in bed.
• Decreased facial expression, monotonous speech and decreased eye blinking.
• A shuffling gait with poor arm swing and stooped posture.
• Unsteady balance; difficulty rising from a sitting position.
• Continuous "pill-rolling" motion of the thumb and forefinger.
• Abnormal tone or stiffness in the trunk and extremities.
• Swallowing problems in later stages.
  

Muscle rigidity

• Stiffness
• Difficulty bending arms or legs
  
  

Unstable, stooped, or slumped-over posture

• Loss of balance
• Gait (walking pattern) changes
• Shuffling walk

Slow movements

• Difficulty beginning to walk
• Difficulty initiating any voluntary movement
• Small steps followed by the need to run to maintain balance
• Freezing of movement when the movement is stopped, inability to resume - movement
• Muscle aches and pains (myalgia)
• Shaking, tremors (varying degrees, may not be present)
• Characteristically occur at rest, may occur at any time
• May become severe enough to interfere with activities
• May be worse when tired, excited, or stressed
• Finger-thumb rubbing (pill-rolling tremor) may be present
  

Changes in facial expression

• Reduced ability to show facial expressions "mask" appearance to face
• Staring
• May be unable to close mouth
• Reduced rate of blinking
  

Voice/speech changes

• Slow speech
• Low-volume voice
• Monotone
• Difficulty speaking
• Loss of fine motor skills
• Difficulty writing, may be small and illegible
• Difficulty eating
• Difficulty with any activity that requires small movements
• Movement, uncontrolled - slow
• Frequent falls
• Decline in intellectual function (may occur, can be severe)
• A variety of gastrointestinal symptoms, mainly constipation.
  

Note: Initial symptoms may be mild and nonspecific (mild tremor, slight feeling that one leg/foot is stiff and dragging, and so on).

Additional symptoms that may be associated with this disease:

• Depression
• Confusion
• Dementia
• Seborrhea (skin)
• Muscle function/feeling loss
• Muscle atrophy
• Memory loss
• Drooling
• Anxiety, stress, and tension

Who gets Parkinson's disease?

Parkinson's disease commonly occurs in older individuals, although it may also occur in young adults. It is present worldwide and in all populations. Men have a slightly higher prevalence rate than women. No race or specific region of the world has been found to be completely devoid of the disease.

What is the mean age of onset of Parkinson's disease?

The mean age of onset of Parkinson's disease is approximately 60 years. It usually occurs in patients over 50 years of age, and onset before age 25 is uncommon. The incidence and prevalence of the disease generally increase with increasing age.

How common is Parkinson's disease?

Average crude prevalence (the total number of people with the disease in a population at a given time) rates for Parkinson's disease have been estimated at 120-180 per 100,000 in Caucasian populations) and the prevalence of the disease in individuals over 65 years of age is roughly 1%. Incidence (the number of new cases of the disease diagnosed in a population during a given time period) rates have been estimated at 20 per 100,000.

Does Parkinson's disease occur more frequently in certain locatiom?

The highest prevalence of Parkinson's disease is in North America and Europe, while the lowest prevalence rates have been found in China, Japan, Nigeria, and Sardinia).

The Parsi community of Bombay, India was recently found to have the highest prevalence rates reported to date. The Parsis are a people who migrated to India between the seventh and tenth centuries from Iran. They have a closed community, and rarely allow inter-marriages with other races or religious groups. Whether genetic factors in a closed community or some environmental toxin present in the area is causing this high prevalence is unknown.

Is Parkinson's disease more common in Caucasians or African-Americans?

Studies conducted in the United States have generally found a lower prevalence of Parkinson's disease among African-Americans. Even in Africa, the prevalence has been found to be lower in blacks than in whites or Indians.


Causes

Although Parkinson's disease was discovered over a century ago the exact cause of the disease remains a mystery.

Bodily movements are regulated by a portion of the brain called the basal ganglia, whose cells require a proper balance of two substances called dopamine and acetylcholine, both involved in the transmission of nerve impulses. In Parkinson's, cells that produce dopamine begin to degenerate. Insufficient dopamine disturbs the balance between dopamine and other transmitters, such as acetylcholine. Dopamine is a chemical messenger responsible for transmitting signals between the substantia nigra and the next "relay station" of the brain, the corpus striatum, to produce smooth, purposeful muscle activity. Loss of dopamine causes the nerve cells of the striatum to fire out of control, leaving patients unable to direct or control their movements in a normal manner. Studies have shown that Parkinson's patients have a loss of 80 percent or more of dopamine-producing cells in the substantia nigra.

The exact cause of this cell death or impairment is not known. Significant findings have been made by research scientists lately that provide important new clues to the disease. One theory holds that free radicals-unstable and potentially damaging molecules generated by normal chemical reactions in the body--may contribute to nerve cell death, thereby leading to Parkinson's disease.

Free Radicals and Anti-Oxidants

Free radicals are the highly unstable chemicals that attack, infiltrate, and injure vital cell structures. Most stable chemical compounds in the body possess a pair of electrons. Sometimes, one member of the electron pair gets stripped away. The resulting compound (less one electron) is called a free radical.

In chemistry, the term free radical means that it is now free to combine with another element to form a new stable compound. One way to think of free radical is the way our social system work. In a family there is husband and wife. They are joined together. Both are "tied up" or not available for other partners. Now, for some reason they get separated. Now both mates can look for another person to join together. The way free radicals work, one of these free spouse go and break up a stable marriage of another couple, by joining with one of the spouses. This results in the ouster of a person from that family creating a brand new "free radical" who goes around prowling to find another "compound" to attack. You can see that free radicals can do lot of harm by forming a chain reaction.

A similar thing happens with free radicals in the body. When a free radical is born, it goes around the body looking for another compound to steal an electron from. This breaks up this"contented" couple, that results in releasing another free radical, and so on. While on the prowl, these free radicals (which are really the oxidation products from the body) can do tremendous damage to the delicate machinery of your cells. The most studied free radical chain reaction in living things is lipid peroxidation. (The term lipid refers to any fat-soluble substance, animal or vegetable. Peroxidation means the formation of a peroxide molecule. These are the molecules with the greatest proportion of oxygen molecules. For example, water molecule has tow hydrogen atoms and one oxygen atom. Hydrogen peroxide has two Hydrogen atoms and two oxygen atoms. In other words, there is an excess oxygen atom in hydrogen peroxide.)

Ninety eight percent of the oxygen we breathe is used by tiny powerhouses within our cells called mitochondria, that convert sugar, fats and inorganic phosphate (ADP), oxygen into adenosine triphosphate (ATP), the universal form of energy we need to live. This energy producing activity of the mitochondria involves a series of intricate, complex and vital biochemical processes dependent on vast numbers of enzymes (estimates vary from 500 to 10,000 sets of oxidative enzymes). These, in turn, are dependent upon dozens of nutrient factors and co-factors. In this metabolism process a very small amount of left over oxygen loses electrons, creating free radicals. These free radicals burn holes in our cellular membranes. Calcium penetrate our cells through these holes. This excess calcium results in cell death. This, in turn, weakens tissues and organs. As this damage continues, our body become "rusty", less able to fight other invaders such as cancer, hardening of the arteries, premature aging, and other bodily disorders.

Because of the amount of oxygen we breathe every day (our bodies take 630 quadrillion damaging oxygen hits per day. This means each of our cells takes about 10,000 hits per day and each DNA strand in the cell gets hit 5,000 times per day. This free radical bombardment causes a typical human cell to undergo thousands of changes or mutations daily.If a DNA strand gets hit and it is not repaired before its twin gets hit, we will have the onset to a potentially lethal cancer.

In addition to the oxygen we breathe, the free radicals can also come from such things as environmental pollution, radiation, cigarette smoke, chemicals, and herbicides.

The key to having a healthy body is to repair the damages caused by the free radicals before it is too late, and to protect the body's tissue cells from the free radicals before they cause mutations. Antioxidants are substances that have free-radical chain-reaction- breaking properties. Like a bouncer, the antioxidants deactivate potentially dangerous free radicals before they can damage a cells machinery. Most of these antioxidants come from plants and are called phytochemicals. More than 60,000 such plant chemicals are identified. Among the most effective and dedicated antioxidants are Vitamin A, C, and E (known as the ACE trio against cancer.). Out of these, Vitamin C is the most powerful.

Each cell produces its own antioxidants. But the ability to produce them decreases as we age. That is why diet rich in anti-oxidant and phytochemical rich fruits and vegetables supplemented with additional vitamins and minerals is important.

Oxidation due to free radicals is thought to cause damage to tissues, including neurons. Normally, free radical damage is kept under control by antioxidant chemicals that protect cells from this damage. Researchers found that patients with Parkinson's disease have increased brain levels of iron, especially in the substantia nigra, and decreased levels of feritin, which serves as a protective mechanism by chelating, or forming a ring around the iron, and isolating it. This led to the conclusion that oxidative mechanisms may cause or contribute to Parkinson's disease.

Parkinson's disease may occur when either an external or an internal toxin selectively destroys dopaminergic neurons. An environmental risk factor such as exposure to pesticides or a toxin in the food supply is an example of the kind of external trigger that could hypothetically cause Parkinson's disease. The theory is based on the fact that there are a number of toxins, such as 1-methyl 4-phenyl-1,2, 3,6,-tetra- hydropyridine (mptp) and neuroleptic drugs, that induce parkinsonian symptoms in humans. So far no research has provided conclusive proof that a toxin is the cause of the disease.

Researchers believe that genetics sometimes plays a role in the cellular breakdown. Fifteen to twenty percent of Parkinson's patients have a close relative who has experienced parkinsonian symptoms (such as a tremor). After studies in animals showed that mptp interferes with the function of mitochondria within nerve cells, investigators became interested in the possibility that impairment in mitochondrial DNA may be the cause of Parkinson's disease. Mitochondria is found in all animal cells that convert the energy in food into fuel for the cells.

In some individuals, the normal, age-related wearing away of dopamine-producing neurons accelerates. The exact cause for this is not known; but, if this happens, then it can also result in Parkinson's disease. This theory is supported by the fact that the loss of antioxidative protective mechanisms is associated with both Parkinson's disease and increasing age.

In rare instances, Parkinson's disease may be caused by a viral infection.

Many researchers believe that a combination of oxidative damage, environmental toxins, genetic predisposition, and accelerated aging may ultimately be shown to cause the disease.

The typical symptoms of Parkinson's also occur in meningitis and various types of poisoning from alcohol, carbon monoxide and heavy metals. This group of symptoms is called Parkinsonism. Overdoses of manganese also cause Parkinson's symptoms, and high levels of stored iron are found in those with Parkinson's disease.

Other causes of parkinsonism include:

• An adverse reaction to prescription drugs
• Use of illegal drugs
• Exposure to environmental toxins
• Stroke
• Thyroid and parathyroid disorders
• Repeated head trauma (for example, the trauma associated with boxing)
• Brain tumor
• An excess of fluid around the brain (called hydrocephalus)
• Brain inflammation (encephalitis) resulting from infection
• Parkinsonism may also be present in persons with other neurological conditions, including Alzheimer's disease, amyotrophic lateral sclerosis (ALS), Creutzfeldt- Jakob disease, Wilson's disease and Huntington's disease.
  

Poor nutrition is an underlying cause of Parkinson's disease. High consumption of meat, rich in protein, also aggravates symptoms of Parkinson's and inhibits the body's use of vitamin B-6, which helps treat brain dysfunction.

Symptoms of Parkinson's should not be confused with milder problems that are common as people get older, including slower, stiffer movements from aching joints, and trembling. Problems with poor memory and a lack of facial expression are often linked to depression.


Dietary Guidelines

Eating a well-balanced, nutritious diet can be beneficial for anybody. A high protein diet, however, may limit levodopa's effectiveness.

Despite some early optimism, recent studies have shown that tocopherol (a form of vitamin E) does not delay Parkinson's disease. This conclusion came from a carefully conducted study called DATATOP (Deprenyl and Tocopherol Antioxidative Therapy for Parkinson's Disease) that examined, over five years, the effects of both deprenyl (Selegiline) and vitamin E on early Parkinson's disease. While deprenyl was found to slow the early symptomatic progression of the disease and delay the need for levodopa, there was no evidence of therapeutic benefit from vitamin E.

Foods to Eat

• Spelt (made as congee): Spelt has been used as an adjunct in the treatment of many disorders, including Parkinson's.
• Fruit
• Vegetables (especially leafy greens)
• Vegetable juice (especially carrot)
• Seaweeds
• Sprouted grains
• Raw seeds (such as sunflower and pumpkin)

Foods to Avoid

• Chemicalized and processed food
• Coffee
• Caffeinated tea
• Sugar
• Tobacco
  

Recommendations

Eat a well-balanced, high-fiber diet. Maximize your intake of fresh green vegetables. Green leafy vegetables, rutabagas, sesame seeds, and sesame butter are good.

As much as possible, buy organic fruits, vegetables, and grains to minimize your exposure to pesticide residues.

Limit your intake of high-protein foods to no more than six ounces per day, taken mostly at dinner.

Vitamin B6 (pyridoxine) , found in bananas, beef, fish, liver, oatmeal, peanuts, potatoes, and whole grains, interferes with the action of L-dopa. If you are taking L-dopa, take these foods only in moderation, if at all. (If you are taking a combination Levadopa and cardidopa such as Sinemet, you need not have to avoid the intake of Vitamin B6.)

Fava beans, also called broad beans, are a natural source of levodopa. One-half cup contains 250 mg, or the same amount as one pill. But don't substitute beans for pills without first consulting your doctor.Patients attempt to relieve the constipation that often accompanies Parkinson's by eating bran. But recent research shows that bran is high in vitamin B-6, which interferes with the effectiveness of levodopa when the drug is taken alone. Prune juice, grains, and fiber laxatives should be substituted instead. Foods seasoned with hot spices have been known to cause uncontrollable physical movement in some people with Parkinson's. Avoid such foods.

Avoid all alcohol, caffeine, and sugar. All these substances create an acidic internal environment and are over- stimulating to a stressed nervous system.

Drink at least six to eight 8-ounce glasses of pure water daily to help flush toxins from your body.

Diet for Parkinson Patients

Parkinson's patients should pay close attention to diet; weight loss, possibly caused by persistent involuntary movements, is a common problem.

In the early stages of Parkinson's disease, people may gain weight because they are less active than they used to be. Some people may eat more because they feel depressed about their medical condition. For these reasons, and the effect of different kinds of food on your medication, you should carefully control your diet. The protein in your diet, for example, affects how your body absorbs some of your medication. Therefore, you may need to cut down on high-protein foods, or plan to eat those foods only at times that won't affect your medication.

A diet called the 7:1 plan-for the ratio of carbohydrates to proteins-is designed for patients taking levodopa (proteins reduce the drug's effectiveness) . Researchers disagree as to whether the proteins should be eaten throughout the day or restricted to the evening meal, when interference with levodopa might be less of a problem. Consult your doctor to determine which method works best for you. Either way, a low-protein diet can lead to deficiencies in calcium, iron, and B vitamins; supplements are therefore advised. (if you are taking levodopa without carbidopa, however, avoid vitamin B-6; the vitamin will interfere with the levodopa.)

Nutritional Supplements for Parkinson's Disease

To prevent or correct possible nutritional deficiencies, take a high-potency multivitamin and mineral supplement daily. Choose a form that is easily digested, such as a soft gel-cap.

Gamma-aminobutyric acid (GABA) is an amino acid that acts as a neurotransmitter. It helps both to strengthen and relax the nervous system. Take 500 milligrams up to three times daily for up to three months in a row.

Acidophilus and bifidobacteria are friendly bacteria that ensure a healthy gastrointestinal tract. Probiotics are especially helpful for preventing constipation, which is often a problem for people with Parkinson's disease. Take a probiotic supplement as recommended on the product label. If you are allergic to milk, select a dairy-free formula.

Alpha-lipoic acid is an antioxidant that also helps to "recharge" other antioxidants in the body. Take 50 to 100 milligrams three times a day.

Calcium and magnesium are imperative for maintaining a healthy nervous system. Take a multimineral supplement that supplies 500 milligrams of calcium and 250 milligrams of magnesium, as well as trace minerals, twice daily.

Coenzyme Q10 is an oxygenating antioxidant that helps prevent free-radical damage and important for cell renewal. Take 30 milligrams two or three times daily.

People with Parkinson's disease often do not utilize nutrients effectively. To insure complete digestion and assimilation of the nutrients in the food you eat, take a digestive-enzyme supplement with each meal.

Evening primrose oil and flaxseed oil contain valuable essential fatty acids (EFAs), which are often deficient in people with Parkinson's disease. Take 1 tablespoonful (or 500 to 1,000 milligrams) of either or both twice daily.

Green-foods supplements supply chlorophyll and important trace minerals. Take a green-foods supplement as directed on the product label.

Marine alginate concentrate and N-acetylcysteine may help in the process of chelating (binding to) heavy metals in the body so that they can be excreted. If you or your health-care provider suspects heavy metal toxicity, take 500 milligrams of marine alginate concentrate three times a day and 500 milligrams of N-acetylcysteine twice daily.

Nicotinamide adenine dinucleotide hydrogren (NADH) is an enzyme that helps to improve neurotransmitter function. Take 10 to 25 milligrams twice daily for beneficial effects in patients with Parkinson's Disease. The most noticeable results are found to occur after intravenous rather than after intramuscular administration.

Phosphatidylserine is a type of lipid important for normal brain function and the effective transmission of nerve impulses. Low levels of phosphatidylserine are associated with Parkinson's disease. Take 50 milligrams of phosphatidylserine three times daily.

Soy Lecithin is rich in phosphatidylcholine . Choline is a vital building block for acetylcholine. Take 3 tbsp. three times daily.

Pine-bark and grape-seed extracts fight free-radical damage and have anti-inflammatory properties. Many people consider Parkinson's disease to be a consequence of degeneration of nerve cells due to free-radical damage. Take 25 to 50 milligrams of either three times daily.

The B vitamins are very important for brain and nerve function. Take a B-complex supplement so that you are getting 25 milligrams of each of the major B vitamins three times a day from all sources. In addition, take 50 milligrams of vitamin B6 (pyridoxine) and pantothenic acid three times daily, between meals, plus 100 milligrams of niacinamide twice daily (morning and evening).
Note: If you are taking L-dopa, talk to your physician before taking any supplemental B vitamins, and do not take additional vitamin B6, as this vitamin interferes with the action of L-dopa.

Vitamin C and the bioflavonoids are powerful antioxidants that fight free radicals. Take 1,000 milligrams of vitamin C with bioflavonoids three times daily for one month. Then gradually increase your intake to the highest level you can tolerate. Vitamin C may help "on-off attacks" (two to five years on levadopa results in shortened positive response time to treatment) and other side effects of levadopa.

Vitamin E is a powerful antioxidant that prevents free- radical damage. Choose a product containing mixed tocopherols and start by taking 200 international units daily, then gradually increase the dosage until you are taking 400 international units in the morning and another 400 international units in the evening. Recent clinical trials have put a big question mark on the usefulness of Vitamin E for treating Parkinson's Disease. But many experts suggest taking Vitamin E for its other benefits even if it doesnot affect Parkinson's Disease directly.

Note: If you have high blood pressure, limit your intake of supplemental vitamin E to a total of 400 international units daily. If you are taking an anticoagulant (blood thinner), consult your physician before taking supplemental vitamin E.

Selenium is an antioxidant that works with vitamin E. It also helps to increase circulation and tissue oxygenation, thereby limiting damage to nerve cells. Take 200 micrograms of selenium daily.

A study with four patients with Parkinson's disease who were given injections of 100 mg. of neotrophin 1 (complex glycoproteins, derived from snake venom) resulted in dramatic improvement after a period of six to eight weeks.

Exercise

Because movements are affected in Parkinson's disease, exercising may help people improve their mobility. Some doctors prescribe physical therapy or muscle- strengthening exercises to tone muscles and to put underused and rigid muscles through a full range of motion.

Exercises will not stop disease progression, but they may improve body strength so that the person is less disabled. Exercises also improve balance, helping people overcome gait problems, and can strengthen certain muscles so that people can speak and swallow better. Exercises can also improve the emotional well- being of parkinsonian patients by giving them a feeling of accomplishment.

Whatever form of exercise you choose, make sure it is something that gets your muscles moving, your heart pumping, and that you can keep up with it every day. Walking, jogging, stretching, swimming, and other activities are terrific ways to help you cope with the tremor, muscle stiffness, and slow movements that may occur with Parkinson's disease. You will probably find a daily exercise routine will help you to feel better about yourself and your condition, continue functioning, maintain a good body weight, and sleep better at night. Make sure to consult your doctor before starting any exercise program. Do not exercise when you feel tired.

• Daily walking

Yoga or gentle stretching

• Yoga is an ideal form of exercise for Parkinson's patients because of its slow movements.

Chi Yi

Chi Yi is a Chinese deep breathing exercise. It increases the oxygen supply in the blood and may thereby help alleviate depression. Sit with your back against the
back of a chair and your feet flat on the floor. Reach toward the ceiling with both
arms, inhaling deeply through your nose as you do so. Hold your breath as you ball your hands into fists, squeezing your arm muscles. Exhale slowly through your nose to a count of six as your bring your tensed arms down, crossing them on your chest over your heart. Lower your chin to your chest. Take four short breaths, completely filling your lungs, and feel your chest expand. Hold for a few seconds, then exhale slowly. Repeat this exercise several times each day, concentrating on the rhythm and depth of each breath. If tremor prohibits arm or head movements, concentrate on the breathing, working toward a rate of only four or five breaths per minute. Limit practice to five minutes per day.

Physiotherapy

Induces relaxation, invigorate the patient, and improve various physical functions. Use as a supportive therapy.

• Ozone-producing machines:
  Ozone may help improve nervous system and brain function in Parkinson's patients. The FDA has not yet approved the machines for medical use; however, they are available through medical doctors and from people who work to make homes and offices more environmentally healthful.
  
• Alternate hot and cold showers: Warm bath with herbs added to the water
• Alternate hot and cold head douches
• Saunas followed by massage
• Outdoor exercise
• Sun and ocean baths
  
  
  Caution: When using warm water, please watch out against skin damage to persons with diminished temperature sensation when extreme temperatures are applied.
  

Herbal Remedies

Larkspur: 20 grams in 4 cups of boiling water; do not drink more than 3 cups a day, a mouthful at a time.

Lady's slipper is good for tremors, especially in debilitated conditions; it clears depression. Use a standard decoction or 3-9 g; tincture, 10-30 drops. Take 3 or 4 times a day for maximum effectiveness.

Skullcap: Combine with lady's slipper for broader action. Strengthens the brain. Standard infusion or 3-9 g; tincture, 10-30 drops (Very often, instead of skullcap germander is given as skullcap. Ask for the genuine herb.)

A combination of herbs that include rhubarb, peony (paeonia), licorice and magnolia bark are said to stop tremors and relax stiff muscles. Consult a herbalist for proper dosage.

Bupleurum Formula with Paeonia and Licorice Combination with magnolia bark - for persons with irritability, debilitating anxiety and insomnia.

Alcoholism is one of the possible indirect causes of Parkinson's, and herbal remedies which support the liver, pancreas and adrenal glands help to alleviate symptoms.

Ginseng, horsetail, hops, skullcap, passion flower and valerian root help to alleviate symptoms of Parkinson's. Prepare a herbal tea using 1 tsp. of herbs in 1 cup of boiling water and drink 3 cups daily.

Herbs also may be used synergistically with the appropriate drugs used to treat Parkinson's disease. For example, passion flower was found to improve the effectiveness of the drug L-dpa (levodopa). It reduces the passive tremor when used with L-dopa. (more than when using L-dopa alone.) However, passion flower only has minimal effect if used alone. Take one-half teaspoonful of passion flower tincture three times a day.

Ginkgo biloba scavenges free radicals and boosts circulation to the brain. Select a product containing at least 24 percent ginkgo heterosides (sometimes called flavoglycosides) and start by taking 40 milligrams three times daily. If you feel fine at that dosage, you can gradually increase to as much as 80 milligrams three times daily.

Degenerative disease is often facilitated by the accumulation of toxins in the body. The following herbs have detoxifying properties:

• Burdock root, dandelion root, ginger root, and milk thistle detoxify the liver.
• Cayenne (capsicum), goldenseal, mullein, Siberian ginseng, and yarrow stimulate the thymus and lymphatic system.
  
  
  Caution: Do not take goidenseal internally on a daily basis for more than one week at a time, do not use it during pregnancy, and use it with caution if you are allergic to ragweed. Do not use Siberian ginseng if you have hypoglycemia, high blood pressure, or a heart disorder.
  
  
• Hawthorn, licorice, red clover, and sarsaparilla cleanse the blood.
  

Caution: Do not use licorice on a daily basis for more than seven days in a row. Avoid it completely if you have high blood pressure.

• Yellow dock cleanses the blood and detoxifies the liver.
• Black cohosh catnip, lemon balm, passionflower, skullcap, and valerian root have anti-stress properties and can help nourish the nervous system.
  
  Caution: Do not use black cohosh during pregnancy.
  

Homeopathy

Consultation with an experienced homeopath is required for Parkinson's disease. However, given below is a sample of homeopathic remedies for occasional use. Take the 6c strength four times daily for up to two weeks when the symptoms are severe, or while waiting for help from a homeopath.

Anthimonium Tartaricum: six every two hours for trembling of head and paralytic hands tremor.

Choose Gelsemium if you have considerable trembling and eyelids so droopy that you may appear to be asleep. You stagger when walking and feel weak and fatigued much of the time. Take Gelsemium 30x or 15c three times daily for up to three days, as needed to relieve symptoms.

Mercurius corrosivus is for trembling hands and excessive salivation. A tremor is accompanied and made worse by perspiration. Sensitivity to heat and cold is felt equally, memory and concentration is patchy, and willpower is weak. Take one dose of Mercurius corrosivus 30x or 15c three times daily for up to three days, as needed to relieve symptoms.

Agaricus is for limbs that are stiff but tremble and twitch. You likely feel itchy, and your back, especially your spine, is probably very sensitive. Take one dose of Agaricus 30x or 15c, as directed on the product label, three times daily for up to three days, as needed to relieve symptoms.

Hyoscyamus is for the person who exhibits inappropriate behavior at inopportune times. You have a lot of twitching, are restless, and tend to be jealous and very suspicious. Take one dose of Hyoscyamus 30x or 15c three times daily for up to three days, as needed to relieve symptoms.

Rhus toxicodendron is good for mild tremors and stiffness that feels better with movement, worse with dampness. Take one dose of Rhus toxicodendron 30x or 15c three times daily for up to three days, as needed to relieve symptoms.

Bach Flower Remedies

Select the remedy that most closely fits your emotional tendencies and concerns, and take it as needed, following the directions on the product label.

Beech is the remedy for impatience and intolerance of your affliction. You have a tendency to be a perfectionist and like an orderly life. You are critical and intolerant of those who don't measure up to your standards or expectations.

Holly will prove helpful if you are angry, prone to fits of temper, and feel jealous and insecure underneath.

Impatiens will ease nervous tension, feelings of impatience, irritability, and a tendency to fidget.

White Chestnut helps to counteract a tendency to obsess on problems without letup, persistent unwanted thoughts, worry or have mental arguments that circle around your mind, difficulty sleeping due to mental chatter and worries.

Reflexology

Practitioners of reflexology believe that the brain, head, and spine all respond to indirect massage. To help ease the tremors of Parkinson's, walk your thumb across the reflexology area for the diaphragm and solar plexus. Working areas for the brain and spinal column may help stabilize the nervous system.

Press three times per day the following points, three minutes each point:

2-pituitory, 3-cerebrum, 4-cerebellum, 12-spine, 20-adrenal, 21-kidney, 24-liver, 52-autonomic nervous system.

Work on the reflexes of all glands and the entire spine to elevate alertness and ambition.
Additionally work on the reflexes of the toes and the colon. Use gentle pressure at first, then increase pressure for ten minutes every other day.

Acupuncture and Acupressure

Acupuncture

According to some studies by acupuncturists, Parkinson's disease may be accompanied by an imbalance of energy along one or more meridians. The muscle stiffness, soreness, and imbalance of Parkinson's may be alleviated by a series of treatments by encouraging the flow of energy or by addressing the tremors and the hardening of the muscles directly.

GV 14, K 3, LIV 3, SP 6, LIV 2, UB 18.

Ear Points: Brain stem, Shen-men, Occiput, Subcortex, Liver.

For Parkinson's Paralysis Agitans:
GV 20, GV 21, GB 20, CV 23

Acupressure

This treatment otherwise known as pressure-point massage, is used to reduce symptoms such as nausea, excessive salivation, anxiety, or muscle pain. Acupressure is also used to impart vital energy.

Four Gates relaxes the muscles.

Stomach 36 improves the absorption of nutrients and strengthens the overall well-being.

Acupressure may be of some use as a short-term, supportive attempt to treat concomitant symptoms. Some case reports and field studies claim efficacy; however, success is probably seen in only a small proportion of patients.

Anthroposophical medicine

In the AM interpretation of degenerative diseases of the central nervous system, encroachment of the upper pole into the extremities is said to be normalized through curative eurhythrny, bathing, and potentized organ preparations.

Acceptable as a supportive treatment for Parkinson's disease. Some studies claim efficacy; however, success is probably seen in only a proportion of patients.

Make sure that the practitioner is properly qualified and trained. Allergies or intolerance are possible with this treatment.

Body Work

Deep-muscle massage stretches the connective tissue around tight muscles, ridding them of cramping and allowing greater freedom of movement. Massage can also improve motion in your joints, soften hardened muscle tissue, and stimulate your lymphatic system.

One especially appropriate method is the feldenkrais method, which consists of a large number of exercises performed either in group classes or solo with a practitioner, aims at improving autonomic motor responses. While lying down, you are guided through a series of light slow movements designed to support your neuromuscular system and alter habitual patterns of movement.

Classical massage helps to invigorate the patient. It also eases muscular and perhaps emotional tension. It is great for relaxation. Some people, however, may find it hared to tolerate close physical contact. Some may be sensitive to manual stimuli. Use only a qualified practitioner.

Juice Therapy

• Carrot and Spinach Juice daily
• Carrot, beet, radish, garlic, and cucumber daily
• Seasonal raw fruit and vegetables
  
  

Diet plays an important role in the treatment of this disease. To begin with, the patient should resort to a short juice fast for five days. In this regimen, he should take a glass of fresh fruit or vegetable juice, diluted with water on 50:50 basis, every two hours from 8 a.m. to 8 p.m. Fruits and vegetables which may be used for juicing are apple, pineapple, grapes, orange, tomato, carrot, cabbage and spinach. A warm water enema should be used daily to cleanse the bowels during the period of fasting.

After the short juice fast, the patient may adopt an all-fruit diet for further 5 days. During this period, he should take three meals a day of fresh juicy fruits, such as apple, pear, peach, papaya, grapes, orange and pineapple, at five-hourly intervals. Thereafter, he may gradually adopt a well-balanced lacto-vegetarian diet. The emphasis should be on raw seeds, nuts and grains, plenty of sprouts, raw milk, preferably goat's milk, and raw fruits and vegetables. Green leafy vegetables and yellow turnips are especially beneficial. Sesame seeds and sesame seed butter can be taken with beneficial results. In general, a low-protein diet of raw, organically grown foods is best for the patient with Parkinson's disease.

The patient should avoid tea, coffee, chocolate, salt, spices, condiments, pickles, flesh foods, white flour and white sugar and all processed, tinned, canned and frozen foods. The short juice fast followed by an all-fruit diet should IJP, repeated at monthly intervals till condition improves.

Use of Vitamin E in high doses is considered beneficial on the treatment of Parkinson's disease. There is preliminary evidence to suggest that massive doses of Vitamin E, say, 800 to 3,000 international units daily, may slow down the progress of the disease. Extensive studies about the efficacy of the Vitamin E therapy for Parkinson's disease are, however, still being carried out.

Everything possible should be done to help the patient to maintain a cheerful mental outlook. He should remain as active as possible and lead a quiet life. Hot moist packs may be applied to the stiffened muscles which should also be gently massaged. The daily warm bath is useful. Fresh air and light exercise, especially walking, are essential to the treatment of Parkinson's disease.