How
Can Vitamins Help with Parkinson Disease?
How can Vitamins help with Parkinson Disease?
By: Dr. George Obikoya
Parkinson's disease (PD) is a common neurodegenerative movement
disorder that is associated with significant medical disability,
reduction in quality of life, and, in advanced stages, caregiver
burden. Approximately half a million to one million individuals
in the United States have been diagnosed with PD, most falling within
the age range of 55 to 60 years at time of diagnosis.
With the increase in the senior population of the United States,
the prevalence of PD is expected to rise. In response to this anticipated
increase in the prevalence of PD, the search for agents that may
delay or arrest its pathologic progression (ie, neuroprotective
agents) has become a high priority among researchers.
Neuroprotection is defined as protecting neurons from cellular damage
induced by various biochemical insults associated with the pathogenesis
of PD. There is no known cure for Parkinson's disease.
Parkinson’s disease is caused by deterioration of nerve cells in
the basal ganglia, the part of the brain responsible for muscle
movement. As less dopamine (a type of neural transmitter) is produced,
muscle function is lost. Symptoms of Parkinson’s include unstable
balance, slow movement, difficulty walking, muscle stiffness or
rigidity, difficulty initiating movement, muscle tremors, muscle
ache, and speech changes.
A growing percentage of the U.S. population is turning to nutritional
supplements in the hope of improving general health and well-being.
It's no surprise, then, that more and more people with PD are asking
whether vitamins or other supplements could benefit Parkinson's
disease (PD) itself or aid in its prevention.
CoEnzyme Q-10, also known as "CoQ10," is a dietary supplement
that is widely available for the maintenance of heart health. However,
in a recent phase 2 study, high doses of CoQ10 (1200 mg per day)
demonstrated symptomatic benefits in patients with early PD.[1]
The putative neuroprotective activity of CoQ10 may be due to its
antioxidant properties and enhancement of the mitochondrial complex
I activity (which may be defective in PD). Of note, the CoQ10 product
used in the study also contained significant amounts of vitamin
E, another known antioxidant. The possible influence of vitamin
E on the results of this study was not evaluated. However, in a
previous clinical study (DATATOP), high-dose vitamin E alone (up
to 2000 IU per day) was not associated with clinical symptomatic
or neuroprotective benefits.[2] However vitamin e in combination
with vitamin c has shown great benefit for Parkinson's disease.
Many individuals with PD already use vitamins in addition to the
medications their doctors gave them to treat the condition. Interest
in studying the effects of vitamins on PD is growing among medical
researchers. Indeed, research findings suggest that certain vitamins
help improve balance in PD. In addition, several vitamins and other
nutritional supplements are now being actively studied in the laboratory
or in clinical trials to determine whether they have a role to play
in treatment of PD.
No intervention is currently known for certain to slow down the
progression of PD, but recent research suggests that one potential
means to this might be found in modifying nerve cell metabolism.
Most cells in our body contain "energy generators" called
mitochondria; their function is vital, and the brain in particular
uses high amounts of energy. Researchers think that deficiencies
in the functioning of mitochondria may play a role in PD, raising
the question as to whether changing the energy balance in nerve
cells could be protective. One compound that has certainly attracted
a lot of attention lately in this connection is Coenzyme Q10, a
common nutritional supplement. CoQ10 plays an important role in
the mitochondria and along with vitamin e, is also a potent antioxidant.
Another supplement that likely acts through its effects on energy
metabolism and could be useful in Parkinson's is creatine. This
compound increases levels of phosphocreatine, an energy source in
the muscle and brain, and in experimental studies it protects against
nerve cell injury.
The National Institute of Neurological Disorders and Stroke (NINDS)
has now funded a multi-center pilot study of creatine (along with
another agent, minocycline) in PD patients who have not yet taken
any medicines for their PD. The supplement has few reported side
effects. Glutathione, a compound with multiple effects on nerve
cell metabolism as well as a powerful antioxidant, is of particular
interest for PD because of studies showing its depletion in the
substantia nigra (the site of major nerve cell damage in PD).
Other supplements at earlier stages of investigation in the laboratory
include nicotinamide, riboflavin, acetyl-l-carnitine and alpha lipoic
acid.
Based on strong evidence linking oxidative damage of nerve cells
to PD, there has been much hope that antioxidants could play a role
in slowing the progression of the disease. Besides CoQ10, many PD
patients take antioxidants such as vitamins E or C. Vitamin E can
combat the damage caused by free radicals. Some have reported that
high dietary intake of vitamin E lowers the risk of PD, although
a rigorous trial of a decade ago- the DATATOP study – mentioned
earlier found no evidence that even high doses of vitamin E (up
to 2000 IU per day) had any effect on progression or symptoms of
PD. However, more recent studies have indicated a definite benefit
with vitamins c AND e were taking at high doses and in combination.
So, what's the bottom-line? For people who are interested in exploring
complimentary approaches to easing PD, there does seem to be increasing
scientific evidence of the efficacy of some available supplements,
but safety has to come first. For example, patients with Parkinson’s
Disease should not take iron supplements, as they appear to increase
the rate at which the disease progresses.
Treatment for Parkinson’s disease is geared toward controlling symptoms.
This can be done using medication that enhances neural transmitters
or helps to mask disease symptoms. It is reasonable to explore supplementing
this treatment with those vitamins of proven effect on PD. Most
importantly though, the use of vitamins as a powerful (and inexpensive)
protector against developing Parkinson's in the first place should
also be considered.
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References:
1.Shults CW, Oakes D, Kieburtz K, et al. Parkinson Study Group.
Effects of coenzyme Q10 in early Parkinson disease: evidence of
slowing of the functional decline. Arch Neurol. 2002;59:1541-1550.
2. Parkinson Study Group. Effects of tocopherol and deprenyl on
the progression of disability in early Parkinsonýs disease. N Engl
J Med. 1993;328:176-183.
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