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Best Nondrug Approaches for Parkinson’s

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Tai chi, dancing and coffee…yes, coffee!…can make a difference…

The telltale tremors, muscle stiffness and other movement problems that plague people with Parkinson’s disease make even the mundane activities of daily living—such as brushing teeth, cooking and dressing—more difficult.

What’s new: Even though medication—such as levodopa (L-dopa) and newer drugs including pramipexole and selegiline—have long been the main treatment to control Parkinson’s symptoms, researchers are discovering more and more nondrug therapies that can help.

Among the best nondrug approaches (each can be used with Parkinson’s medication)… 

EXERCISE

For people with Parkinson’s, exercise is like a drug. It raises neurotrophic factors, proteins that promote the growth and health of neurons. Research consistently shows that exercise can improve motor symptoms (such as walking speed and stability) and quality of life.

For the best results: Exercise 30 to 60 minutes every single day. Aim to work hard enough to break a sweat, but back off if you get too fatigued—especially the following day (this indicates the body is not recovering properly). Parkinson’s symptoms can worsen with over-exercise. Smart exercise habits…

For better gait speed: Choose a lower-intensity exercise, such as walking on a treadmill (but hold on to the balance bars), rather than high-intensity exercise (such as running), which has a higher risk for falls and other injuries.

A recent study showed that a walking group of Parkinson’s patients performed better than a group of patients who ran. Important safety tip: Parkinson’s patients should exercise with a partner and take precautions to prevent falls—for example, minimizing distractions, such as ringing cell phones.

For aerobic exercise: Use a recumbent bicycle or rowing machine and other exercises that don’t rely on balance.

For strength and flexibility: Do stretching and progressive resistance training.

Excellent resource: For a wide variety of exercises, including aerobic workouts, standing and sitting stretches, strengthening moves, balance exercises and fall-prevention tips, the National Parkinson Foundation’s Fitness Counts book is available as a free download here.

For balance: Researchers are now discovering that yoga postures, tai chi (with its slow, controlled movements) and certain types of dancing (such as the tango, which involves rhythmic forward-and-backward steps) are excellent ways to improve balance.

COFFEE AND TEA

Could drinking coffee or tea help with Parkinson’s? According to research, it can—when consumed in the correct amounts.

Here’s why: Caffeine blocks certain receptors in the brain that regulate the neurotransmitter dopamine, which becomes depleted and leads to the impaired motor coordination that characterizes Parkinson’s. In carefully controlled studies, Parkinson’s patients who ingested low doses of caffeine—about 100 mg twice daily—had improved motor symptoms, such as tremors and stiffness, compared with people who had no caffeine or higher doses of caffeine.

My advice: Have 100 mg of caffeine (about the amount in one six-ounce cup of home-brewed coffee or two cups of black or green tea) twice a day—once in the morning and once in the mid-afternoon. Note: Even decaffeinated coffee has about 10 mg to 25 mg of caffeine per cup.

SUPPLEMENTS

Researchers have studied various supplements for years to identify ones that could help manage Parkinson’s symptoms and/or boost the effects of levodopa, but large studies have failed to prove that these supplements provide such benefits.

However, because Parkinson’s is a complex disease that can cause about 20 different motor and nonmotor symptoms that evolve over time, the existing research may not apply to everyone. Some people with Parkinson’s may benefit from…

  • Coenzyme Q10 (CoQ10): This supplement promotes the health of the body’s mitochondria (“energy generators” in the cells), which are believed to play a role in Parkinson’s. In a large study, people with Parkinson’s who took 1,200 mg per day showed some improvement in symptoms over a 16-month study period. However, follow-up studies found no beneficial effects.
  • Riboflavin and alpha-lipoic acid: Are among the other supplements that are continuing to be studied.

Important: If you wish to try these or other supplements, be sure to consult your doctor to ensure that there are no possible interactions with your other medications.

MARIJUANA

A few small studies have concluded that marijuana can improve some neurological symptoms, but larger studies are needed to show benefits for Parkinson’s patients, especially for symptoms such as depression and anxiety.

However: Marijuana is challenging for several reasons—first, it is illegal in most states. If you do live in a state that allows medical marijuana use, it has possible side effects—for example, it can impair balance and driving…it is difficult to know the exact dosage, even if it’s purchased from a dispensary…and with marijuana edibles (such as cookies and candies), the effects may take longer to appear, and you may accidentally ingest too much.

If you want to try marijuana: Work closely with your doctor to help you avoid such pitfalls.

SEEING THE RIGHT DOCTOR

For anyone with Parkinson’s, it’s crucial to see a neurologist and, if possible, one who has advanced training in Parkinson’s disease and movement disorders.

Important new finding: A large study showed that patients treated by a neurologist had a lower risk for hip fracture and were less likely to be placed in a nursing facility. They were also 22% less likely to die during the four-year study.

Neurologists are best equipped to treat the ever-changing symptoms of Parkinson’s. For optimal care, see the neurologist every four to six months. The National Parkinson Foundation’s Helpline, 800-4PD-INFO (473-4636) can assist you in finding expert care.

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Source: Michael S. Okun, MD, professor and chair of the department of neurology and codirector of the Center for Movement Disorders and Neurorestoration at the University of Florida College of Medicine in Gainesville. He is also the medical director at the National Parkinson Foundation and has written more than 400 medical journal articles. Dr. Okun’s latest book is 10 Breakthrough Therapies for Parkinson’s Disease.  Date: June 1, 2016 Publication: Bottom Line Health
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