According to the Parkinson’s Foundation, more than 10 million people worldwide and nearly 1 million Americans are living with Parkinson’s disease (PD). Every year, nearly 90,000 people in the U.S. are diagnosed with this ailment, which causes the gradual loss of dopamine-producing neurons in the brain. Symptoms that develop slowly over years include tremors; stiff muscles; a slow, shuffling gait; and difficulties with movement and speech. 

There is no cure for PD, and by the time a patient is diagnosed, they may have already lost 60 to 80 percent of their dopamine-producing cells. According to Kenneth Sharlin, a board-certified neurologist and certified functional medicine doctor, the first line of defense for PD is levodopa (L-Dopa), a pharmaceutical that is converted to dopamine in the body. “Unfortunately, natural strategies don’t get a lot of research, so no supplement has been shown to effectively treat the disease,” he asserts. “Mucuna pruriens, a tropical legume that grows in Africa, Asia and the Pacific Islands, naturally contains levodopa, but studies have shown it to be unreliable.”

Dopamine is a neurotransmitter that plays a role in controlling memory, mood, sleep, learning, concentration and movement. “If the car doesn’t have gas, then you can’t drive it,” explains Sharlin. Once a patient is taking levodopa to bring dopamine levels up, complementary strategies can be employed to help manage PD symptoms by as much as 73 percent, according to a panel of doctors participating in The Parkinson’s Solutions Summit. Exercise, sleep and even intimacy with a partner can all be managed well once the car has “gas” to drive it.

Exercise

According to Sharlin, the number one strategy for PD patients to maintain their motor function is exercise such as bicycling, chair yoga, movement classes in warm water pools, Pilates and dance. A meta-analysis published in Gerontology and Geriatrics analyzed 15 randomized controlled trials involving 498 participants in several countries to investigate the health impacts of self-directed physical activity (SDPA) on patients with early and mid-stage PD. The study examined the effects of moderate-intensity exercises, including aerobics, dance, strength training, flexibility exercises and Nordic walking. The researchers found that the SDPA significantly enhanced gait function, balance, mobility, function and postural control.

Gut Health

“Monitoring gut function is very important for patients with PD, as constipation is very common,” states Trupti Gokani, a board-certified neurologist, health and mindset coach, and Ayurvedic expert. Improving gut function with the help of key nutrients from vegetables, fruits, clean protein, nuts and seeds, olive oil, herbs and spices has been shown to slow the progression of the disease. It is best to choose organic when possible, as that will decrease the exposure to brain-toxic chemicals. A gluten-free diet has also been found to improve PD symptoms.

Sharlin recommends an antioxidant-rich diet packed with polyphenols, along with green tea that contains catechins called epigallocatechin-3-gallate (EGCG), a natural antioxidant with neuroprotective properties.

Stress Reduction

“Anxiety linked to PD can worsen the symptoms,” Gokani points out. Chronic stress is a risk factor for PD, because it elevates the hormone cortisol, which can interfere with neuronal plasticity and damage dopamine-producing neurons in the brain.

Incorporating deep breathing, meditation and other relaxation techniques is integral to improving the patient’s quality of life. According to Sharlin, “Mindfulness-based stress reduction techniques to self-regulate have a positive impact in regulating Parkinsonism.”

New Test to Confirm Diagnosis

When a patient comes to his office exhibiting PD symptoms, Sharlin now has a new way to confirm a PD diagnosis by taking a small tissue sample and sending it to the lab to look for a neural protein called alpha synuclein, which is associated with PD. In a 2023 National Institutes of Health study involving 428 people with PD and 120 control volunteers, this skin biopsy was found to be very accurate, with 92.7 percent sensitivity. 

Deep Brain Stimulation

According to Sharlin, deep brain stimulation (DBS) is a well-researched and well-developed treatment for PD. The surgical therapy involves implanting electrodes within areas of the brain to interrupt irregular signals that cause movement-related symptoms. A 2019 retrospective study of 400 patients that underwent DBS implantation found that 75 percent of the participants felt the procedure provided symptom control. 

Focused ultrasound is another PD tool, using ultrasound beams to destroy areas in the brain cells that are causing movement problems. This procedure is permanent and can be done on only one side of the brain, so it helps symptoms on only one side of the body. Treatment to both sides could cause speech, swallowing or memory problems. Sharlin notes that the results from focused ultrasound are no better than DBS and involve more intense intervention. Also, not all Parkinson’s patients are good candidates for this procedure.