Parkinson disease is condition of the nervous system that affects movement and gets worse over time. Its symptoms -- tremors (often starting in one hand), slowed movement, rigidity -- are caused when nerve cells in the brain that make a chemical called dopamine start to break down and die. Dopamine is a neurotransmitter, or messenger, that sends messages to the parts of the brain that control movement.
Parkinson disease usually affects people after age 60, but it may start as early as age 40. There is no cure for Parkinson disease, but medications can help reduce the symptoms.
Signs and Symptoms
Symptoms can start very slowly and not be noticed for years. Often they start on one side of the body.
Secondary symptoms may include:
What Causes It?
Researchers are not sure why some people get Parkinson disease. In people with Parkinson disease, brain cells that produce the chemical messenger dopamine start to die. Dopamine send signals to areas of the brain that deal with muscle activity and movement. The brain starts to lose the ability to tell the body when and how to move.
Risk factors include having a relative with Parkinson disease, being exposed to certain pesticides and herbicides, getting older, and lower levels of estrogen in women.
What to Expect at Your Doctor's Office
Since tests cannot positively identify Parkinson disease, your doctor may rely mostly on interviews with you and your family. Your doctor may order brain scans to measure dopamine activity. Tests may be needed to rule out other conditions that cause similar symptoms.
Exercise, especially intensive exercise, has been shown to improve symptoms and help maintain balance and mobility. Walking, swimming, jogging, or even dancing may help. Because people with Parkinson disease often have low levels of vitamin D, they are at risk of osteoporosis. Lifting weights can help reduce that risk. Your doctor may recommend an exercise program for you.
Several drugs treat the symptoms of Parkinson disease, but they do not cure the disease. Your doctor may change medications and adjust dosages often. Certain drugs used for the treatment of other diseases, especially glaucoma, heart disease, and high blood pressure, may also be used to help treat Parkinson disease. Doctors may try to wait to start drug therapy because the drugs tend to lose effectiveness over time. Among the drugs used are:
Psychotherapy can help you cope with associated conditions such as depression. Speech, physical, and occupational therapy may help.
Complementary and Alternative Therapies
DO NOT try to treat Parkinson disease with alternative therapies alone. Used with conventional medications, complementary and alternative therapies (CAM) may help provide some relief of symptoms and slow progression of the disease. Some CAM therapies may interfere with certain medications, so work with your physician to find the safest, most effective CAM therapies for you.
Nutrition and Supplements
A low-protein diet helps the body use levodopa and carbidopa most efficiently, so your doctor may suggest that you limit the protein you eat, and eat most protein during the evening hours rather than morning and afternoon. DO NOT go on a low-protein diet by yourself -- your doctor should watch your diet to make sure you get enough nutrients. A fiber supplement may help prevent constipation, which is a common symptom of Parkinson disease.
Many supplements may interact with medications you take for Parkinson disease, or may work only at particular doses. DO NOT take any supplements, even vitamins, without your doctor's guidance.
Herbs are a way to strengthen and tone the body's systems. As with any therapy, you should work with your doctor to diagnose your problem before starting any treatment. You may use herbs as dried extracts (capsules, powders, or teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted.
Consult a trained homeopath who can determine the right remedy for you and change it when your symptoms change.
Massage may help increase circulation and decrease muscle spasm. Cranio-sacral therapy, an osteopathic form of body work that focuses on the brain and spinal column, may reduce tremors and improve function.
The following movement therapies may help people with Parkinson disease have better motor skills and balance, and help them walk better.
Tai chi, Qigong and yoga can improve balance, flexibility, and range of motion in people with Parkinson disease. They may also boost mood, and improve sleep.
Traditional Chinese Medicine and Acupuncture
Traditional Chinese Medicine (TCM) views disease as caused by internal imbalances. It has historically been used to treat Parkinson disease with acupuncture and individually prepared herbal remedies. One study showed that acupuncture improved symptoms in a small group of people with Parkinson disease. People with Parkinson disease may also find that acupuncture helps them sleep better. If you consult a TCM practitioner, make sure your doctor is aware of any suggested treatment.
Since Parkinson disease gets worse as time goes on, you will need to be under constant medical care. Drug treatments often do not work as well over time, and you must keep a close eye on your symptoms.
Exercise helps improve mobility. It is important to note the Parkinson disease patients with dementia are twice as likely to have insulin resistance. Conditions like depression and dementia are often diagnosed in this population, but not adequately treated.
Bach JP, Riedel O, Klotsche J, Spottke A, Dodel R, Wittchen HU. Impact of complications and comorbidities on treatment costs and health-related quality of life of patients with Parkinson's disease. J Neurol Sci. 2012;314(1-2):41-7.
Barichella M, Cereda E, Pezzoli G. Major nutritional issues in the management of Parkinson's disease. Mov Disord. 2009 Oct 15;24(13):1881-92. Review.
Bega D, Gonzalez-Latapi P, Zadikoff C, Simuni T. A review of the clinical evidence for complementary and alternative therapies in Parkinson's disease. Curr Treat Options Neurol. 2014;16(10):314.
Bender A, Koch W, Elstner M, et al. Creatine supplementation in Parkinson disease: a placebo-controlled randomized pilot trial. Neurology. 2006;67:1262-4.
Bosco D, Plastino M, Cristiano D, et al. Dementia is associated with insulin resistance in patients with Parkinson's disease. J Neurol Sci. 2012;315(1-2):39-43.
Canning CG, Sherrington C, Lord SR, et al. Exercise for falls prevention in Parkinson disease: a randomized controlled trial. Neurology. 2015;84(3):304-12.
Chen FP, Chang CM, Shiu JH, et al. A clinical study of integrating acupuncture and Western medicine in treating patients with Parkinson's disease. Am J Chin Med. 2015;43(3):407-23.
Chen LW, Wang YQ, Wei LC, Shi M, Chan YS. Chinese herbs and herbal extracts for neuroprotection of dopaminergic neurons and potential therapeutic treatment of Parkinson's disease. CNS Neurol Disord Drug Targets. 2007 Aug;6(4):273-81. Review.
Connolly BS, Lang AE. Pharmacological treatment of Parkinson disease: a review. JAMA. 2014;311(16):1670-83.
Cruickshank TM, Reyes AR, Ziman MR. A systematic review and meta-analysis of strength training in individuals with multiple sclerosis or Parkinson's disease. Medicine (Baltimore). 2015;94(4):e411.
Diederich NJ, Stebbins G, Schiltz C, Goetz CG. Are patients with Parkinson's disease blind to blindsight? Brain. 2014;137(Pt 6):1838-49.
Duker A, Espay A. Surgical treatment of Parkinson disease. Neurolgic Clinics. 2013;31(3).
Earhart GM. Dance as therapy for individuals with Parkinson disease. Eur J Phys Rehabil Med. 2009 Jun;45(2):231-8. Review.
Ferri FF. Ferri's Clinical Advisor 2014. 1st ed. Philadelphia, PA: Elsevier Mosby; 2013.
Finseth TA, Hedeman JL, Brown RP, Johnson KI, Binder MS, Kluger BM. Self-reported efficacy of cannabis and other complementary medicine modalities by Parkinson's disease patients in colorado. Evid Based Complement Alterrnat Med. 2015; 2015;874849.
Ghaffari BD, Kluger B. Mechanisms for alternative treatments in Parkinson's disease: acupuncture, tai chi, and other treatments. Curr Neurol Neurosci Rep. 2014;14(6):451.
Hass CJ, Collins MA, Juncos JL. Resistance training with creatine monohydrate improves upper-body strength in patients with Parkinson's disease: A randomized trial. Neurorehabil Neural Repair. 2007;21(2):107-15.
Hauser RA, Zesiewicz TA. Advances in the pharmacologic management of early Parkinson disease. Neurologist. 2007;13(3):126-32.
Joh TH, Park HJ, Kim SN, Lee H. Recent development of acupuncture on Parkinson's disease. Neurol Res. 2010 Feb;32 Suppl 1:5-9.
Katzenschlager R, Evans A, Manson A, et al. Mucuna pruriens in Parkinson's disease: a double blind clinical and pharmacological study. J Neurol Neurosurg Psychiatry. 2004;75:1672-77.
Lees A. Alternatives to levodopa in the initial treatment of early Parkinson's disease. Drugs Aging. 2005;22(9):731-40.
Moretto A, Colosio C. The role of pesticide exposure in the genesis of Parkinson's disease: epidemiological studies and experimental data. Toxicology. 2013;307:24-34.
Nagashayana N, Sankarankutty P, Nampoothiri MRV, et al. Association of l-DOPA with recovery following Ayurveda medication in Parkinson's Disease. J Neurol Sci. 2000;176:124-7.
The NINDS NET-PD Investigators. A randomized clinical trial of coenzyme Q10 and GPI-1485 in early Parkinson disease. Neurology. 2007;68:20-8.
The NINDS NET-PD Investigators. A randomized, double-blind, futility clinical trial of creatine and minocycline in early Parkinson disease. Neurology. 2006;66:664-71.
Renaud J, Nabavi SF, Daglia M, Nabavi Sm, Martinoli MG. Epigallocatechin-3-Gallate, a Promising Molecule for Parkinson's disease. Rejuvenation Res. 2015;18(3):257-69.
Sheffield JK, Jankovic J. Botulinum toxin in the treatment of tremors, dystonias, sialorrhea and other symptoms associated with Parkinson's disease. Expert Rev Neurother. 2007;7(6)637-47.
Shults CW, Oakes D, Kieburtz K, et al. Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol. 2002;59:1541-50.
Wassom DJ, Lyons KE, Pahwa R, Liu W. Qigong exercise may improve sleep quality and gait performance in Parkinson's disease: a pilot study. Int J Neurosci. 2015;125(8):578-84.
Ye Z, Altena E, Nombela C, et al. Selective serotonin reuptake inhibition modulates response inhibition in Parkinson's disease. Brain. 2014;137(Pt 4):1145-55.
Yuan H, Zhang ZW, Liang LW, et al. Treatment strategies for Parkinson's disease. Neurosci Bull. 2010 Feb;26(1):66-76.
Review Date: 4/27/2016
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.