Thanks to the pioneering work of Dr Geoffrey Leader and Lucille Leader, a doctor and nutritionist living in London, we now know that the right nutritional intervention can effectively improve the symptoms of Parkinson’s disease. Harry’s story is a case in point. Harry was referred by his GP to Dr Geoffrey Leader and Lucille Leader at their clinic in London. He made repetitive movements, had tremors (made worse by stress), intractable constipation and very low energy, and was very underweight. The Leaders arranged biochemical tests, which demonstrated that Harry was deficient in nutrients. They also found that he was eating foods that compromised the absorption of his L-dopa medication. They recommended nutrients to address the deficiencies that were found, dealt successfully with the constipation, worked out a suitable diet and a schedule for taking the L-dopa in relation to different foods, which would maximise the efficacy of Harry’s drugs. This enabled him to take smaller doses of L-dopa, which in turn reduced its side-effects, which included the distressing dyskinesia.
The weight problem was addressed using a specific dietary strategy that was compatible with his drug regimen. They also helped Harry to keep his stress levels low by a special relaxation technique called Autogenic Training and use of a dedicated CD, Parkinson’s Disease Relaxation by David Uri. also helps control the symptoms. Within a few weeks, Harry was experiencing a feeling of wellbeing. His bowel function had normalised, his energy had improved, the dyskinesia was a thing of the past, and he was putting on weight. His body movements were more controlled. Note: The full details of this integrated nutritional strategy are given in the Leaders’ books, Parkinson’s Disease: The Way Forward and Parkinson’s Disease Reducing Symptoms with Nutrition and Drugs. To purchase, click here. How we make dopamineDopamine is a neurotransmitter (chemical messenger) found within the brain. It has a variety of influences on brain function including playing a role in regulating… (Fig 31) [1] 
Adapted with permission from Dr Geoffrey Leader and Lucille Leader, Parkinson’s Disease — The Way Forward and Parkinson’s Disease Reducing Symptoms with Nutrition and Drugs Many Roads to Dopamine Deficiency There is little doubt that dopamine deficiency is the major cause of the symptoms of Parkinson’s, and most drug therapy aims to improve the body’s ability to make dopamine from L-dopa. But, why do some people develop this impaired ability to make this key neurotransmitterA neurotransmitter is a chemical messenger that carries signals between body cells. They are various types of neurotransmitters which play a major role in everyday…? There are many answers to this question.
In some cases the neurons that produce dopamine don’t work properly, sometimes because they lack the raw materials, or the enzymes that turn the building blocks, amino acidsAmino acids are commonly known as the building blocks of protein. There are 20 standard amino acids from which almost all proteins are made. Nine…, into neurotransmitters. The neurons can die off or be damaged, for example by oxidants, or by environmental toxins such as pesticides and herbicides. Interestingly, researchers at the University of Miami have found levels of these chemicals to be higher in the brains of Parkinson’s sufferers.[2] The incidence of Parkinson’s is notably higher in rural areas where a lot of crop spraying takes place, and some pesticide combinations have shown a clear geographical correlation with incidences of the disease.[3,4] Deficiency of nutrients such as folic acidWhat it does: Critical during pregnancy for the development of a baby’s brain and nerves. Also essential for brain and nerve function. Needed for utilising… can also make these dopamine-producing brain cells more susceptible to damage.[5]
The balance of neurotransmitters, including dopamine, is controlled to a large extent by the process of methylationMethylation is what occurs when the body takes one substance and turns it into another, so that it can be detoxified and excreted from the…. Most people with Parkinson’s have raised homocysteineHomocysteine is an amino acid found in the blood. Elevated levels of homocysteine have been associated with narrowing and hardening of the arteries, an increased… levels[6], which indicates disrupted methylation patterns. However, whether raised homocysteine is a cause or consequence of the disease is not yet clear, since L-dopa medication tends to raise homocysteine levels.[7] Deficiency in vitamin B6 has also been linked to an increased risk of Parkinson’s, more so than folic acid or B12, the other key homocysteine-lowering vitamins; this suggests that B6 may play a specific part in preventing Parkinson’s in addition to its homocysteine-lowering role.[8] Either way, I recommend testing for homocysteine and supplementing homocysteine-lowering nutrients accordingly.
In addition to faulty methylation, sometimes there is a problem in how the body detoxifies, a job primarily done by the liver, leaving neurons unprotected.[9] Then there are other factors such as prolonged stress and the likelihood of genetic predispositions. Geoffrey and Lucille Leader figured that each of these pieces of the jigsaw puzzle could be made a lot better if sufferers followed a targeted optimum nutrition programme. They started to test patients with Parkinson’s disease and found that literally 100 per cent of them had nutritional deficiencies based on tests that measure what is going on within cells. They also found that many people were deficient in stomach acid and digestive enzymesDigestive enzymes break down carbohydrates, fats and proteins into their smallest components, allowing them to be absorbed by the body. Examples of digestive enzymes include…, leading to poor digestion, and had increased intestinal permeability, leading to faulty absorption of nutrients. Intestinal permeability is easily tested by drinking solution that shouldn’t pass through the gut wall, and then measuring urinary levels.
Using such a test, people with Parkinson’s disease may often show an increase in gut permeability or evidence of malabsorption. While there is no conclusive evidence yet that Parkinson’s disease is caused by nutrient deficiencies, the Leaders have found that correcting these deficiencies often helps. Brain Toxins, Oxidants and the Liver All this faulty digestion and absorption places extra stress on the liver, the detoxification capital of the body. Since the brain’s neurons can’t protect themselves from toxins, they depend on the liver. A simple example of this is alcohol – once you drink more than your liver can detoxify, you get drunk, which is what happens when brain cells are exposed to this toxin. In excess, you lose muscular control and movements, including speech, slow down. Problems with liver detoxification are often a hallmark of Parkinson’s patients.
One of the liver’s best detox allies is the sulphur-containing amino acids, which have the ability to mop up undesirable toxins in a process called sulphation. Researchers have reported faulty sulphation in patients with Parkinson’s, which can be helped by supplementing cysteine, methionine and molybdenumWhat it does: Helps rid the body of protein breakdown products, strengthens teeth and may help reduce the risk of tooth decay, detoxifies the body… and avoiding wine, coffee, certain cheeses and chocolate, all known inhibitors of sulphation.[10] Eating foods rich in glucosinolates, such as broccoli, Brussels sprouts, cabbage, cauliflower and kale, also helps the liver to detoxify. The greatest toxins of all are oxidants, or ‘free radicals’. Giving antioxidants helps to prevent free radical damage to brain cells and slows the progression of the disease.
In a 7-year pilot study, 21 patients with early Parkinson’s were given 3,000mg of vitamin CWhat it does: Strengthens immune system – fights infections. Makes collagen, keeping bones, skin and joints firm and strong. Antioxidant, detoxifying pollutants and protecting against… and 3,200iu of vitamin EWhat it does: Acts as an antioxidant, protecting cells from damage, including against cancer. Helps body use oxygen, preventing blood clots, thrombosis, atherosclerosis. Improves wound… daily. The need for drug therapy was delayed up to two to three years compared to those who did not receive the antioxidants.[11] Along with its negative effect on neurons, Parkinson’s also damages function in the mitochondria, which are the energy factories in our cells where energy conversion takes place. One of the most critical antioxidants for protecting mitochondria is coenzyme Q10 (CoQ10). The older you are, the more likely you are to be deficient. A study published in 2002 in the Archives of Neurology has determined that CoQ10 slows the progression of Parkinson’s disease.
Researchers at 10 different universities across the US tested a total of 80 Parkinson’s patients who were in the early stages of the disease and were not taking any medications for their condition. Participants took either a placebo, or 300, 600, or 1,200mg of CoQ10 once a day for 16 months, or until their condition required more traditional medical treatment. Halfway through the trial, there was already a marked difference between the four groups, with those participants given the 300mg and 600mg dosages noticing a lessening of their motor impairments, while those receiving the 1,200mg dosage experienced a significant reduction in their loss of motor function. By the end of the study, those in the 1,200mg group had a 44 per cent slower rate of deterioration, while those in the 300mg and 600mg groups enjoyed a 20 per cent slower rate of disease progression. These nutrients are some but by no means all of the allies that can support liver function, thereby preventing brain damage from toxins.
Dr Jeffrey Bland from Gig Harbor, Washington, an expert in liver detoxification, has also found tremendous improvement by supporting liver function with nutritional supplementation, increasing the effectiveness of drugs, reducing symptoms and boosting energy levels in those suffering from the early stages of Parkinson’s in studies.[12] It is best to fllow any liver detox programme with the supervision of a nutritional therapist if you have Parkinson’s. Personalised Nutrition Works Best The best results with Parkinson’s come from a total optimum nutrition approach. This involves both diet and supplements, helping to improve digestion, absorption, liver function and the cell’s ability to work properly and to produce dopamine, thus optimising cellular metabolismMetabolism is a term that is used to describe the chemical reactions that take place within the body’s cells. The body gets the energy it… and energy production.
As you can see in Figure 31, the ability to make dopamine efficiently depends on many vitamins and minerals. This includes nutrients such as zincWhat it does: Component of over 200 enzymes in the body, essential for growth, important for healing, controls hormones, aids ability to cope with stress…, magnesiumWhat it does: Strengthens bones and teeth, promotes healthy muscles by helping them to relax, also important for PMS, important for heart muscles and nervous… and the B vitamins, especially B6 and folic acid. Researchers at the National Institute on Ageing in the US found that mice fed a folic acid-deficient diet have a significantly greater risk of developing Parkinson’s-like symptoms. One likely reason for this is that without folic acid, the body produces too much homocysteine, a toxic substance that damages brain cells and so hinders dopamine production. Researchers at Boston University have found that a high homocysteine level is a strong, independent risk factor for the development of Alzheimer’s disease. [13] In mice fed adequate amounts of folic acid, they were able to repair the damage in dopamine-producing neurons and counteract the adverse effects of homocysteine.[14]
The Leaders have found the best approach involves a tailor-made nutritional programme of diet and supplements and have found that this may often reduce symptoms and make drugs more effective, thus optimising dosage. They recommend appropriate supplements based on patients’ biochemical individuality, including vitamins, minerals, essential fats, amino acids, antioxidants, phospholipids and brain-friendly herbs such as gingko. As with so many mental health problems, controlling blood sugar and checking and correcting food allergies or intolerances can make a big difference. The most common allergy-provoking foods are the glutenGluten is a protein found in the cereals wheat, rye and barley. Obvious sources of gluten in the diet are bread, pasta, breakfast cereals and… grains (especially wheat, but also rye, oats, barley and spelt) and dairy products. Managing stress is also important because we respond to stress by producing the stress hormones noradrenalin and adrenalin, which are made from dopamine. This is why the symptoms of Parkinson’s often get worse when the sufferer is stressed.
Working with Medication: What to Eat When The right diet is very important in such a strategy that tackles every piece of the jigsaw of Parkinson’s. Movement problems can get worse when dense proteinProteins are large molecules consisting of chains of amino acids. Proteins are essential nutrients for the human body – they are a building block of… foods containing certain amino acids in high proportion are eaten too close to the times of taking L-dopa medication.[15] This is because L-dopa competes with the amino acids for absorption at the receptor sites in the intestine and at the blood-brain barrier, so less gets through. To make best use of the L-dopa, protein-rich foods containing the other amino acids should not be eaten at the same time as taking L-dopa medication, according to the following guidelines: L-dopa medication and diet – what to eat when* L-dopa is affected by protein-containing foods which contain significant amounts of the amino acids: tyrosine, phenylalanine, valine, leucine, isoleucine, tryptophan, methionine and histidine. Foods which contain these amino acids include eggs, fish, meat, poultry, dairy produce (not butter), pulses, green peas, spinach, sago, soy, couscous, bulgar, coconut, avocado, asparagus and gluten-containing grains (oats, rye, wheat, barley, spelt).
• Take L-dopa medication Wait ONE HOUR or until the drug takes effect before eating any of the foods listed above. • After eating any of the foods listed above, wait TWO HOURS, if possible, before taking L-dopa medication again if it is needed.
*This dietary protocol has been developed and proven helpful by Dr Geoffrey and Lucille Leader and is reproduced with their kind permission.
With older types of the drug L-dopa, vitamin B6 caused its conversion to dopamine before reaching the brain. This was disastrous. Latterday L-dopa drugs contain a decarboxylase inhibitor, which inhibits premature carboxylation of L-dopa to dopamine. As such, vitamin B6, which helps turn L-dopa into dopamine, can be used safely together with the Parkinson’s drugs Stalevo, Sinemet and Madopar.[16] The drug selegiline is also often used for Parkinson’s disease. In higher doses (above 30mg), there is a risk of hypertensionHypertension is more commonly known as high blood pressure…. if a person eats foods rich in another amino acid – tyramine.[17] These include Cheddar and other strong cheese, ripe avocado, pepperoni, salami, soy sauce, old liver pâté, overripe bananas, brewer’s yeast, broad beans, Chianti, overripe or canned figs, Vermouth, Drambuie, yeast extract (marmite, etc.), miso soup, fish (pickled, salted or smoked), caviar, chocolate (large quantities) or caffeine (large quantities).
Some people are more susceptible to this dose-dependent side-effect than others, and few react at a dose of 10mg, which is commonly given for Parkinson’s.[18] While being careful to avoid these foods around medication, it is important to get enough protein from foods at other times. Good whole proteins include fish, and eggs. Many people choose to have their meal containing concentrated protein at night. This is because they do not need as much help with movement control at night as during the day when their L-dopa medication is necessary to see them through all their activities. Some people leave out L-dopa completely after the protein meal. Otherwise it is best to follow the time protocol for taking L-dopa with a protein-rich meal, as above.
It is also important to have a well-balanced diet throughout the day including fruits and vegetables, gluten-free wholegrains and plenty of fluids. A common problem in Parkinson’s is constipation. Having a diet rich in fruits and vegetables and drinking plenty of water throughout the day makes a big difference, as can a few prunes, figs or dried apricots with each meal, or psyllium husk capsules between meals with water. There are also special fibres, for example from papaya, which help relieve constipation In summary, with the appropriate individualised nutritional management there’s a good chance you can put the brakes on Parkinson’s disease. It may alleviate symptoms and reduce the speed of increasing drug dosages. I recommend the following:
• See a nutritional therapist or doctor who can assess you for nutritional deficiencies, digestive problems and liver function.
• Pursue a tailor-made nutritional strategy, including a specific diet regime that maximizes the effects of any medication.
• Have your homocysteine levels checked and supplement homocysteine-lowering nutrients accordingly
• Avoid environmental toxins and eat organic when possible.
• Do all you can to reduce your level of stress.
• Reduce auto-intoxication from constipation by eating here to four prunes, figs or apricots before each meal
Resources: For further information, read ‘Parkinson’s Disease Reducing Symptoms with Nutrition and Drugs’, available online from our bookshop. The following books, ‘Parkinsons The Way Forward’ and ‘Parkinsons’s Disease Dopamine Metabolism’, also by Dr Geoffrey Leader and Lucille Leader, are available from www.denorpress.com
REFERENCES:
1. V.L. Davidson and D.B. Sittman, Biochemistry: The National Medical Series for Independent Study, Harawl Publishing (1994), pp.477-8
2. L. Fleming et al., ‘Parkinsons’ disease and brain levels of organochlorine pesticides’, Ann Neurol, Vol 36(1), 1994, pp.100-3
3. M. Thiruchevlvam et al., ‘The Nigrostriatal Dopaminergic System as a preferential target of repeated exposures to combined paraquat and maneb: implications for Parkinson’s Disease’, Journal of Neuroscience, Vol 20(24), 2000, pp.9207-14 and J. Corell et al., ‘The risk of Parkinson’s disease with exposure to pesticides, farming, well water and rural living’, Neurology, Vol 67, 1998, pp.1210-18
4. L. Leader, Parkinson’s Disease – The Way Forward, Denor Press (2000), p.77
5. W. Duan et al., ‘Dietary folate deficiency and elevated homocysteine levels endanger dopaminergic neurons in models of Parkinson’s Disease’, J Neurochemistry, vol 80, 2002, pp.101-10
6. S. Hassin-Baer et al., ‘Plasma homocysteine levels and Parkinson’s disease: Disease progression, carotid intima-media thickness and neuropsychiatric complications’, Clin Neuropharmacol, Vol 29(6), 2006, pp. 305-11
7. R.B. Postuma et al., ‘Vitamins and entacapone in levodopa-induced hyperhomocysteinemia: A randomized controlled study’, Neurology, Vol 66(12), 2006, pp. 1941-3
8. L. M. de Lau et al., ‘Dietary folate, vitamin B12, and vitamin B6 and the risk of Parkinson’s disease’, Neurology, Vol 67(2), 2006, pp. 315-8
9. S. Hassin-Baer et al., ‘Plasma homocysteine levels and Parkinson’s disease: Disease progression carotid intima-media thickness and neuropsychiatric complications’, Clin Neuropharmacol, Vol 29 (6), 2006, pp.305-11
10. R.B. Postuma et al., ‘Vitamins and entacapone in levodopa-induced hyperhomocysteinmia: A randomized controlled study’, Neurology, Vol 66(12), 2006, pp.1941-3
11.L.M. de Lau et al., ‘Dietary folate, vitamin B12, and vitamin B6 and the risk of Parkinson’s disease‘, Neurology, Vol 67(2), 2006, pp.315-18
12. L. Leader, Parkinson’s Disease – The Way Forward (2001), p.87, ‘Optimizing Function by Nutritional Manipulation’, p.145, ‘Liver Detoxification and Optimal Liver Function’, Helen Kimber
13. G.B. Steventon et al., ‘Plasma cysteine and sulphate levels in patients with motor neurone, Parkinson’s and Alzheimer’s Disease’, Neurosci Letts, Vol 110, 1990, pp.216-20
14. S. Fahn, ‘A pilot trial of high dose alpha-tocopherol and ascorbate in early Parkinson’s Disease’, Ann Neurol, Vol 32(S), 1992, pp.128-32
15. J.S. Bland and J.A. Bralley, ‘Nutritional upregulation of hepatic detoxification enzymes’, J Applied Nutrition, Vol 4, 1992, pp.3-15
16. R.B. D’Agostino et al., ‘Plasma homocysteine as a risk factor for dementia and Alzheimer’s disease’, N Engl J Med, Vol 346(7), 2002, pp. 476-83
17. W. Duan, M.P. Mattson et al., ‘Dietary folate deficiency and elevated homocysteine levels endanger dopaminergic neurons in models of Parkinson’s disease’, J Neurochem, Vol 80(1), 2002, pp.101-10
18. G.Leader and L. Leader, Parkinson’s Disease – The New Nutritional Handbook, Denor Press, (1996/7), p.96
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