Dietary Supplements and Parkinson's

 

If I'm being honest, I've been eating unhealthy food all my life. My credo was: give the body what it wants, just not too much and then it will fit. 

So my menu mainly consisted of meat, sausage, white bread, junk food and all sorts of sweet things. There was no room for vegetables and fruit (except for strawberries) and all the greens have never tasted good to me.

There was an occasional bad conscience Dietary Supplement, mostly vitamin D (because I was also a couch potato), vitamin C, calcium, magnesium and vitamin B12 complex. Every now and then some probiotic.

In between there was a fitness studio contract for 6 months every few years, which I no longer or only sparingly used after 2 months at the latest. Of course, I consumed plenty of protein shakes during this time.

When I asked my doctor if he could advise me on any supplements based on my blood work, the same mantra always came back: "Eat a healthy diet, lots of fruit and vegetables, little meat, whole grain bread", then you can access the whole - I quote – “stuff” – abstain.

After surviving a mesenteric vein embolism, not being able to tolerate more and more food for 5 years, my 4 cerebral arteries are no longer completely patent, meanwhile I maintain the blood supply to my heart with 4 stents and, to make matters worse, I also got Parkinson's, I had my doubts seriously on my credo "Give the body what it wants...".

Without question, my lifestyle has made a not inconsiderable contribution to my frailty. I'm not sure how big the contribution was. But I know that the nutritional supplement industry has made it very easy for me with their promises of salvation and with their false appearance of being "natural" or even medicinal.

Today I eat healthily, with occasional small slip-ups. My food intolerances have almost completely disappeared, I do a lot of sport and, if you generously disregard my Parkinson's symptoms, I feel fit.

I only allow nutritional supplements into my body when my doctor usually recommends a vitamin preparation due to the high dose of medication that has become available, as the required amount cannot be adequately provided through the daily diet.

This is my very personal story. Yours may be a different, more positive one. In order to create a certain balance, we should rather let the experts have their say.

The BfR - Federal Institute for Risk Assessment - has its say first.
The BfR has produced a small educational cartoon about nutritional supplements in sport, which gives us an easy introduction to the complex topic.

But what happens when Parkinson's comes into play? Are there positive or negative interactions?

Dr. Ilona Csoti, Medical Director of the Gertrudis Klinik Parkinson Zentrum in Biskirchen. Your contribution also expands the spectrum to include the subject of spices.

Dietary Supplements, Spices, and Parkinson's

An alliance that is not always sacred ...

Interactions between drugs (called interactions) are understood as mutual influencing of their effects and / or tolerability. They can occur when two or more drugs are administered at the same time, the risk increasing with the number of drugs used.

Currently there is a causal one Therapy Parkinson's syndromes (PS) are not possible. With modern drug combination treatment we can alleviate symptoms of the disease and improve quality of life over a long period of time, but a cure or even a halt cannot be achieved. Many sufferers therefore hope that various nutritional supplements/spices will have a preventative effect and/or slow down the progression of the disease. If you believe the numerous suppliers, the substances it contains are intended to reduce the cell-destroying oxidative stress in the cells in the brain affected by the disease and thus slow down the cell damage and thus the progression of the disease.

Dietary supplements, also known as supplements, are considered food. But that alone is not enough to feed oneself. They supplement the general diet with micronutrients such as vitamins, minerals, trace elements or other substances in concentrated form and often in high doses. For this reason, overdosing is possible, which is definitely not an advantage, but rather risky. They are not considered medicinal products and for this reason do not have to go through an official approval process. Accordingly, there is no test for harmlessness to health and material purity. Food supplements, although they are offered in a drug-like form, must be clearly differentiated from them, in particular with regard to the effect of the ingredients and the application. Most preparations are useless for healthy people if they eat a largely balanced diet. For certain risk groups - and this also includes Parkinson's patients - it can be useful to take selected food supplements.

 

In contrast to food supplements, spices are parts of plants that are used in small quantities as flavoring and odor-giving ingredients for general nutrition. This includes dried herbs, but also seeds, fruits, leaves, flowers and flower parts, roots and rhizomes, bark and onions. The desired effect is due to the natural content of flavors and aromas, which are mostly found in essential oils. Spices can be microbiologically contaminated, for example by mold toxins or pathogens such as salmonella. For this reason, they are regularly examined by the State Office for Health and Food Safety for their microbiological quality, as are the food supplements. This should be taken into account when buying spices from less strictly controlled cultivation.

Most of the scientific studies on this topic deal with how one can best protect oneself against this disease through a certain diet, i.e. with prophylaxis. Good study results in those already affected by the disease with regard to symptom control or prognosis are limited and limited to a few really necessary supplements. However, deficiencies are to be expected in Parkinson's patients and have also been proven, especially due to the low-protein diet that has been propagated for decades, age-related malnutrition (malnutrition and / or malnutrition) and the Parkinson's-associated metabolic and organ toxicity (e.g. gastric and intestinal paralysis) . Dopamine replacement therapy can also lead to harmful breakdown products in long-term treatment with higher L-Dopa doses and, as a result, to a lack of vitamins, especially the B vitamins (B12, B6 and folic acid).

In the by Mischley et al. "CAM Care in PD" study (Complementary and alternative medicine in Parkinson's disease) published in 2017, asked 1 Parkinson's patients with online questionnaires about their illness data and dietary habits. Result: fresh vegetables, fresh fruits, nuts, seeds, olive oil, wine, coconut oil, fresh herbs and the use of spices were associated with a slower course of the disease. The following supplements were taken by the patients with different frequencies: inosine, glutathione, DHEA (dehydroepiandrosterone), coenzyme Q307, fish oil, quercetin, turmeric, gingko biloba, coconut oil, reveratrol, vitamin D, alpha-lipoic acid, probiotics, NADH (nicotinamide adenine hydride), Multivitamin supplements, calcium, vitamin B10, vitamin B6, folic acid, N-acetylcysteine, rubidium, estrogen, mucuna pruriens, fava beans, melatonin and iron. After eliminating all possible statistical errors, only fish oil was associated with slower progression. It is rich in omega-12 fatty acids, which are said to have anti-inflammatory and cell-protecting effects. It should be noted that this is a subjective assessment of the patient based on a questionnaire.

A review article published in 2020 on the topic of “Lifestyle and nutrition in Parkinson's disease” selected 6 out of more than 000 publications as relevant. In addition to the above-mentioned food supplements, reference is made here to the protein deficiency threatened by the disease and a recommended source of 55 mg whey protein spread over the day, as it is difficult to find organic meat or poultry for a sufficient protein intake and glutathione is ineffective as food supplements seems to be. The cysteine ​​contained in whey is required for glutathione production, which supports detoxification. The importance of good digestion is also pointed out, which can be supported by a high-fiber diet and exercise. Finally, the negative influence of lack of sleep and stress is discussed. In our own literature research from 20, numerous studies on food supplements were also found. Here are some additions:

A vitamin D deficiency is common in Parkinson's patients and is associated with an increased risk of falls and injuries. In several studies, an oral diet supplement with vitamin D (1000 IU / d) led to a significant reduction in fractures (broken bones). If osteoporosis is proven, additional calcium should be given if the calcium intake is below 1 mg / d (current DVO guideline on osteoporosis). Modern vitamin D supplements are combined with vitamin K000 to support the correct utilization of calcium. Note: A natural calcium supply can be provided by mineral water with a high calcium content. However, it should be noted that a vitamin D overdose can lead to permanent kidney damage.

Because of the risk factors already mentioned above, Parkinson's sufferers can experience a deficiency in B vitamins, especially vitamin B12, vitamin B6 and folic acid. A deficiency in niacin has also been reported in recent studies. However, it is also known that an untargeted "watering can treatment" with vitamin B complex preparations can even be harmful under certain circumstances. In particular, an overdose of vitamin B6 can lead to an inhibition of the L-DOPA effect! However, such an overdose only seems to occur with synthetic vitamin preparations, not with natural vitamins in food. Replacement therapy with B vitamins should therefore only take place if a deficiency has been determined by a blood test. A clear deficiency in vitamin B12 can be quickly compensated for by injections, after which oral therapy can be switched to. Slight deficiencies in vitamin B6 can be compensated for through diet. B6 can be found in legumes, nuts, herbs and spices, among other things.

A Mediterranean diet is rich in these antioxidants and is said to protect against Parkinson's. So far, however, no such neuroprotective effectiveness has been demonstrated in those affected for such food supplements.

Ubiquinone is structurally related to vitamins K and E and is involved in energy production as a coenzyme within the respiratory chain. Since there is a disturbance of cellular respiration in Parkinson's disease, the hypothesis was put forward that high-dose coenzyme Q10 can have a neuroprotective effect. This was supported by results from cell culture studies and in the Parkinson's animal model. In a study carried out by the Parkinson Study Group (QE3) with 600 patients, however, it was not possible to slow down the disease at a very early stage. Taking into account the study results, the use of Q10 for neuroprotection in Parkinson's patients in early stages of the disease cannot be recommended.

Foods containing nicotine, including tomatoes, potatoes, eggplants, chillies, and peppers, have been shown to have a reduced risk of Parkinson's disease in men and women who have never smoked. Lycopene, the red pigment in tomatoes, was able to protect dopaminergic nerve cells from oxidative stress in animal experiments. In animal experiments, mustard oil glycosides have an antioxidant effect. They are particularly found in cruciferous plants such as broccoli, but also in cauliflower, white cabbage, red cabbage, horseradish, rocket, cress and mustard. They give these vegetables their characteristic pungent taste. An inhibitory effect on monoamine oxidases (MAO) A and B has been demonstrated for several colorants (anthocyanins) in red berries and vegetables. Strawberries, raspberries, blackberries and heather as well as elderberries are particularly rich in anthocyanins, as well as grapes, cherries, beetroot and red cabbage. For foods containing carotene (including kale, carrots, sweet potatoes, parsley) and beta-carotene, epidemiological studies have shown a neuroprotective effect: they have antioxidant properties and protect against free radicals. Systematic clinical studies with Parkinson's patients are lacking. When soybean oil is extracted, soy lecithin is produced as a by-product, which contains the isoflavone genistein (soybean, tofu, chickpeas, kidney beans, broccoli, dark chocolate) and vitamin E, among other things. In animal studies, genistein showed neuroprotective properties and improved learning and memory.

There are no systematic studies with Parkinson's patients. Fenugreek (BHK) are said to have cell-protecting, antioxidant and anti-inflammatory properties. In addition to vitamin C, iron, calcium and magnesium, fenugreek seeds contain steroid saponins, bitter substances and trigonellin. The polyphenols theaflavin or epigallocatechin gallate contained in tea are said to have antioxidant, antiapoptic and anti-inflammatory properties. Based on the findings from numerous preclinical studies, polyphenols from green tea have been tested in the treatment of Denovo Parkinson's patients. However, the study could not find any effect. In addition to caffeine, coffee also contains theophylline, various flavonoids and tannins with an antioxidant effect. Caffeine and synthetic adenosine A2A antagonists are being investigated in phase II and III clinical trials for the symptomatic treatment of Parkinson's disease. Istradefylline, an A2A adenosine receptor antagonist and an analogue of caffeine, was approved for the treatment of Parkinson's disease in Japan in 2013 and in the USA in 2018. The flavonoids resveratrol and quercetin contained in red wine had a proven neuroprotective effect in Parkinson's animal models. Part of the neuroprotective effect of red wine is attributed to oligomeric proanthocyanidins (OPC). These are, for example, bioflavonoids which also occur in grape seeds and which are composed of several flavanols. In grape seeds these are z. B. catechin, epicatechin, epicatechin gallate, epigallogatechin-3-gallate and gallocetechin. They have an antioxidant and anti-inflammatory effect.

Several studies found lower levels of iron, copper and zinc in Parkinson's patients (compared to healthy control groups), while the level for selenium did not differ significantly. The effectiveness of food supplements in patients with an existing, laboratory-proven iron deficiency or restless legs syndrome is undisputed. In this case, if ferritin levels are below 50 μg / l, substitution with iron is recommended. A zinc deficiency can lead to wound healing disorders, which are more common in Parkinson's patients. However, it has not been systematically investigated whether substitution leads to an improvement in disease symptoms or prognosis in all patients.

The spice curcumin has been used in Ayurvedic and Chinese medicine for 2500 years. It comes from the rhizome of turmeric (turmeric). The polyphenol curcumin is synthetically produced as E 100 as a color in foods, but also as a flavor carrier in curry powder. Studies suggest antioxidant, anti-inflammatory and analgesic effects. In Parkinson's laboratory models, it showed a neuroprotective effect.

In summary, food supplements can only be recommended without reservation if there is an existing deficiency, mainly due to the mixed study situation on the effectiveness, especially in Parkinson's disease. However, spices and a balanced diet with vitamins, minerals and secondary plant substances are harmless and have been proven to be beneficial. In addition to regular exercise, nutritional supplements with whey protein appear to be useful against the threat of muscle breakdown (sarcopenia), and the low-protein diet recommended for years should be avoided.

Gertrudis Clinic Parkinson Center GmbH 

Specialized neurological hospital

Karl-Ferdinand-Broll Str. 2-4.

D-35638 Leun-Biskirchen 

Phone: 06473-305-0

Fax: 06473-305-57

Email: info@parkinson.de

Medical Director

 dr medical Ilona Csoti

 September 13, 2021

 

Miss Dr. Csoti told me that many patients in the admission laboratory were demonstrably overdosed. Vitamin B6 in particular is not safe for Parkinson's patients; she sees the most frequent overdoses when taking vitamin B complex.

This also coincides with my observations in the individual Parkinson's forums. The tenor within the communities is more pro food supplements and the recommended dosage is usually a very subjective result, triggered by try and error, and not by a doctor's recommendation.

Let's keep in touch and tell me what you think

If you have suggestions or want to get rid of criticism, this is the right place for it.

0 Comments

Leave a comment

Participate in the discussion?
Leave us your comment!

Would you like to comment on the article or add something?

This website uses Akismet to reduce spam. Learn more about how your comment data is processed.

Sometimes a simple star rating is enough


Your rating
[Total: 2 Average: 4]
You don't want to miss a thing. Then just subscribe to me.

[email-subscribers-form id=”2″]

Could the post interest your friends? Then you can share it here.


Facts Parkinson Journal

more articles from the rubric advice

It is gefunden werden konnte leider nichts

Sorry, no entry meets your search criteria

PHP code snippets Powered By: XYZScripts.com