Dr. Weyrich's Naturopathic Functional Medicine Notebook is a collection of information on topics of interest to Dr. Weyrich that may be of interest to the world wide audience. Due to limitations of time, not all information that Dr. Weyrich knows or would like to further research is published here. Dr. Weyrich welcomes financial contributions to support specific research topics, as well as copies of non-free access journal articles for him to review on a topic. Constructive criticism is also welcome.

Overview of Parkinson's Disease

A neurodegenerative disease primarily affecting dopamine production in the substantia nigra region of the brain.

Complimentary and alternative treatments for Parkinson's disease that are considered below include:

  • Low Dose Naltrexone
  • Conventional Neuro-feedback
  • Neurotransmitter Balancing
  • Herbal Medicine
  • Nutritional Medicine
  • Genomics, Epigenetics, and Nutrigenomics
  • Art Therapy
  • Treat H. Pylori infections

Signs and Symptoms of Parkinson's Disease

According to [https://www.parkinson.org/symptoms_primary the most common symptoms of Parkinson's disease are:

  • Resting tremmor (e.g. unintentional "pill-rolling" movement of hands when they are idle.)
  • Rigidity (stiffness of the spine, arms, and legs).
  • Generalized slowing of motion (bradykinesia). Some patients pause or freeze when moving without being able to start again.
  • Postural instability: (loss of strength, balance, coordination; flexed posture).

Other symptoms of Parkinson's disease include:
  • Mood changes, such as depression and fatigue.
  • Urinary problems.
  • Trouble speaking normally.
  • Low blood pressure.
  • Digestive issues, including constipation.
  • Trouble sleeping, including difficulty turning in bed.
  • Skin problems.
  • Drooling.
  • Increased sweating.
  • Muscle spasms and cramps.
  • Voice changes.
  • Erectile dysfunction.
  • Shuffling gait.
  • Cogwheel rigidity (jerky motion).
  • Lack of facial expression (e.g. mask-like face).
  • Changes in handwriting (especially becoming smaller).
  • Difficulty swallowing.
  • Loss of smell.
Symptom Assessment Tools
  • [Geminiani1991]
  • Webster Rating Scale (WRS) [Webster1968], [Geminiani1991], [Ginanneschi1988], [Kennard1984], [Ramaker2002].
  • Columbia University Rating Scale (CURS) [Ramaker2002], [Hely1993], [Ginanneschi1988],
  • Sidney Scale [Hely1993].
  • Parkinson's Disease Impairment Scale [Ramaker2002],
  • Northwestern University Disability Scale (NUDS) [Ramaker2002]
  • Schwab and England Disability Scale [Ramaker2002]
  • Intermediate Scale for Assessment of Parkinson's Disease [Ramaker2002]
  • Extensive Disability Scale [Ramaker2002]
  • New York University Impairment and Disability Scale [Ramaker2002]
  • University of California Los Angeles Impairment and Disability Scale [Ramaker2002]
  • Unified Parkinson's Disease Rating Scale (UPDRS) [Ramaker2002]
  • Short Parkinson Evaluation Scale [Ramaker2002]
  • Hoehn and Yahr staging [Ginanneschi1988], scale for assessment of functional disability (ADL), SCAG-scale, Hoehn & Jahr-scale (HY), mod. Webster step second-test (WSST), Purdue-pegboard, questionnaire for subjective complaints (SC), WDG, LPS1/2, 3/4, 6, 7, 10, clinical assessment of dementia, v. Zerssen-scale and orthostatic hypotension (60 degrees tilt up).
  • [https://parkinsonslife.eu/free-online-tool-allows-you-to-track-parkinsons-symptoms/
  • [https://www.parkinsons.org.uk/sites/default/files/2017-12/The%20Parkinson%27s%20Disease%20Questionnaire.pdf
  • [https://www.parkinsons.org.uk/professionals/clinical-tools-and-assessments

Etiology of Parkinson's Disease

Some practitioners have noted an association with inflammatory process mediated by homocysteine [Rogers2008, pg 9]. Note that the common diuretic hydrochlorothiazide (HCTZ) increases homocysteine levels [Westphal2003].

See [https://en.wikipedia.org/wiki/Causes_of_Parkinson%27s_disease].

Other possible environmental or genetic factors include lead, iron, aluminum toxicity, pesticides, dairy, dry cleaning chemicals, malnutrition (overconsumption or deficiency), dairy, mitochondrial insufficiency, reactive oxygen species, Heliobacter pylori, elevated homocysteine.

According to [Mischlev2010], "elevated homocysteine levels [may be] associated with worsening PD motor symptoms, dyskinesias, and ... cognitive symptoms." [Qureshi2008], [Kuhn1998], [67] Muller T, Werne B, Fowler B, Kuhn W. Nigral endothelial dysfunction, homocysteine, and Parkinson's disease. Lancet Jul 10 1999;354(9173): 126-127.

Differential Diagnosis of Parkinson's Disease

See [Stacy, M. and J. Jankovic. Differential diagnosis of Parkinson's disease and the parkinsonism plus syndromes. Neurol Clin 1992;10(2): 341-59.]

Treatment of Parkinson's Disease

Please see conventional, complimentary and alternative medical treatments for important background information regarding the different types of medical treatments discussed below.

Allopathic Treatments

See [Olanow2009].

Naturopathic, Complimentary and Alternative Treatments

Parkinson's disease is a multi-factorial neurodegenerative disease that is caused by a combination of various factors, including environment and the individual's genetic propensities. As such, different treatments will most benefit different individual patients. Often a judicious combination of several of the following interventions will give maximum benefit to an individual suffering from Parkinson's disease. However, there is no clear algorithm for choosing the interventions that are most likey to benefit any individual patient, and trial and error "therepeutic trials" are necessary.

Low Dose Naltrexone (LDN)

According to the Low Dose Naltrexone home page [LDN], Parkinson's Disease is a neurodegenerative disease that is associated with autoimmune processes. LDN has been seen to benefit Parkinson's Disease. [LDN_Autoimmune] presents a case review of seven patients with Parkinson's Disease who were treated with LDN by the late Dr. Bihari [Bihari2003], [Bihari2013]. The result was that "all [seven] have shown no progression since beginning LDN. Indeed, two of them have shown clear evidence of improvement in signs and symptoms."

Dr. Weyrich has been trained in the use of Low Dose Naltrexone (LDN). However, Dr. Weyrich has not treated any cases of Parkinson's Disease with LDN.

Please see What is Low Dose Naltrexone? for more information.

Conventional Neuro-feedback

Neuro-feedback may be useful for treating Parkinson's disease. Dr. Weyrich has been certified in Neuro-feedback since 2008, and more recently completed an additional residency training program at ADD Clinic of Scottsdale, AZ. However, Dr. Weyrich has not treated any cases of Parkinson's disease with this technique.

Please see What is Neurofeedback? for more information.

Neurotransmitter Balancing

Neuro Research [Hinz2015] reports that Parkinson's Disease can be benefited by balancing neurotransmitter levels in the body.

Dr. Weyrich has been trained in neurotransmitter balancing protocols, but has not treated Parkinson's Disease using this technique.

Please see What is Neurotransmitter Balancing? for more information.

Herbal Medicine

  • Coffee consumption may cause earlier onset of Parkinson's disease, and therefore may be contraidicated in succeptible individuals [Kandinov2009].
  • Tea Contains antioxidants and may chelate iron out of the brain [Kandinov2009].
  • Velvet bean (macuna) is a natural source of levodopa. However, it is toxic to persons who have a rare genetic disorder called G6PD deficiency [Katzenschlager2004], [Manyam2004], [Misra2007], [Tharakan2007].
  • Fava Beans are a natural source of levodopa. However, they are toxic to persons who have a rare genetic disorder called G6PD deficiency.
  • Turmeric (curcumin) may be effective in vitro in reducing α-synuclein [Ono2006]. Turmeric contains antioxidant and anti-inflammatory compounds that have a sparing effect on the glutathione system and benefits mitochondrial health [Sun2008], [Jagatha2008].
  • Marijuana may be helpful in treating dyskinesia associated with Parkinson's disease. Dr. Weyrich makes no recomendation regarding the use of medical marijuana. [Venderova2004], [Carroll2004].

Nutritional Medicine

Genomics, Epigenetics, and Nutrigenomics

By identifying genetic propensities in an individual patient that are associated with Parkinson's disease, the most appropriate interventions for each individual patient may be more precisely identified, thereby reducing the amount of trial and error in designing the most effective treatment protocol.

Genes associated with Parkinson's disease include the following:

Please see What are Genomics, Epigenetics, and Nutrigenomics? for more information.

Treat H. Pylori Infections

There appears to be a significant association between Parkinson's disease and peptic ulcer disease. Peptic ulcer disease, in turn is most commonly associated with <&LOCAL_INLINE hpylori.html " Heliobacter pylori infections [Strang1965], [Szabo1979], [Dobbs2005], [Dobbs2008], [de-la-Fuente-Fernandez2002], [Bjarnason2005].

According to [Mischlev2010], "Researchers have demonstrated that gait can improve dramatically following eradication of H. pylori."

Art Therapy

Please see [Mischlev2010].

Pathophysiology of Parkinson's Disease

Lewy bodies are found at autopsy in the cytoplasm of neurons in the substantia nigra, and are associated with Parkinson's disease, as well as certain dementias and Down syndrome. Many elderly patients have Lewy bodies without neurological symptoms [Jellinger2004].

Lewy bodies are composed of two proteins, the abnormal protein α-synuclein and the normal protein ubiquitin [Olanow2004].

It is unclear whether Lewy bodies cause death of dopaminergic neurons, or whether they are a side effect of some other process.

References for Parkinson's Disease