Conventional medicine’s track record in fighting Parkinson’s is awful. After hundreds of millions—if not billions—of dollars in research, there are simply no medications available that can dramatically slow the progression of this devastating disease.
However, there are many medications and some supplements to treat the symptoms associated with it. If someone in my family had this disease, I would not hesitate to try one of the supplements recommended in this section to at least reduce the risks or complications associated with it, such as dementia, depression, or bone loss.
Several major clinical trials of supplements for Parkinson’s are being conducted, which reflects the desperate need for effective treatments.
What is Parkinson’s Disease?
Parkinson’s disease (PD) is a progressive neurodegenerative disorder with a variety of potential symptoms, including slowness of movement, rigidity (movements are not smooth), tremors usually during rest, difficulty walking (gait abnormalities), loss of muscle mass and strength, and an increase in muscle and joint pain. Dementia, depression, and other mental health issues are also common with this disease (see the Alzheimer’s Disease, Dementia, and Mild Cognitive Impairment section and the Depression section). In fact, it’s now the second leading cause of dementia.
Although experts aren’t sure what causes it, people with PD do have an abnormally low number of neurons in a part of the brain known as the substantia nigra pars compacta (as well as differences in other supportive brain structures). The loss of neurons, which are the primary providers of dopamine to other parts of the brain, can lead to some of the physical problems of PD. This is why the main treatment for PD, which has been the primary treatment since I was a baby (that is a long time, folks), is using drugs that increase dopamine levels in the brain.
What are the Best Supplements For Treating Parkinson’s Disease?
1. (tie) Inosine (inosine monophosphate) 500 to 3,000 milligrams a day, depending on uric acid levels
If the research on this supplement continues to be positive, it will take the top spot soon, although it does come with risks (more information on that in a moment). Inosine plays a role in energy production in the body, which has intrigued athletic-performance researchers for years (so far to no avail). But inosine has other roles, and here’s what’s really fascinating about this compound: It can dramatically raise uric acid, which naturally blocks certain compounds that increase inflammation in parts of the body, including the brain. Parkinson’s patients often have lower uric acid (or urate) levels than people without the disease. In some cases, PD sufferers with higher urate levels appear to have a slower progression of the disease. Researchers are currently studying inosine for relapsing-remitting multiple sclerosis and Parkinson’s disease specifically for this reason (see the Multiple Sclerosis section). The complete outcome is still unknown, but it appears to be helping some patients with multiple sclerosis, and I have had families of PD patients swear by it.
The Michael J. Fox Foundation for Parkinson’s Research and other groups helped finance the latest inosine study, called SURE-PD (Safety of Urate Elevation in Parkinson’s Disease). Researchers studied doses of 500 to 3,000 milligrams of inosine per day (versus placebo) in early-stage PD patients with urate levels less than 6 mg/dL at baseline. The preliminary results came in as I was finishing this article: Not only was inosine as safe as a placebo overall (no significant differences in side effects except for three cases of kidney stones in the inosine group of 51 patients over 24 months), but it also significantly raised uric acid levels in the cerebrospinal fluid and blood and there’s some hint that it could be slowing the progression of the disease. The SURE-PD researchers announced that inosine should move to a Phase 3–like trial ASAP. Based on these results, it’s time to talk about this option with your doctor today.
Inosine increases the risk of kidney stones, so if you have a history of gout or kidney issues, you should avoid it or work closely with your doctor to make sure your uric acid levels are not going too high.
1. (tie) Creatine monohydrate 20 grams for 5 days and then 4 to 10 grams a day
Creatine is well known in athletic circles for providing a minimal to moderate exercise boost. Small studies have shown significant improvement in muscle strength and reduction in muscle fatigue with 5 grams per day (after a loading, or “ramp up,” dose of 20 grams daily for the first 5 days). Studies with PD patients have shown that creatine monohydrate, along with resistance exercise, may improve muscle weakness, fatigue, muscle loss, and mood and may allow some people to reduce their dose of conventional dopaminergic drugs. Researchers have studied daily doses as low as 4 grams, and they appear to be as safe as a placebo (except for some weight gain).
The results with creatine are so compelling—not only as an energy source for muscle tissue but also as a neuroprotectant— that it is moving to a major government-funded Phase 3–like trial with PD patients (the FDA requires Phase 3 trials for pharmaceuticals before approving them). The National Institute of Neurological Disorders and Stroke Exploratory Trials in Parkinson’s Disease network is conducting a study, called LS-1, that will track 1,700 PD patients over 5 years to see if creatine monohydrate (10 grams daily) slows clinical decline better than placebo. It’s the largest trial ever of early-stage PD!
The biggest concern over creatine is whether these dosages might negatively impact kidney function in older patients, but this hasn’t been an issue so far in clinical studies. This side effect is overhyped by people who don’t have much knowledge in the area of supplements or PD. Weight gain and (rarely) gastrointestinal upset are more of an issue.
2. Vitamin D3 1,200 IU a day or enough to raise blood levels to approximately 40 ng/mL
If you read all the other sections in this article, you’ll know that I rarely recommend vitamin D supplementation and testing. It’s simply overhyped these days. But I am recommending it for Parkinson’s patients! Vitamin D reduces the risk of falls in older people, and PD patients have a higher risk of falls and hip fractures (plus, they tend to be low in D).
In a 12-month randomized trial with 114 Parkinson’s patients in Tokyo, vitamin D3 appeared to reduce the progression of the disease, which may simply be a result of increasing muscle strength and balance (most tissues and cells have receptors for this vitamin, including muscle tissue, and improving the ability of the muscles to finely coordinate activity improves balance).
Patients in this trial started with a vitamin D level of 22 ng/mL, which increased to 42 ng/mL after taking 1,200 IU per day (side effects were similar to the placebo). This study suggests low vitamin D levels could increase disease progression because there was little to no progression in the supplement group compared to the placebo group.
3. Caffeine pills 50 to 200 milligrams twice daily maximum or 1 to 2 cups of coffee
Some of the largest epidemiologic studies to address the impact of caffeine on disease prevention have essentially found that just two to four cups of coffee a day— about 300 milligrams—could reduce the risk of Parkinson’s.
And they have discovered that caffeine may improve some of the symptoms of PD as well. Caffeine works by blocking receptors of a substance called A2A adenosine that may play a role in Parkinson’s symptoms. The equivalent of 1 to 2 cups of coffee per day may reduce involuntary movements (such as tremors) and may increase the ability to perform voluntary movements.
It can also help with fatigue, which is a problem in PD patients, so I’m a fan regardless. Most clinical trials have used between 100 to 200 milligrams in pill form twice a day, but I’ve seen 50 milligrams work, too (an 8-ounce cup of coffee contains about 100 milligrams), and studies have shown that caffeine in beverages may work just as well. In the CALM-PD trial, subjects who consumed more than 12 ounces of coffee a day reduced their risk of developing dyskinesia, which is difficulty performing voluntary movements, a common side effect of Levodopa treatment for Parkinson’s. (You can also get caffeine in guarana, an Amazonian plant, and in yerba mate, but look for the tea or drink forms because pills with these ingredients lack good research up against the beverage sources in the area of PD.)
4. Omega-3 fatty acids
Omega-3 fatty acids (at just 1,000 to 2,000 milligrams per day) may have a slight impact on depression in people without PD, but more research on this is needed. A well-done smaller, older trial with PD patients from Brazil found that taking fish oil with or without regular antidepressants appeared to further reduce depressive symptoms when compared to a placebo. And other studies in elderly patients without PD suggest omega-3 fatty acids might help maintain and increase muscle.
There is no question that omega-3s from marine sources are overhyped, but this is a situation where there is at least some rational reason for testing it.
What Supplements Are Useless For Treating Parkinson’s Disease?
High doses of CoQ10 and vitamin E. Preliminary studies suggested that large doses of these two supplements could slow the progression of PD, but it looks like a bust. The National Institute of Neurological Disorders and Stroke stopped a large Phase 3 trial (known as the QE3 study, administered by the Parkinson Study Group) in progress because these dietary supplements in large doses were not helping early-stage PD patients.
What Lifestyle Changes Can Help With Parkinson’s Disease?
Heart healthy = brain and body healthy
Lowering cholesterol may decrease the risk of PD because it could have an anti-inflammatory effect and improve bloodflow in the brain. Moderate to vigorous exercise (30 to 60 minutes) on most days of the week is also associated with a lower risk, again, perhaps due to improved bloodflow. Interestingly, smoking/nicotine use may reduce the risk of PD.
Control your blood sugar
Diabetes may increase the risk of brain cell damage as well as PD. Reducing glucose to normal levels could help slow the progression of the disease.