Without Exercise there can be no Effective Treatment for Parkinson's

Physical activity is essential for life, for health. But sport is as necessary for the Parkinson's sufferer as Levodopa, proper nutrition or sunbathing (vitamin D). There are hundreds of scientific studies that prove it: EXERCISE IS A "MEDICINE" FOR PARKINSON'S. The Dutch neurologist Bastiaan Bloem sends the exercise in prescriptions so that his patients become aware of its CRITICAL IMPORTANCE. Always adapted to the situation of each patient by his neurologist: progressive, prudent and safe to avoid falls, injuries, etc.

Some of the benefits of exercise. No medication or treatment can achieve this:

Intense physical exercise on a static bicycle (especially forced exercise done in tandem with a healthy person) provides an improvement in motor symptoms of about 35-40%, similar to a dose of levodopa (Alberts 2011). Exercise also promotes neuroplasticity and neurogenesis (Mattson 2000). It can even prevent it by 43% (Yang 2015), delay the onset of symptoms (Tsai 2002), and slow and stop the progression of the disease (Oguh 2014).

Exercise is the essential complement to any treatment that might be designed for this disease (Formisano 1992). Nothing can replace it. In 1992, Sasco and colleagues were the first to publish an epidemiological study on the benefits of physical exercise for Parkinson's.

    
EXERCISE, A "MEDICINE" TO PARKINSON´S DISEASE.

Some of the extraordinary benefits of the "medicine" called exercise to treat Parkinson's:

   1. Increases dopamine, promotes neuroprotection, neurogenesis

   and neuroplasticity (Lau 2011, Tillerson 2001, 2002, 2003; Mattson 2000, 2003).

   2. Improves mental or cognitive ability (David 2015).

   3. Improvement of up to 40% in symptoms (Alberts 2009, 2011).

   4. Prevents or delays the disease by up to 43% (Ahlskog 2011, Tsai 2002, Yang 2015)

   5. Stops its usual progression (Oguh 2014).

   6. Improves depression and sleep disorders (Butler 1998, Reynolds 2016)).

   7. Lack of exercise increases the risk of Parkinson's disease (Xu 2010).

   8. Improves the perceived well-being of the patient (Baatile 2000).

   9. Fewer falls occur (Allen 2011)

   In short, almost everything improves: motor symptoms (Prodoehl 2015, David 2016, Chung 2016, Bhalsing 2018) and non-engines (David 2015, Reynolds 2016).

Bhalsing's study "Role of physical activity in Parkinson's disease" (2018) seems to me to be a good summary.

From walking to aquatic exercise, aerobic, intensive, forced, dance, tango and "martial arts" like Taichi or Qigong (physical, respiratory, energetic approach).

LESSON FOR US: My father didn't accept it until his last months of life and paid a very high price. Even at the end, after 18 years of being diagnosed (1994-2012) and the last 12 years of taking levodopa, when he was doing light arm stretching, breathing exercises and walking around the house for a few minutes helped by my mother or me, his general condition improved. It's never too late, but the sooner you start, the better.

Let's not forget the basics of Parkinson's: improving nutrition (turmeric, artichokes, asparagus, tomatoes, oranges, nuts, peppers, kiwis, fiber, smoothies, etc.) The opposite would be like treating a sailor suffering from scurvy with exercise and coagulants, and forgetting the vitamin C in oranges and lemons.

Jesus Marquez Rivera. Parkinson's here and now.

Our "Tips" and "Laws" for the Parkinson´s. 25 years of experiences.

Our "Tips" and "Laws" for the Parkinson´s. 25 years of experiences (1994-2019).

“Even though nothing changes,
if I change, everything changes."
Marcel Proust

(The result of more than 25 years of experience from my sick father (1994-2012) and myself and and advice from many sick people and specialists. Please, let's not start from scratch and take advantage of what it took so much effort and pain to bring many people together).

I think we should open our minds to keep the best, whatever works, whether old or modern, orthodox or heterodox, with the guidance of the doctor and a mixture of courage and prudence.

by Jesus Marquez Rivera (Parkinson here and now).


Throughout all those years we learned certain "tips" that helped us a lot. We also came up with something like our unwritten Parkinson's laws. Not only our daily experiences, but also the advice of the neurologists my father visited and of many sick people and veteran carergivers who treasured an experience of extraordinary value that must serve everyone, always adapted to each particular case by the advice of the doctor and the pharmacist.

SIMPLE "TIPS" THAT WERE USEFUL TO US.

A small sample of the simple "tips" we learned from readings, conversations and daily experience. These habits are easy to incorporate into everyday life and they should always be consulted with the neurologist:

1. TAKE THE MEDICATION 20-30 MINUTES BEFORE EATING. The doctor will adapt the appropriate time to the circumstances of each patient. In this way, once you start eating, the stomach will have passed the medication into the intestine, and digestion will not delay or hinder the absorption of levodopa.

2. Taking the medication with a cold drink facilitates the act of swallowing to avoid choking.

3. Adding lemon juice to the drink (we use half lemon juice), facilitates the assimilation of levodopa by the stomach's pH and by its vitamin C content.

4. A little cold cola can help prevent or reduce nausea. Never "light" or "zero" (contains aspartame, which is suspected to be neurotoxic. But the debate remains open.)

5. Take one or two golden kiwis or gold before breakfast. Its richness in antioxidants and neuroprotective nutrients did him a lot of good (vitamin C, lutein, folate, magnesium, vitamin E, chromium).

6. Leave the night before several dried black plums without bone to soak in a glass of water covered with a plate. In the morning, my father drank the water and ate the plums. Mucilages and other substances from plums are one of the best natural laxatives. It also contains about 20 antioxidants. Consult your doctor if you have diabetes.

7. As long as my father was consuming one or two glasses of "gazpacho" a day, he never caught a cold and his health in general improved. Then we learned that tomato protects neurons from the neurotoxic residues of levodopa (Suganuma 2002). Gazpacho is a drink typical of the Mediterranean diet, made with water, ripe tomatoes, cucumber, etc.

8. The use of the medicinal plant passiflora in drops (extract in vegetable glycerin, not in alcohol) along with the medication was good for him. In the last few months we had to reduce the amount because his body, already so weakened, suffered too much drowsiness during the day. Passionflower also boosts levodopa and is rich in tyrosine, the precursor to dopa (and dopamine).


OUR "LAWS" ABOUT PARKINSON´S .

We were treasuring knowledge that we called the "laws" of the disease (so important they seemed to us):

1. Do not stop the medication at once. Some neurologists mention hospital admissions or surgery as moments to consider.

2. Do not abuse the medication in order to improve the symptoms. This mortgages the future, since it will shorten the years in which the medication will be effective and will anticipate and increase the adverse effects (dyskinesias, wearing off, etc.).

3. You should eat in the ON phase (when the medication has already begun to take effect). This is more important as the disease progresses (avoid choking, aspiration to the bronchi).

4. Patience (often difficult). What has taken years or decades to get sick cannot be improved or cured in a short time. A food, an infusion or a physical exercise may not have immediate benefit, but it may prevent many disorders and improve the progression of the disease.

5. The low-protein diet (about 80-100 mg per day) reduces the competition of proteins with levodopa, which is an amino acid and uses the same "carts" to get to the brain. Some experts also recommend the protein redistribution diet, either in small amounts throughout the day, or more often, leave the protein-richest for dinner.

6. The hypocaloric diet is extremely important for neurodegenerative diseases because it favors autophagy (cleaning of cells and extracellular matrix) and benefits the brain in many ways. A diet low in calories and rich in nutrients is a very important key.

(Excerpt from the book written in Spanish, "A different way of looking at Parkinson's. Almost 20 years of experience with my father's disease 1994-2012", pp. 110-113. Amazon 2015).

I invite you to visit the project "Parkinson here and now" in Spanish and English, on Facebook and on Blogger. I offer you information capable of changing the way you see the disease...

I hope you find it helpful.

(I apologize for any possible errors in translating this text from Spanish into English. Thank you for your understanding.)

Another piece to complete the back side of the Parkinson´s puzzle

ANOTHER PIECE TO COMPLETE THE BACK SIDE OF THE PUZZLE: BETWEEN 50% AND 87% LESS RISK OF SUFFERING FROM PARKINSON'S!

"The real voyage of discovery consists not in seeking 

new landscapes, but in having new eyes."

Marcel Proust

Natural anti-inflammatories.

People who take non-steroidal anti-inflammatory drugs over the years have half the risk of Parkinson's (Teismann 2001, 2003; Samii 2009).

Nonsteroidal anti-inflammatory drugs (NSAIDs) include "aspirin", diclofenac, ibuprofen, etc.).

The combination of tobacco (nicotine), coffee and non-steroidal anti-inflammatory drugs (NAIDS) reduces the risk by 87%. I'll put it in words to make sure there's no mistake: eighty-seven percent! (Powers 2008).

Natural anti-inflammatories such as turmeric have similar efficacy to ibuprofen but without its adverse effects. Turmeric needs three things to be well assimilated: black pepper (the piperine it contains), fat and heat (Shep 2019).

We know that turmeric and curry can be responsible for India having 4 to 5 times fewer Azheimer's patients than the United States. And it may be so because in India itself, there is a similar difference between those who consume these spices and those who do not (Pandav 2008; Ringman 2005; Mishra 2008).

Other natural anti-inflammatories: red onion quercetin, Cayenne pepper capsaine, oily fish omega 3, pineapple bromelain, etc.

(In my case, I usually use it with natural fried tomato or canned, in a frying pan. Sofrito with olive oil, garlic, etc. I usually add the turmeric and black pepper (dessert spoonful of turmeric and a fifth of pepper) when the natural tomato is cooked or the fried tomato is hot. Too much time exposed to heat can reduce its effectiveness).

(by Jesus Marquez Rivera - Parkinson here and now)

The back side of the Parkinson´s puzzle

THE BACK SIDE OF THE PARKINSON´S PUZZLE.
 

"Every day we know more and understand less."

Albert Einstein

A simple story to illustrate the future that will or will not lead to the cure of Parkinson's (observing with the eyes of a child the very complex puzzle of Parkinson's as we see it today, and with that look back to the simplest image of Nature, to what is effective):

"A boy went to the office where his father was finishing an urgent job and asked him to play with him, to answer his questions. The father was very busy and could not pay attention to him. The only thing that occurred to him was to entrust him with a task to distract him until he finished...

"Take it, son." The child received a puzzle of an image of planet Earth. The father knew that his son would take at least a few hours to finish it. To his surprise, the child came in after half an hour with the puzzle already finished.

"But how did you finish it so soon?". he asked in surprise.

The boy said to him: "It was very easy: the puzzle on the back had the figure of a man". Of course, the boy had seen a man many times, so it didn't cost him anything to do the task his father had entrusted him with."

I don't know if I've managed to convey what I meant by the story. I will give an example: we know that magnesium is capable of preventing the aggregation of spontaneous alpha-synuclein and that which is produced by iron, which prevents neurological damage by the famous toxic MPTP which produces experimental parkinsonism (magnesium is also a powerful neuroprotective) which is the anti-stress mineral, which is a laxative, which relaxes muscles, which is a chelator (like an antidote) of the neurotoxic aluminium, which is as powerful a regulator of genes as vitamin C, B12 or D, etc. So many are its properties that the question is: why investigate only in the complex face of the puzzle what we already have in the image of the back, in Nature?

(by Jesus Marquez Rivera - Parkinson here and now)

AntiParkinson "pills" - 1. Put magnesium in your life.

ANTIPARKINSON "PILLS" - 1.- PUT MAGNESIUM IN YOUR LIFE.

Little by little we are discovering more facets (as in a precious stone) of this reality so confused that it is the Parkinson´s disease.

Magnesium from food (very green leafy vegetables, nuts,

wholemeal bread...) and supplements (carbonate, citrate, chloride...) is laxative, neuroprotective, fights stress, intervenes in the synthesis of levodopa, prevents Parkinsonism by the toxic MPTP in mice (Oyanagi 2010), improves nerve impulse and muscle contractions, helps to better control the bladder of urine -incontinence-, a chelating agent of heavy metals and aluminium (Yasui 1992), prevents the aggregation of spontaneous alpha-synuclein and that is produced by iron (Golts 2002), very important for genes and the hopeful Epigenetics -which controls genes, put simply- (Piovesan 2012), and so on.

The magnesium concentration in Parkinson's patients is low. A relationship has been observed between the level of magnesium and the duration and severity of the disease (Barbiroli 1999). We need to read this last one a thousand times.

There are hundreds of scientific studies. Some of the authors are prestigious neuroscientists such as Vink, Piovesan, Oyanagi, Durlach, Wallach, Yasui…

Natural sources of magnesium are less because of modern "mania" of refining everything: whole sugar, sea salt, wholemeal bread... and the inexplicable use of magnesium-free fertilizers that impoverish the soil.

The doctor or pharmacist should be consulted in order to adapt the changes to each person, according to their personal situation (age, illnesses, medicines, food). When something new feels wrong, there are always different options. The knowledge and experience of the specialists indicated are very important.

"The father of the disease could have been anyone,

but there's no doubt the mother was the bad diet."

Ancient Chinese proverb

(Source: Parkinson here and now, on Facebook 09/08/2019 and in this blog 08/12/2019).

A conversation with N, a friend with Parkinson's disease

(This fragment belongs to a book written in Spanish and already published on Amazon (in 2015). The title is “A different way to see Parkinson´s Disease. Almost 20 years of experience as a caregiver for my father 1994-2012”. I'd like to be able to translate it into English someday.

First of all, let me express my sincere apologies for the mistakes in translation from Spanish to English).

“A conversation with N, a friend with Parkinson's disease.


“Nothing in life is to be feared,
it is only to be understood.
Now is the time to understand more,
so that we may fear less”.
Marie Curie




A friend of mine explains to me by phone and in summary the case of N and she asked me out for coffee home and to talk to her, because she had been diagnosed with Parkinson's disease long time ago and she was very worried and depressed.

Shy and retiring, I was greeted rather coldly. We sat and talked about some irrelevant issues to ease the tension. I thought that I must first win her trust.

N was a retired officer, about 70 years and she was overwhelmed by parkinsonian symptoms. They are beginning to show their true face and also she felt her neurologist didn´t understand nor paid attention, etc.

First of all I made it clear I was not a doctor and that's what was going to tell him it was the result of my experience as a caregiver for the past 10 years of my father's life. I was talking about the trauma of diagnosis, the fear of the future, the fear to lose work, family and friends, lack of empathy with your doctor, etc., and she was nodding almost all these things that I mentioned. She recognized them as her own.

I told her about the case of “healing” of a woman named “Fatima” in a book of the neurologist Dr. Rafael Gonzalez Maldonado (we had taken as a real case, being actually a fictionalized reconstruction from several clinical cases), the case of Dr. Mark Peter Hurni, alleged cases of "self-healing" (Annetta Freeman, Howard Shifke, John Pepper), paradoxical kinesia, the amazing momentary health improvement of my father for a few minutes in 2010, the hope produced by the hundreds of millions of dollars that the Michael J. Fox Foundation collected for research studies, the spectacular videos of doctors Birkmayer and Permultter, the video of the blue glasses to control terrible dyskinesias caused by the medication in a patient, etc.

Once our friend and hostess left the living room to bring us something from the kitchen, I told her that there were many reasons for hope, that I would print her the scientific studies she wanted and I would teach her videos of those famous neurologists with the spectacular results (intravenous glutathione therapy with Dr. Perlmutter and intravenous NADH therapy with Dr. Birkmayer).

She began to mourn. I imagine that the view of everything, unknown until then, was really difficult emotionally.

I explained her what my father and I were lost and confused so many years, that there was an official orthodox Neurology, which had advanced a lot, but not enough for the patients and their families (my father and I felt it in this way and also many others we talk to), but that there was another Neurology as scientific or more than the previous one, but that it looked for other ways. Sometimes the same neurologist had gone through two phases, such as Walther Birkmayer, firstly one of the “fathers” of levodopa and later one of the greatest "heretics" in the Parkinson world by proposing NADH (a form of vitamin B3) as an alternative to the almost sacred "Levodopa". This "other Neurology" remained outside the official channels because, in our opinion, it had not yet been allowed to show its results in the daily clinic.

I recommended her that she buy the first two books of Dr. Gonzalez Maldonado and even she go to his office in Granada, if possible.

I told her that Genetics, drugs and surgery had limitations, I told her about the importance of "antiparkinsonian" foods, the importance of the Sun and vitamin D, involved in 33 diseases and thousands of genes, the need for a physical activity as intense as possible approved by his neurologist and adapted to his personal circumstances, changing emotions, laughing, crying, getting angry, putting on music throughout the day ... imagining a weighing scale with a positive cymbal and another negative. In the first one she had to accumulate all the factors against Parkinson's disease that she could. In the second, she had to eliminte from her life all the possible factors that are believed to favor the disease. Tens, hundreds. And always consult everything with the neurologist. If it did not hurt you, go ahead. Wisely, but with perseverance.

The farewell was very different from what happened just an hour and a half before. She hugged me and gave me two kisses. She whispered: "Thank you, you've given me the courage to live and fight."
Now N much less shaking, his face was more expressive and she smiled.

That was one of the most enriching experiences in recent years.”

Vitamin C in the world of Parkinson´s

VITAMIN C IN THE WORLD OF PARKINSON'S

by Jesus Marquez Rivera. 12/03/2019

(Extended and updated version of "Vitamin C and Parkinson's, is essential to prevent and treat this disease?". Published in Spanish in 2015, in "Parkinson here and now".)


I apologize for the errors in the use of the English language. My first language is Spanish. I would appreciate any correction. Thanks.

"Once you eliminate the impossible, whatever
remains, no matter how improbable, must be the truth."
Arthur Conan Doyle, "Sherlock Holmes."

Introduction.

Could vitamin C be an essential element in future Parkinson's treatments?

Did you know that vitamin C is essential in the chain of synthesis of phenylalanine - tyrosine - dopa - dopamine - norepinephrine (noradrenaline)? And that there are surprising studies on the potential of foods rich in this vitamin to prevent and improve the quality of life of Parkinsonians?

The current figures for Parkinson's disease are very troubling. The forecasts for the coming decades are typical of a "pandemic" (Dorsey 2007, 2018). Vitamin C has been a great unknown to the Parkinson's world for many years. Books dealing with the disease do not usually mention the vitamin. And those about the vitamin avoid mentioning Parkinson's disease. As if it were a taboo. As if there were no reasons to use it and studies supporting such uses (tyrosine, precursor of dopa; carnitine, mitochondria and energy; collagen and integrity of the blood-brain barrier; regeneration of glutathione, vitamin E and flavonoids; less oxidation of levodopa remnants; fascinating redox system dehydroascorbic acid-gluthione, using the oxidized form to enter the brain, cells and mitochondria, etc.).

Parkinson's Disease increasingly seems to me a kind of multicarencial syndrome, as well as multifactorial (Cawein 1970; Karobath 1971; Charlton 1992, 1997; Hinz 2011, 2016), in which vitamin C could play a surprising role in its causes and development, as well as in future treatments.

1. The initial surprise about the importance of this vitamin, so little known in relation to Parkinson's disease.

If someone had told me years ago that a diet rich in vitamin C prevented Parkinson's and that a vitamin C deficiency increased the risk of Parkinson's disease, I wouldn't have taken it seriously or it would have been incomprehensible. I didn't understand that there could be anything other than medication and other official treatments.

When I started having a relationship with Parkinson's about 25 years ago (because of my father's diagnosis in 1994), I couldn't even suspect something like that.

But the most worrying thing is that 18 years later, after my father's death in 2012, the important role of vitamin C remained unclear, despite numerous favourable and some unfavourable studies.

I had to spend three years preparing a book to awaken to this reality which is before our eyes, but which we do not usually see.

Today I began to see the problem from different points of view, being the nutritional the most important.

Two exceptional books were largely responsible for that slow and costly process of changing our mentalities. In them, the authors mentioned and commented on several studies that forever changed our view of Parkinson's disease and possible complementary or alternative treatments (especially in terms of prevention and reduction of the adverse effects of medication, with the consequent improvement in the quality of life of patients and their families):


    The first was "Tratamientos heterodoxos en la enfermedad de Parkinson" (Heterodox treatments in Parkinson's disease), by neurologist Dr. Rafael González Maldonado. The most important book we had at our disposal in those years and even today. I find it incomprehensible that it has not yet been translated into English. In this book we discovered the study of the famous neurologist Stanley Fahn, from 1992, in which he reached very revealing conclusions about the use of vitamin C and E supplements (3000 mg and 3200 IU, respectively), with which he managed to delay the start of the usual Parkinson's medication by 2.5 years (agonists or levodopa with inhibitors).

    The second was "Textbook of Nutritional Medicine", by Dr. Melvyn Werbach. In this work, chapter 16, dedicated to Parkinson's, mentioned a series of studies that were conducted in the 1990s, in which its authors (Cerhan 1994, Singh 1995, De Rijk 1997) found that a diet rich in vitamin C reduced the risk of Parkinson's and that a diet poor in this vitamin, increased it. In the later sections of this article, we will check the reasons and studies that support the direct relationship between the consumption of vitamin C, either in foods or supplements, and different aspects of the disease.

What we barely understood then became clearer later, especially when we learned that dopamine needs ascorbate (vitamin C) to make its synthesis from tyrosine and the active form of vitamin B6 from dopa.

WITHOUT VITAMIN C SUFFICIENT, THERE CANNOT BE SO MUCH DOPAMIN nor a very long etcetera of substances that form the more than 300 or 400 biological reactions in which this vitamin participates.

More and more studies continue to appear, as well as new properties of vitamin C:

- its epigenetic potential (Young 2015; Guz 2017);
- its production in small quantities in the intestinal flora (LeBlanc 2013);
- its role in the neurogenesis of the adult human brain (Oyarce 2014);
- the relationship between scurvy and a type of Parkinsonism (Noble 2013, Quiroga 2014).
- scurvy would not only be a product of a food deficiency, but there would be a greater propensity according to certain genetic characteristics (Delanghe 2007).

2. The functions of vitamin C and its possible direct relationship with Parkinson's disease.

Due to the comments of the authors cited above, the search began for the reasons why a rich diet reduced the risk of developing Parkinson's and a deficient diet increased it.

Knowing some of the functions of vitamin C, it seemed possible to us its direct relationship with the causes, prevention and treatment of Parkinson's disease.

In books and articles by specialists in nutrition and vitamins we found very revealing information about health and, specifically, about some aspects of what we were learning about Parkinson's disease:

1. The main function of vitamin C is the prevention of its deficiency disease, scurvy. As well as avoiding the disorders produced by a deficiency not so serious as to produce scurvy (subclinical). Hospital studies often show levels of scurvy and subclinical deficiency among those admitted, especially the elderly (Gan 2008, Raynaud-Simon 2010) and more frequent in the developed world than we think (Smith 2011, Callus 2018).

2. Essential in the synthesis of collagen, hydroxylation of the amino acids lysine and proline (Ernglad 1986). The hematoencephalic barrier (protective of the brain), is based on a narrowing of the capillaries and on the good state of the internal covering of the blood vessels (endothelium), which depend on the good state of the collagen. The most obvious symptom of scurvy is generalised bleeding in the body due to the impossibility or difficulty of forming collagen.

3. Vitamin C is a vital, water-soluble antioxidant (in addition, it "recycles" vitamin E, flavonoids and glutathione, so important in Parkinson's). Excessive oxidation (by free radicals) is one of the most accepted hypotheses about the cause of this disease. Without enough vitamin C, the brain is defenceless against the oxidation of the remnants of dopamine.

Vitamin C participates in redox reactions (recovery of oxidized forms to those reduced or useful for the body):

Vitamin C is essential in everything related to glutathione. With a low level of this vitamin, reduced glutathione (GSH) and oxidized glutathione (GSSG), as well as the relationship between both, are low (Henning, 1991). Vitamin C regenerates vitamin E (Halpner, 1998). And it also recycles flavonoids (Jacob 1997). One study has shown its ability to prevent Parkinson's by 40%. (Gao 2012)

4. Vitamin C is essential in the synthesis of carnitine, the substance necessary for cells to transform fat into energy (in the mitochondria). Lack of energy is one of the main symptoms of Parkinson's... and also of scurvy. Carnitine is neuroprotective (Jacob 1997, Rebouche 1995).


5. Vitamin C is part of the metabolism of tyrosine, an amino acid that is a precursor to dopa and dopamine, the neurotransmitter that Parkinson's patients lack (but not only).

Norepinephrine (noradrenaline) needs ascorbate (vitamin C) to be synthesized from dopamine.

The body requires vitamin C, magnesium and some B vitamins for the conversion of tryptophan into serotonin (tryptophan is also a precursor of the famous melatonin, to which we will dedicate an article).


6. It is involved in the formation of glial cells (90 % of those in the brain, which in certain circumstances become neurons) and in the synthesis of the myelin covering the nerves (Englard 1986, Katsuki 1996).


7. Essential in microsomal metabolism (detoxifying function of the liver). Neurologists Jean Lombard and Jill Marjama-Lyons advise milk thistle silymarin for those taking levodopa (metabolized in the liver). Silymarin regenerates the liver (used to recover liver damaged by poisonous mushrooms).

8. It regulates cholesterol (it transforms it into bile acids); it strengthens the immune system which interacts with the central nervous system (Rabin 1989); it reduces the release of histamine (allergic reactions) and increases its degradation in hydantoin, etc.



3. What the studies affirm and nobody told us.

In addition to observing the critical functions of vitamin C in our health and the reasonable relationship that we establish from them with Parkinson's, there are numerous important studies that confirm those links.

The vision of these studies gathered in a list allows us to understand the true dimension of this vitamin in many aspects of the disease:

    - A diet rich in vitamin C reduces the risk of Parkinson's, while a diet poor in vitamin C increases the risk of Parkinson's (Cerhan 1994, Singh 1995, De Rijk 1997).

    - It stimulates the production of dopamine, participates in the metabolism of tyrosine, the precursor of dopa, and this of dopamine, and finally in the conversion of dopamine into norepinephrine (Seitz 1998).

    - It is recommended in the initial stages of the disease (Seitz 1998) and also in the advanced stages (Linazasoro 1995). It seems to improve the state of the patients: speech, writing, mobility of the head, less salivation (Sacks 1975). This was a 62-year-old patient and each time he replaced vitamin C with a placebo, the patient worsened and improved again when the vitamin was restored (without the patient knowing it).

    - It reduces the toxicity of levodopa (Pardo 1993, Berg 2001, Riederer 1989, Florence 1988, Offen 1996).

    - It reduces damage to blood vessels by hyperhomocysteinemia (Krajkovicova 2002). The amino acid homocysteine is also neurotoxic. Parkinson's patients often have high levels. Levodopa raises them higher. In addition, vitamin C activates folate (vitamin B9), which is mainly responsible, together with vitamins B6 and B12, for the reduction of homocysteine levels (Postuma 2006, Reutens 2002).


The role of vitamin C in the synthesis of carnitine, in the synthesis of serotonin and in the recovery of useful forms of vitamin E, flavonoids and glutathione, further multiply its value. the selection of a few studies among the many available will not give an idea of its critical importance:



CARNITINE. It has neuroprotective capacity against known parkinsonizing toxics, such as MPTP.

MELATONINE. Doctor Acuña Castroviejo and his team have carried out numerous studies and advise Parkinson's patients. It is a powerful endogenous antioxidant (synthesized by the body), but whose production is reduced over the years, making the brain more vulnerable. It seems particularly effective in dyskinesias induced by levodopa.

VITAMIN E. Despite the prestigious DATATOP study (conducted with only one part of vitamin E, alpha-tocopherol), which found no evidence of the protective capacity of vitamin E in the form of a Parkinson's supplement, there are studies to the contrary. No one questions the neuroprotective capacity of vitamin E in foods (it is now known that this is mainly due to tocotrienols). A diet rich in vitamin C and E prevents disease (Martin 2002).

Studies by Fahn and Martin seem to indicate that foods and supplements have much the same bioavailability and efficacy. In vitamin C it is clear (ascorbic acid is the same), in E not so much (normally only alpha-tocopherol, without tocotrienols, is used in supplements and studies).

FLAVONOIDS. A Harvard study links a sufficient intake of flavonoids with up to 40% less risk of developing Parkinson's (Gao 2012).

GLUTATHIONE. The health and Parkinson's disease properties of reduced glutathione have been confirmed by numerous studies. When the level of vitamin C is low, the level of reduced glutathione is also low. In Parkinson's patients there is only 50% glutathione in the substantia nigra, and in advanced stages only 2%.

DEHYDROASCORBIC ACID (oxidized and reversible form of ascorbic acid).

Could the oxidized form of vitamin C in Parkinson's be of extraordinary importance? In order to cross the blood-brain barrier, the cell membrane and enter the mitochondria, ascorbic acid oxidizes to the form of dehydroascorbic acid (which can cross it as if it were glucose - it uses the same transporters) and, once inside, glutathione helps this oxidized vitamin C return to its normal (reduced) form and can act as an antioxidant in the brain and mitochondria. It seems likely that a very low level of glutathione will hinder this recovery of vitamin C to its reduced or active form, progressively preventing its antioxidant activity in the brain and mitochondria as the disease progresses.

FOLATE (VITAMIN B9). This vitamin has many essential functions, but perhaps the most interesting is its ability to regulate the level of dangerous homocysteine. Vitamin C "activates" folate and reduces vascular damage from high homocysteine levels.



4. What a "simple" vitamin can teach us.

So many years we were lost and hopeless in the "parkinsonian labyrinth" that when we were able to reach conclusions like the next one, we regained some hope. For my father it was too late, but I trust that many patients do not need all the time that a neurodegenerative disease lasts to learn some essential things, as happened to us.

If there isn't enough vitamin C, there can't be enough dopamine, or carnitine, or norepinephrine, or reduced glutathione (the useful form), or serotonin. Motor problems, tremors, fatigue, insomnia or depression will be normal with these deficiencies.

What would happen if a newly diagnosed patient was given foods rich in vitamin C, flavonoids, vitamin E, vitamins B3, B6 and B9, green tea, coffee, vitamin D, silymarin, etc., in the amount to be determined by his neurologist, waiting to delay as much as possible the need for medication or take the smallest doses if necessary? Vitamin C, alone or with other nutrients, could be a real revolution in the coming decades. The revolution that millions of sick people and their families are waiting for in silence. Since the body eliminates the vitamin C that it does not need every four or five hours through the urine, one way to keep the level stable is to consume some food rich in vitamin C distributed throughout the day.

The studies of Padayatty in 2004 with the oral and intravenous forms and of Hickey in 2008 with the liposomal form open a field for new studies.

Without taking it as a general recommendation and bearing in mind that the doctor must be the one who adjusts it to each patient (state of health, other diseases and medications, previous renal problems, etc.), Padayatty's study in 2004 reached revolutionary conclusions: by oral means a blood concentration three times greater than that supposed possible before could be achieved. Three grams every four hours led to 220 micromoles per litre (previously it was believed that it was only possible to reach 80 micromoles per litre orally).

Vitamin C, both from food sources with lemon juice with water (Yazawa 1994) and from supplements, improves the benefits of levodopa and reduces adverse effects (Sacks 1975).

For the treatment of motor fluctuations soluble levodopa has been proposed: e.g. 10 tablets of Sinemet-Plus in 1 litre of water with 1 gram of vitamin C, take 100 ml every 90 minutes (Kulisevsky 2013). Always with the guidance of a neurologist.

Vitamin C, alone or with other nutrients, could be a real revolution in the coming decades. The revolution that millions of sick people and their families are waiting for in silence.

Given that the body eliminates the vitamin C that it does not need every four or five hours through the urine, one possibility of keeping the level stable is to consume some food rich in vitamin C distributed throughout the day.

Changes in Science and Medicine go slowly, too slowly for the sick and their families. Perhaps we should help doctors and researchers, bringing the experience and experiences of patients to accelerate these changes.

If it does not harm the patient and the neurologist does not advise against it, why not try it?



5. Vitamin C at the frontier of what we know about "Parkinson's diseases".


The oxidative hypothesis of Parkinson's disease.


Dr. Sir William Osler ("father" of Modern Medicine) believed that Parkinson's was caused by accelerated aging of the brain. In the original, "state of accelerated aging" (The Principles and Practice of Medicine, 1892. -in Rajesh Pahwa, Kelly E. Lyons. Handbook of Parkinson's Disease, p. 14-).

The prestigious neurologist Warren Olanow reported on the role of free radicals and metabolites (remnants) of levodopa therapy in neuronal death. This hypothesis suggests that antioxidant therapies may slow the rate of progression of PD and shows concern that metabolites -rests- from levodopa treatment may accelerate the rate of neuronal degeneration (Olanow 1990).

Jenner and Olanow showed the role of oxidative stress in the pathogenesis (origin and evolution) of Parkinson's disease, especially iron content in the brain, damage to mitochondria, lack of antioxidant protection, superoxide dismutase (SOD) and reduced or active glutathione (GSH) (Jenner and Olanow 1996).

Will vitamin C be oxidized -because it crosses the protective barrier of the brain and the membranes of neurons and mitochondria- and active glutathione -because it devotes its antioxidant capacity once inside it- keys to the cause and progression of Parkinson's?

We insit on something that could be of paramount importance. Vitamin C cannot cross the barrier that protects the brain. It oxidizes and can (as dehydroascorbic acid). And once in the brain it is activated again (redox mechanism) thanks to glutathione. Thus it is able to reduce the damage caused by the oxidation of the remains of levodopa in the substantia nigra and other areas of the brain (Pardo 1993, Berg 2001, Riederer 1989, Florence 1988, Offen 1996). It also occurs with neurons and mitochondrias.

Parkinson's patients have a low glutathione level, which also affects the mechanism of reduction of the oxidized form of vitamin C. This could leave the substantia nigra and mitochondria defenceless, by a very low or insufficient level of GSH (reduced glutathione) and of ascorbic acid/dehydroascorbic acid for the increased needs in Parkinson's patients and more when they are treated with levodopa.

We know that the possible neuroprotective effect of the drug selegiline is due to the fact that it slightly elevates glutathione (Tanaka 2002). Why not try in future studies administering better liposomal glutathione, NAC, etc.?

Studies with NAC (N-acetylcysteine) have shown that it multiplies by almost three - 3.4% to 8.3% - the dopamine transporters (DAT), which makes the scarce dopamine produced by the brain of patients in advanced stages is better used and more effective (Monti 2019).


Is a multicarential hypothesis reasonable?


Is Parkinson's disease a set of multiple deficiencies? Why do so many vitamins and minerals prevent or reduce the risk of the disease?

As early as the 1970s, vitamin deficiencies in Parkison patients were mentioned. Among others, vitamin E, vitamin B12 and folic acid with high levels of homocysteine, riboflavin, vitamin D, vitamin K, glutathione, magnesium, vitamin C and vitamin B6 (Cawein 1970).

Dr. Marty Hinz completed the list of multiple deficiencies in patients before and after starting treatment (Hinz 2011, 2016), which had already been mentioned in part by other researchers (Karobath 1971; Charlton 1992, 1997).

Dopamine deficiencies occur in patients, but also in many other things, such as tyrosine hydroxylase, norepinephrine and serotonin (Charlton 1992, 1997; Karobath 1971). Those taking levodopa also reduce tryptophan, sulphur amino acids such as glutathione and SAMe, epinephrine (Karobath 1971, Zhelyaskov 1968, Hinz 2010, Liu 2000, Fuller 1982)...

Other researchers had already pointed, before Hinz, towards glutathione deficit -Sechi in 1996-, magnesium deficit -Barbiroli in 1999-, or high homocysteine level -Yasui in 2000 and Muller in 2001-, as responsible for the severity of the symptoms and the current progression of the disease.


Is there parkinsonism for scurvy?


There is Parkinsonism caused by severe deficiency of vitamin C or scurvy (Nobile 2013; Quiroga 2014). It is not strange since ascorbic acid is antioxidant and anti-inflammatory, regulates cortisol (the stress hormone), converts dopamine into norepinephrine, tyrosine into dopa, synthesizes carnitine, activates vitamin B9 which regulates the neurotoxic homocysteine, regulates the glutathione level and a thousand other things.

6. Some final reflections.

We are close to very important changes in the Parkinson's world. Given the forecasts made by experts such as Dorsey, it is no longer a question of whether there will be but when they will be made. Prevention by promoting the use of polyphenols from green tea or vitamins C and E in foods (as is done by fortifying foods with vitamins such as B1 and B3). And it may be necessary to use the media (successful programmes, television series, films, etc.). As well as oral, liposomal and intravenous vitamin C studies, similar to what the famous neurologist Stanley Fahn did in 1992 with vitamins C and E.

It does not seem crazy to say that the future of the Parkinson's world, to find a way out in the current parkinsonian labyrinth, depends very much on the acceptance of vitamins, minerals and other nutrients in the treatment of the disease. And we will see in the next decade. It will mean a real revolution. And vitamin C will play a very important role in that future world without Parkinson's that I dream of.

I am convinced that the basis for the cure of this disease is already in the published studies and especially in those that have appeared in the last two or three years. We only have to find figures of social and scientific prestige that give the necessary impetus to initiate changes: perhaps a large-scale prevention and the development of new protocols before and after starting with levodopa - which correspond to researchers and doctors establish - but I suspect they'll be a lot like the protocol Dr. Marty Hinz has proposed.

If we don't do this or something else, future generations will judge us extremely harshly.



-----


WARNING. Any change should always be consulted with the doctor and the pharmacist, who can assess many aspects that escape the knowledge and experience of the patients and their families.

Courage is good medicine. But prudence too.



------


LIST OF STUDIES MENTIONED IN THIS ARTICLE (its purpose is not to adorn the article or appear a scholarship that corresponds to the wise consulted, but to show that there is "much Science and Medicine" supporting the proper use of vitamin C):

Acuña, Reiter (1997). Melatonin is protective against MPTP-induced striatal and hippocampal lesions. Life Sci.

Berg (2001). Brain iron pathways and their relevance to Parkinson's disease. J Neurochem.

Bruno (2006). Faster plasma vitamin E disappearance in smokers is normalized by vitamin C supplementation. Free Radic Biol Med.

Callus (2018). Scurvy is back. Nutrition and Metabolic Insights.

Cawein (1970). Vitamin preparations for patients with Parkinsonism. N Engl J Med.

Cerhan (1994). Antioxidant intake and risk of Parkinson´s Disease in older women. Am J Epidemiol.

Charlton (1992). Parkinson's disease-like effects of S-adenosyl-L-methionine: effects of L-dopa. Pharmacol Biochem Behav.

Charlton 1997). Depletion of nigrostriatal and forebrain tyrosine hydroxylase by S-adenosylmethionine: a model that may explain the occurrence of depression in Parkinson's disease. Life Sci.

De Rijk (1997). Dietary antioxidants and Parkinson´s Disease. The Rotterdam Study. Arch Neurology.

Delangue (2007). Vitamin C deficiency and scurvy are not only a dietary problem but are codetermined by the haptoglobin polymorphism. Clinical Chemistry.

Dorsey (2007). Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology.

Dorsey (2018). The Emerging Evidence of the Parkinson Pandemic. J Parkinsons Dis.

Englard (1986). The biochemical functions of ascorbic acid. Ann Rev Nutr.

Fahn (1992). A pilot trial of high-dose alpha-tocopherol and ascorbate in early Parkinson's disease. Ann Neurol.

Florence (1988). Neurotoxicity of manganese. Lancet.

Gan (2008). Vitamin C deficiency in a university teaching hospital. J Am Coll Nutr.

Gao (2012). Habitual intake of dietary flavonoids and risk of Parkinson disease. Neurology.

Guz (2017). The role of vitamin C in epigenetic regulation. Postepy Hig Med Dosw.

Halpner (1998). Protection by vitamin C of oxidant-induced loss of vitamin E in rat hepatocytes. J Nutr Biochem.

Hellenbrand (1996). Diet and Parkinson's disease. II: A possible role for the past intake of specific nutrients. Results from a self-administered food-frequency questionnaire in a case-control study. Neurology.

Hinz (2011). Amino acid management of Parkinson’s disease: a case study. Int J Gen Med.

Hinz (2016). Parkinson's disease managing reversible neurodegeneration. Neuropsychiatr Dis Treat.

Jacob (1995). The integrated antioxidant system. Nutr Res.

Jacob (1997). Urinary carnitine excretion increases during experimental vitamin C depletion of healthy men. J Nutr Biochem.

Karobath (1971). The effect of L-dopa on the concentrations of tryptophan, tyrosine and serotonin in rat brain. Eur J Pharmacol.

Katsuki (1996). Vitamin C and nervous tissue. In vivo and in vitro aspects. Subcell Biochem.

Krajcovicova-Kudlackova (2002). Homocysteine and vitamin C. Bratisl Lek Listy.

LeBlanc (2013). Bacteria as vitamin suppliers to their host: a gut microbiota perspective. Curr Opin Biotechnol.

Linazasoro (1995). Treatment of complicated Parkinson disease with a solution of levodopa-carbidopa and ascorbic acid. Neurologia.

Maher (2002). Epidemiologic study of 203 sibling pairs with Parkinson's disease: the GenePD study. Neurology.

Noble (2013). Old disease, new look? A first report of parkinsonism due to scurvy, and of refeeding-induced worsening of scurvy. Psychosomatics.

Offen (1996). Prevention of dopamine-induced cell death by thiol antioxidants: posible implications for treatment of Parkinson´s disease. Exp. Neurol.

Oyarce (2014). The oxidized form of vitamin C, dehydroascorbic acid, regulates neuronal energy metabolism. Journal of Neurochemistry.

Pardo (1993). Ascorbic acid protects against levodopa-induced neurotoxicity on a catecholamine-rich human neuroblastoma cell line. Mov Disord.

Postuma (2006). Vitamins and entacapone in levodopa-induced hyperhomocysteinemia: a randomized controlled study. Neurology.

Quiroga (2014). Ascorbate and zinc responsive parkinsonism. Ann Pharmacother.

Rabin (1989). Bidirectional interaction between the central nervous system and the immune system.Crit Rev Immunol.

Raynaud-Simon (2010). Scurvy in hospitalized elderly patients. J. Nutr. Health Aging.

Reutens (2002). Homocysteine in neuropsychiatric disorders of the elderly. Int J Geriatr Psychiatry.

Riederer (1989). Transition metals, ferritin, glutathione, and ascorbic acid in parkinsonian brains. J Neurochem.

Rebouche (1995). Renal handling of carnitine in experimental vitamin C deficiency. Metabolism.

Sacks (1975). Ascorbic acid in levodopa therapy. Lancet.

Seitz (1998). Ascorbic acid stimulates DOPA synthesis and tyrosine hydroxylase gene expression in the human neuroblastoma cell line SK-N-SH. Neurosci Lett.

Singh (1995). Dietary intake and plasma levels of antioxidant vitamins in health and disease: a hospital-based case-control study. J Nutr Environ Med.

Smith (2011). Scurvy in the developed world. Can. Med. Assoc. J.

Yapa (1992). Detection of subclinical ascorbate deficiency in early Parkinson's disease. Public Health.

Young (2015). Regulation of the Epigenome by Vitamin C. Annu Rev Nutr.

Zisapel (2001). Melatonin-dopamine interactions: from basic neurochemistry to a clinical setting. Cell Mol Neurobiol.