Complementary and Alternative Medicine Treatment Options for Parkinson's Disease

By: Invigorate Physical Therapy and Wellness

- Hey, guys, welcome back to Canada. I am excited to come to you for another live broadcast today. We are actually now a day after the end of the conference, but there was so much material from all of the workshops that I went to that it's been overflowing into further days. So today I wanted to check in and let you know a little bit more about the complementary and alternative medicine approaches that I learned about in the workshop I attended yesterday. This is a question that I get a lot, and it's really not surprising, because in the workshop they were talking about how actually 50% to 90% of people who have been diagnosed with Parkinson's pursue some type of complementary or alternative medicine at some point in their journey along the way. I'm going to really define what that means to be a complementary or alternative medicine here in a second. But come in, as you file in, just say hello.

I'd love to check in with you guys. Hi, Patty, welcome, welcome. As I said, it's been overflowing so much information from this conference. Naomi and I are actually going to come together and do a joint Facebook Life later tonight on yet another topic this evening. So make sure you stay tuned for that. I got so many questions about complementary and alternative medicine approaches from you all before I came to this conference. I think a lot of them are going to be answered today.

If you have more questions, as I go along, just put them in the comment section below, and I'll see if we can get to them as well. But really, when we're talking about complementary and alternative medicine for Parkinson's, really the definition is medical products and practices that are not a part of the standard medical care. A lot of people think that this alternative medicine is just far off down the woo-woo train, and it's just crystals and spiritual healers. But really it's a medical practice.

It's just not part of the standard medical care. Actually, about 50% of people who have been diagnosed with Parkinson's will pursue some type of alternative medication at some point in time. I'm going to run through maybe what some of those options would look like, because you probably have explored a lot of these complementary adjuncts to your Parkinson's treatment. If you have, as I go through some of these, just give me a thumbs up, or a heart if you loved it, a sad face if it didn't work for you. Share your experience in the comment section below. Because really, complementary and alternative medicine can cover things like exercise, we're learning.

Complementary and Alternative Medicine Treatment Options for Parkinson's Disease

That's a complementary approach. It's not part of the standard medical care. We talked about tai chi, music therapy, dance, a lot of different supplements, which I'm going to talk with you more about here in a second, things like melatonin, the Mucuna pruriens. We talked a lot about cannabis.

I'm going to share that a little bit with you guys today. But acupuncture, glutathione, Coenzyme Q10, creatine, vitamin E, stem cells, certain diets. Those are all falling into this complementary and alternative medicine. I know that I have definitely tried quite a few of those on that list for my own health. If you have, just give me a thumbs up and let me know what you've tried.

I'm going to run through a lot of the evidence, the most recent evidence for a lot of these complementary approaches, and let you know what's being supported in the literature, what's emerging, maybe what's not part of the literature quite yet, or even some things that are actually dangerous that are on that list. So make sure that you stay tuned for that. But I want to say to you before I get into the research here, that complementary alternative medicine, when you're exploring a lot of these things, it was really interested, we talked a lot in the workshop about how these things should complement your medical care, and to maximize the benefit that you're getting from your traditional medical approach. I know there are a lot of people, this might be you, out there who are really interested in just completely putting the medical care to the side.

You don't want to take Parkinson's medications. You don't want DBS. Hopefully you're exercising. But you're looking at some of these complementary approaches as a pure alternative to medical care.

That's fine. Your decision is your own. Your body is your own.

You can do absolutely whatever you want with your own body. But something we touched a lot on was, and something I talk a lot about in my practice is, we really want to make sure that we are building a solid foundation for you with healthy lifestyle, exercise, diet. Then we're protecting your brain as much as possible. Then we're supplementing this healthy lifestyle with the medications and the traditional medical approaches. Maybe it's DBS, maybe it's medication. We're supplementing your program with those things so that they can bring you up to the ultimate quality of life.

Because in the end, it's all about are you able to do the things that you want to do as effectively as you can possibly do them. When you're listening to me talk about some of these complementary approaches, think about them in terms of actually complementing your medical care, instead of taking the place of it. That's where all of these come in. Of course, it's all guided by a healthcare team, and make sure that you're sharing your decisions and your actions and everything that you're doing with your healthcare team, because they need to know absolutely everything, so that they can optimize and help you understand really what you're doing to your body and what kinds of options are available for you. Let's go ahead and dive in. Just give me a thumbs up if you're ready to rock and roll. Because we're going to start with the five things that are actually supported a lot by the evidence. The gold standard in healthcare is we want to see randomized controlled trials.

That's like double blind randomized control trials, if you follow Michael J. Fox Foundation, you've probably heard that term quite a bit. But that really just helps the study be as objective as possible, versus things like case studies are maybe a one-person to two-person, six-person event that they're pulling evidence from. That might not carry over into the larger population because it's not a big enough group. These five complementary approaches have lots of evidence. They have lots of randomized controlled trials. The very first thing that you won't be surprised by is exercise is a complement to your medical program.

It actually has been shown over and over again to prevent or delay the disease process, improve your motor functions, improve your nonmotor functions. There's one aspect we talked about in this workshop where it actually increases a thing called BDNF, brain derived neurotropic factor, which is essential for maintaining healthy neurons in your brain and creating new ones. So exercise stimulates, protects your brain, and helps your brain grow new neurons, which is wonderful for a neurological diagnosis.

Exercise is absolutely the key. You need to be exercising every day, getting your daily dose, at least 20 minutes a day, shooting for two and a half hours of vigorous exercise every week, where you're getting your heart rate up, it's challenging, it's cognitively challenging, it's fun. It's just got to be part of your exercise daily regimen. The second thing that has lots of evidence behind it, a lot of randomized control- I shouldn't say a lot. There are quite a few randomized controlled trials for tai chi, showing that it helps to improve balance and motor function. Also music therapy. Several studies are suggesting that improves the quality of life, voice, motor function, and freezing.

Dance, of course. I know plenty of you out there love, love, love your dance. Lots of studies are suggesting that there's benefit for your motor function and balance as well.

As far as all of these exercise treatments are concerned, I want to encourage you fully to participate in the thing that fits you best, be it tai chi, be it music therapy, dance, whatever it is that's working for you, please participate and participate fully. I want to strongly encourage you to bring on a physiotherapist or a physical therapist to be your go-to person to individualize your exercise program to your specific needs. If you're in this group environment, which is wonderful for social reasons and for accountability, and it's fantastic, but you need to be seen one on one so that they can help you hone in on your specific symptoms that are giving you the most challenge, because you won't get that individual attention in a group fitness class. I just want to, of course, make a plug for physical therapy in there. But you should be seeing your physical therapist just like you see your dentist, just like you see your primary care provider. When you have Parkinson's, they need to be on your calendar at least once a year, if not once every six months.

If you have an exacerbation, a sharp decline, you need to be seeing them as well. That's just my plug for physical therapy. Pairing it with your group fitness classes, there's a lot of research that's coming out that really shows the benefit for that. I know it's coming out of the Power Gym in Arizona. They're doing a lot of studies. Emily Borscher did a study.

She presented it here at the MDS conference, where one time a week with a skilled physical therapist and three group classes a week really improved people's skills and motor function and gait and balance and all that stuff. I can probably share the abstract with you in the comment section below. But exercise, exercise, exercise. Number one complementary approach for Parkinson's. The last supplement actually that had a lot of evidence behind it was melatonin. Melatonin, the studies were really small but are suggesting there's benefit for REM behavior disorder, which is very common in Parkinson's, and helps improve subjective, so your own opinion of how quality your sleep was. So if you are having trouble sleeping, melatonin is supported by the research, and a safe method to help you improve your sleep quality, potentially.

We're going to talk about supplement quality here in a second, so stay tuned for that. All right, people are saying hi. I can't not say hi. Kathleen, hi from Nappa.

Tell Wyman hello for me. Peggy, Mike and Peggy in Austin. Oh, hey guys, welcome.

Let's see, Jean from Tinley Park, Illinois. Welcome back. Tina, of course, tuning in from Vegas. And Patty. Hello, guys, hello! Okay, so I want to move on to some other complementary approaches that have some evidence, and actually there's only one that comes in this category, and it's a supplement. It's actually the Mucuna pruriens, which is the natural supplement that is supposed to have high levels of natural levodopa. The evidence, there's some evidence, but it's really not great evidence behind Mucuna pruriens. It's not really well regulated, and it's hard to know what dosage you're getting when you take it orally, because this was actually really interesting, none of the top five best sellers of Mucuna pruriens on Amazon actually contain Mucuna, which is wild.

So if you're ordering Mucuna, there's a high, high chance that you are not getting a quality supplement. You potentially may not even be getting what you think you're paying for. That was the trouble that this physician talked about. It does have some beneficial research behind it, but the quality of supplements, he said he didn't feel comfortable suggesting any supplements that are on the market, because none of them are really found to have high quality Mucuna in them. If you are taking that, I'd definitely check your source to make sure that you're getting high quality. But he himself says that he doesn't usually recommend it, because he doesn't know where to really get that high quality supplement from.

He does this for a living in Colorado. That is the down and dirty on Mucuna pruriens. The next category I'm going to talk about actually is the very little or mixed findings of the evidence. There are quite a few, let's see, we've got six things to cover in this category that either have no evidence, or mixed findings. Mixed findings, definitely don't mean anything's bad or good.

It's just there haven't been a lot of high quality large studies to draw a definitive good or bad around. The first one, of course, that everyone is curious about right now is cannabis. Cannabis, marijuana, weekd CBD oil is the concentrated form. Cannabis, marijuana typically has THC in it. The CBD oil takes out the THC, which we'll talk about here in a second. But as far as the studies are concerned, cannabis does not have a lot of evidence to support improvements in motor symptoms.

So as far as those large, randomized, controlled trials. Now there are some case studies that support cannabis for tremor. Those studies are still small, and kind of a case by case basis. I do want to encourage everyone to obviously follow the laws in their state as much as possible. The non-RCT, which means not the big studies, are showing that there are actually some improvement for nonmotor symptoms as well.

So those things like your REM behavior sleep disorder, appetite, nausea, pain, anxiety, and just sleep quality overall. Those might be things to explore cannabis with, CBD. But it definitely- He talked about how, you think about who goes on, who smokes marijuana, or who does CBD oil, the side effect of marijuana most of the time is kind of feeling cognitively dopey, and having some apathy, potentially some dizziness and low blood pressure. Especially if you're eating edibles, it's a variable concentration of the potency, so you're not really sure what you're getting. Those are some of the side effects. If you think about it, if marijuana slows you down, and you're already slow, bradykinetic, as a person with Parkinson's, then you can see that those maybe don't improve your motor symptoms.

But those other nonmotor symptoms may see some benefit. He was talking about how some of his clients were able to reduce the use of other medications, or even alcohol that they had been using to, and maybe this is you, you can give me a thumbs up if it's you, people had been using alcohol or other drugs to help them sleep better, bring their anxiety down, potentially increase their appetite, where now they just do cannabis, and those things kind of self-regulate, and they can go off of excessive amounts of other drugs and other alcohol, such like that. If that's you, and you feel comfortable giving a thumbs up, we'd love your feedback. There's really no strong evidence that smoking marijuana is neuroprotective or slows the disease process. These are some tips for practical use.

You want to, and I'm saying this as a healthcare practitioner, just relaying information I learned. Please do not take this as medical advice. I cannot stress that enough. You need to be talking with your naturopath, your neurologist, your movement disorder specialist about what works best for you. But as far as practically using marijuana, starting low and going slow. Make sure that you review the side effects and your target symptoms with your healthcare team. So instead of just walking into your doctor's office or the local, I forget what that's called.

It's not a distillery. Where you go and get your cannabis from states where it's legal. Don't just walk in and say, "I want to smoke marijuana for my Parkinson's," or "I want to get some cannabis for my Parkinson's." What are your target symptoms? What are you trying to improve? Is it sleep? Is it anxiety? Is it appetite? What kinds of things so you can go in with a direct approach to using marijuana medicinally.

You also could consider creams and patches for pain. Those have less side effects that potentially smoking it. They talked about using THC. When you have CBD oil, you can either get it with or without THC. THC is typically better for appetite and nausea, and CBD is typically better for agitation, anxiety, and sleep. The mixed products where you have some CBD and some THC are typically more effective, is what this physician was saying. That is kind of the lowdown on cannabis.

I wanted to do a quick plug right here. Let me see if I can find the link. I'm going to put it in the comment section below. There's a naturopath here who is doing a subjective study, which means that you go in and you do a really long survey. You don't have to go anywhere. It's just subjective what you say. It's called Cam Care in Parkinson's.

I'll put the link in the comment section below. If you want to go in to this survey and give them feedback on what kinds of things you're doing in the complementary medicine world, it's an ongoing study and it's helping a lot of healthcare practitioners understand what happens when you take supplements, what happens when you are using cannabis medicinally, what happens when you're exercising, eating a certain way, sleeping a certain way. So it's going to help build our complementary medicine database, so that these studies can be a little bit more robust in the future. I wanted to, I'll put that in the comment section below. But it's an ongoing, you can enroll in it if you qualify, and it's just a giant survey asking you about what you've done, and how you've done with what you've tried. The last few things that have no findings, or mixed findings. Acupuncture has mixed findings.

They're seeing that it's helpful for stress, anxiety, fatigue, and sleep. But potentially less evidence that it's helpful for motor symptoms, except for some anecdotal evidence around dystonia. If you have dystonia and you want to try acupuncture, it's a safe treatment technique. You could give it a try and see if it works for you. Okay, the next few here are supplements, and I want everybody to listen up, because I feel like these are popular supplements that get recommended a lot, and actually don't have a lot of evidence to back them up, according to this workshop that I attended today, from the most recent evidence. Glutathione was injected via IV therapy, was not found to be effective.

There's also not a lot of evidence that it actually crosses the blood-brain barrier, which is that barrier between the blood vessels in your head and your brain, which would be how that glutathione would get in. Another thing that's really found to be not effective in the research is Coenzyme Q10. Also creatine and vitamin E don't have a lot of research to support them.

Now, they're not necessarily dangerous, but things like glutathione could be potentially very expensive if you're doing IV therapy quite often. There's no safety risks, it sounds like, for glutathione, Coenzyme Q10, creatine, and vitamin E. But it could be a cost thing, where you're spending a lot of money on these supplements that may or may not be helping you out. Also, the quality of your supplement could vary quite a bit.

We're finding, of course, that supplements that come from across seas, so if they're not from the United States, there are some areas of the world that just aren't really high quality supplements that are not worth your money. That brings me to a class of complementary approaches that actually there's evidence of harm. These are the ones that I want you guys to be aware of, because I don't want you falling down into this trap of spending a lot of money on something that you think may be really helping you and they actually could be hurting you. The first thing, and this physician was very, very enthusiastic about avoiding this approach was actually stem cells. He was talking about how there are cancers associated with untested stem cell treatments. He was talking about how there actually isn't a lot of research to support stem cell treatment in Parkinson's at all. Another thing that he was referring to was a high-protein diet.

We talk about this a lot at Invigorate. I encourage plant based, whole foods, eating lots of vegetables and nuts and things that come from nature, supplementing it with some high quality protein like grass fed meats, wild caught fish, some cage free eggs. But diets that are really high in protein and don't emphasize nutrient quality or anything like that can actually be dangerous because it can block the absorption of your Parkinson's medication, if you're always eating protein all the time and not getting things like fiber in your diet from vegetables, and lots of nutrients and antioxidants. You want to make sure that if you are following a healthy diet that it is obviously rich in vegetables. If you want to learn more about nutrition and Parkinson's, I have a whole gut series, video series that's free.

You can go to InvigoratePT.com/guthealth. We can put that link in the comment section below as well. It's free. Talks all about nutrition and Parkinson's, and suggesting different things that you could eat to help maximize your gut health, and therefore your brain health. Okay, our last evidence of harm complementary approach falls under just supplements in general.

There are some Chinese herbal supplements that are on the market that may contain toxins, pesticides, and even Viagra. You want to be very, very careful and screen every supplement that you're taking for quality, doing your research and making sure the brand is reputable, a reputable source, and making sure that, potentially just staying away from supplements that come out of China, it sounds like. There are also a lot of drug and herbal interactions. So it's really important that you share everything you take supplementally with your healthcare provider. So things even like garlic, ginseng, you know those things, cranberry juice. Those things, everything that you take as a supplement you need to be sharing. Cannabis, whether it's legal or not in your state, you need to be sharing that with your physician, because those can have serious interactions with different Parkinson's medications, or even non-Parkinson's medications. Write down everything, even if you think it doesn't matter.

Aspirin, St. John's wort, all that stuff. Write it down so you can bring it to your healthcare team, so that they can help you make the best and safest decision for you as far as interactions go with different supplements. I want to close here with just some general advice. I got so many questions from people asking me about specific supplements, like Restore Gold.

I'm forgetting some of the other ones that I got. But I got so many questions about very specific supplements that they did not talk about in this workshop, nor know about really. But he did give some very common sense advice for recognizing approaches and things that you hear as BS.

He says it's bad science, but it's BS. Here is how to recognize a complementary approach that may not be the best science out there. You want to avoid anything that claims to cure everything, or almost everything. You also want to avoid approaches that are inconsistent with what you know to be true from reputable sources. You also want to avoid things that are only available outside of the United States, things that ask you to stop your conventional treatments. So again, complementary approaches should go hand in hand with your medical approach. If they're asking you to completely stop all your other treatments, that could be a red flag that it's bad science.

Some terms they may use are revolutionary, or it's a miracle drug, or a miracle approach. You want to be really careful with those because potentially they could be from bad science. Things that rely on obscure publications.

So there's maybe only one published study for that approach found in one obscure journal, not a major publication, not a peer reviewed journal. Do your research and see where is that study coming out of, because oftentimes people can just pay to have studies done and have them published in some random offshoot journal, and then all of a sudden they have studies that back up their claim. So really dig into the quality of that study, the quality of that journal, to make sure that it's a peer reviewed journal.

Of course, randomized control trials are the highest quality. I see a lot of thumbs up, so you guys must already know that stuff. Then finally, you want to avoid anything that just has a clear profit motive. A lot of the things that we talked about today and in the workshop yesterday, was complementary, but it wasn't outlandish. It wasn't thousands and thousands of dollars, taking out a loan to get all these injections or whatnot. Those are just some common sense approaches.

Check with your neurologist. Check with whoever you find reputable in the Parkinson's world to see if those things are legit or not. But please don't go spending half of your retirement income on things that have not been proven.

I don't want you to get taken advantage of. So that is what we learned in the complementary and alternative medication approach workshop. If you guys have more questions, put them in the comment section below. If you found this helpful, please share it with your support groups, with your family, your friends, with anybody you think may benefit. Like I said, up to 50% to 90% of people who have been diagnosed with Parkinson's, just like you, are considering trying some of these approaches, and they should definitely know what they're getting into and what the research says about them. So please share this with anybody you think may benefit.

I'd really appreciate it, and I know that they will too. All right, let's see. Tino, "You are the most legit I have found in Parkinson's." Aw, I appreciate that. We need to bring in more professionals, don't we? Paul, "Did you meet Dr.

Brudian?" I don't know. I'm bad with names. I don't know if I met them. But I'll have to check to see if they did one of the lectures. Irene, "Thanks for this wonderful information." You're so welcome. Oh, and Paul's from Michigan, cool. "Dr. Kleuger is a rock star and so easy to understand, "very down to earth." I'll have to look up which one that was.

I feel like that's probably the Colorado guy. Okay. All right, guys. I want to, oh, see- Jean says, "How much melatonin?" You know, I would have to go back and look at the studies. We didn't talk about it specifically. But I can see if I can find an abstract and put it in the comment section below if I find that for you Jean. Thanks for asking.

Okay, all right, guys. I'm going to sign off here. But I will be back very soon with my friend and colleague Naomi Kasiro. We are going to talk about sexual dysfunction in Parkinson's a little bit later tonight. She's out seeing clients.

We're going to check back in and talk about sexual dysfunction. That was another awesome workshop we went to. I will see you guys all very soon. Bye.

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