Health knowledge made personal
Join this community!
› Share page:
Go
Search posts:

Are Healthy Diets Delaying PD Pr ...

Posted Oct 05 2009 10:03pm
Are Healthy Diets Delaying PD Progression?

Dear Doctor,

Do you agree that healthy diets will delay the progression of PD?

What about small amounts of liquor or beer per day, as it has been shown to help decrease the risk of heart attack and stroke on some people? It could also relieve the risk of side-effects from Levodopa and Dopamine Agonists, hence, slowing down or delaying the progression of PD.

What do you recommend are the healthy meals that regulate our bowel movements and improve our lifestyle? Is this helpful for slowing down the PD progression?

Thanks.

TEO KIM HOE


Dear Teo,

Healty meals are always helpful. Too much alcohol is not good. Exercise is wonderful!!

Dr. Ramon L. Rodriguez, MD


Dear Doctor,

Could you address the alcohol question in more detail? How much is too much? My mom takes Stalevo, Lexapro, Seroquel, Aricept, and Flexaril. She has not been drinking for a number of years but, frankly, I think she would benefit from an occasional beer or scotch. Would that conflict with any or all of her medicines?

Thanks,

Zae


Dear Zae,

Alcohol in moderation, a few drinks a week is probably ok. I worry about the use of alchohol in any PD patient with postural instability of gait dysfunction as even small changes in balance could lead to falls with injuries like hip fractures.

Dr. Michael S. Okun, M.D.


Dear Doctor,

Parkinson’s medications develop complications. There are motor and non-motor syndromes on patients. Low blood pressure is one of the non-motor syndromes.

I am one of the sufferers. I had a mini stroke (T.I.A.) last month.

Lately, I discovered that my blood pressure is low (100/76) when standing but normal (145/76) when sitting or lying down in the bed, thereby causing me dizziness, headache and fainting spells.

Hypotension is usually causing health problems for the elderly. Sudden drops in blood pressure can be life-threatening. What causes Parkinson’s medications to increase hypotension?

Is hypotension related to the mini stroke that I had last month?

Would the increase in salt consumption in my diet help to regulate my blood pressure, as advised by my doctor? What are the alternatives?

Kindly advise.

TEO KIM HOE


What Should I Eat?

Dear Doctor,

What are the good things to eat when I have Parkinson disease?

Thanks.

TEO KIM HOE


Dear Friend,

I advise everyone with PD to “make the most of every bite.” Every bit of food can make a difference to your health, and that will help you best manage PD. Choose wholesome, nourishing foods, the less processed the better. If you care to provide more data, I might be able to give a fuller response: age, gender, when diagnosed with PD, the names of all medications used (both PD, and other medications, including over-the-counter medications, vitamins, herbal or other supplements), any other diagnosed conditions (such as elevated blood pressure, food allergies, diabetes, high cholesterol, etc.), any particular complaints or concerns such as nausea, edema, weight changes, constipation, sadness, etc.

Best regards,
Dr. Kathrynne Holden, MS, RD


Dear Doctor,

I am male. I was diagnosed with PD in 2003. I am 68 years old. I am taking one Sinemet 25/100 with Jumex 5gm each in the morning and afternoon, and two Sinemet in the evening. I do not have diabetes, high blood pressure, food allergies or high cholesterol. I have constipation but it is not always. I do not have nausea, weight change or sadness. I spend 2 hours in the sports centre from Monday to Friday.

Kindly advise what are the foods to eat to help my PD.

TEO KIM HOE


Dear Teo,

You appear to be in such excellent health that it is difficult to say how it could be improved. Also, I don’t know what your current diet is, although your regime is so impressive that I’m sure it is very nutritious.

However, here are some comments:
§ Omega-3 fatty acids are a very important component of the brain and nervous system. Fish, especially the fattier fish, are the best sources of Omega-3 fatty acids, and I strongly recommend several servings of fish each week.

§ Calcium and Magnesium play key roles in muscle contraction and relaxation, and it is very important to be sure to get enough of these. Magnesium is abundant in whole, unprocessed grains, vegetables, nuts, and other foods, so I would certainly eat as few stripped, processed foods as possible. Calcium is a bit more difficult to find, except for dairy products; but unless you are allergic to them, these are very good foods, rich in high-quality protein as well as calcium. I would, however, be certain to take levodopa at least 30 minutes before dairy foods – they can, in some people, block levodopa absorption more strongly than other protein foods.

§ If you take vitamin/mineral supplements, I would avoid those that contain iron. Iron is a pro-oxidant (the opposite of antioxidant) and is implicated in heart disease, cancer, and PD. We must have iron, but a normal diet usually supplies our needs, and supplements can “over-do it.”

§ Occasional constipation isn’t a problem, but I would still be certain to eat a high-fiber diet and drink plenty of fluids. PD can slow peristalsis (movement of the gastrointestinal tract), and this can result in constipation. Both fiber and fluids are protective, not only against constipation, but other diseases as well, including dehydration, high blood pressure, and heart disease.

§ Vitamin E (from foods, not from supplements) is very protective, and I would be certain to eat foods rich in Vitamin E. If you will search the forum, you will find my article on Vitamin E, which may be helpful.

Keep up your excellent work, you set a great example for us all!

Best regards,
Dr. Kathrynne Holden, MS, RD
Dehydration and PD

Dear Doctor,

Kindly brief me as follows:

What is dehydration and how to prevent its effects on PD patients?

Thanks.

TEO KIM HOE


Sure. Dehydration is when you have not taken in enough fluids for your body’s cellular and other processes to function properly. We recommend PD patients to take 6-8 glasses of water a day. We feel this may help symptomatically, especially with balance, gait and dizziness. Hope that is helpful for you.

Dr. Michael S. Okun, M.D.


Dear Doctor,

I suffer from dehydration. As a PD patient, I did not realise how important water is for health. As I did not feel thirsty, I did not see the reason to take more water after exercising in the gym?

I have learned from your reply that fluid replacement is critical to replace fluids lost when taking a long duration of exercise. Besides, the PD medications can raise the risk of dehydration.

Dehydration can lead to confusion, weakness, balancing problem, respiratory failure and even death.

Kindly elaborate the symptoms and signs of dehydration.

Thanks.

TEO KIM HOE


Dear Teo,

As a human, you need water to survive and you are losing water all the time. As a PD patient, having a low water content may cause worsening of the symptoms, so you need to drink lots of water before, during and after workouts and throughout the day. Avoid taking too much fluid with caffeine content, as that may not help your hydration status. People with PD and dehydration may feel lightheaded, dizzy (particularly on standing), fatigued, as well as a general worsening of symptoms.

Dr. Michael S. Okun


I suffer from dehydration. It is the side-effect of Levodopa and dopamine agonists medications. Dehydration is a loss or deficiency of water in body tissues. This condition may result from inadequate water intake and/or excessive removal of water from the body, i.e. from sweating, vomiting or diarrhoea.

Symptoms include great thirst, nausea and exhaustion. Thirst leads to dehydration. In order to minimize the side-efect of PD medications:

1. I apply "Biotane" gel to moisturize my dry lips;

2. I take "Biotane" gum to minimize my dryness mouth;

3. I use "Biotane" mouth wash to minimize my rough and sticky tongue; and

4. I take two litres of water daily to minimise my thirst, as I am doing strenuous exercises daily.

TEO KIM HOE


Dear Teo,

Thank you for the post. The PD medications actually cause lowering of blood pressure, which may have similar symptoms as dehydration.

We do not recommend biotane for our clinic patients.

Thank you for the post/comment.

Dr. Michael S. Okun, M.D.


Dear Teo,

I don’t know if you read all of the posts/replies, so I am copying part of a reply that I sent to a post about Dehydration and PD. I would like your opinion as to what your thoughts are about the quoted material below.

The book, “You’re Not Sick, You’re Thirsty” ‘Water for Health, for Healing, for Life’ by F. Batmanghelidj (Warner Books) will really open your eyes up to some things that we may be taking medications but drinking more water could have ‘fixed’ it.

To quote a paragraph that I found extremely interesting: (please note that I am not suggesting anything by quoting this to you, only sharing what the book says)

“Dehydration can cause a breach in the blood-brain barrier. Any such breach compromises the integrity of normal brain functions. I (the author) am of the strong opinion that dehydration that compromises the protective shield of the blood-brain barrier is the primary cause of most of the diseases of the central nervous system. When the barrier becomes compromised, the solid waste of such microscopic bleedings is converted into plaques that are the hallmarks of most neurological disorders, such as Multiple Sclerosis, Parkinson’s disease, and Alzheimer’s disease. I (the author) think the same process takes place in migraine headaches.”

Thanks,
Janice


Water is the one of the most important components of cells in many vital organs (including the brain). Water plays a major role in maintaining the integrity of the blood-brain barrier. Thus, dehydration certainly causes brain cell dysfunction. However, it difficult to ascertain whether the degree of cell dysfunction, due to dehydration, is sufficient to lead to brain diseases such as Parkinson’s Disease.

Dr. Chew Nee Kong
Kuala Lumpur


Thank you for the comment. Dehydration has been linked to worsening symptoms, but is not linked to causing PD. I agree.

Dr. Michael S. Okun, M.D.
Antioxidants

Dear Doctor,

Is it true that nutrients’ intake must be added if we do more exercises, as exercises may reduce the level of antioxidants in our blood?

Does Jumex have an impact on the amount of nutrients intake? Jumex contains long term neuron-protective properties. However, it also increases cellular energy production that has potentially negative effects. The enhanced cellular function increases free radicals and aggravates stress. It may be necessary to periodically re-adjust the nutrients to put back the appropriate level of antioxidants in our blood.

Kindly advise.

Thanks.

TEO KIM HOE


Dear Teo,

In the case of exercises, generally only athletes need to be concerned about additional nutrients. Humans evolved to hunt, run, gather food, and otherwise, engage in physical labor, and meet their nutrient needs with their normal daily diet. Athletes, however, have a much higher activity level than normal, and may need extra nutrients.

Water is an exception. This most vital of all nutrients is easily lost by all humans and needs to be constantly replenished.

In the case of people with PD, there is an additional factor. PD is stressful and stress produces free radicals, and thus cellular damage. While there is no evidence that dietary nutrients can have an effect upon the area of the brain affected by PD, diet most certainly affects the health otherwise. Here, the first line of defense is a nourishing diet. Foods contain an array and balance of phytochemicals, flavonoids, vitamins and minerals that cannot be duplicated in pills and other supplements. Vegetables, fruits, nuts and seeds, whole grains, cooked legumes, and fish should be the backbone and mainstay of the daily diet. A multivitamin supplement is a good addition, but does not take the place of foods. An annual physical examination with lab tests will determine whether there is a need for other supplements, and this certainly can be the case as we age – vitamin B12, for example, is less well absorbed.

Jumex (selegeline), and in fact all PD medications, can have undesirable side effects that increase various kinds of stress, and here again, a wholesome diet, plus exercise, is the best way to combat these effects. You are doing exactly the right things in following a good exercise program and eating healthful foods.

Best regards,
Dr. Kathrynne Holden, MS, RD


Dear Doctor,

Thank you for your excellent reply.

However, I still believe that when we do more exercises, we would need more nutrients to protect our body from oxidative stress, whether or not we are an athlete.

The increasing energy production in the cells (from some medications, exercises, stress, etc.) will increase free radicals production. This is the natural biological process in the body.

But regular exercising will also increase endogenous antioxidant enzyme that enhances antioxidant mechanism in the overall body.

The aging process, antioxidant level and oxidative stress are dynamic processes which we have to monitor every 6 months or annually, at least, i.e. through blood test on the nutrient levels.

I understand that most PD patients have deficiencies or decreased antioxidants, folic acid and Vitamin B12 or 6, and these deficiencies occur in normal old adults too.

To improve our nutrient level in a natural and safe way, we need to have more fruits, vegetables and fish (source of co-enzyme Q10).

Kindly advise.

Best regards,
TEO KIM HOE


Dear Teo,

Yes, it’s very true that exercises, medications, and in fact, even metabolizing the food we eat, result in the production of free radicals. However, a healthy human body is very well adapted to combat these free radicals by producing its own metabolic pathways and enzymes to quench the free radicals. The key, first and foremost, is a high-quality diet that supports the production of such enzymes – as you say, fruits, vegetables, and fish are excellent.

Having said that however, this can change with age, disease conditions (such as PD) and many types of medications. That is why CoQ10 (co-enzyme Q10) and creatine are being studied, to see if they can help alleviate the negative effects suffered by PD patients. It is also good to remember that long-time use of levodopa can result in higher levels of homocysteine in the blood, and if this happens, supplements of B vitamins are needed.

Best regards,
Dr. Kathrynne Holden, MS, RD


Dear Doctor,

I wish to add the following to my earlier email.

The level of nutrients in our body depends on 3 factors:

1. The amounts of nutrient taken from food and supplements.

2. Ability of intestinal absorption.

3. Utilization of nutrients by our body, depending upon our level of physical activity. If we do more exercises, we will need more nutrients, hence affecting the level of antioxidants in our body.

Thanks.

TEO KIM HOE



Sodium

Dear Doctor,

What are the symptoms of deficient sodium for Parkinson’s patients?

What are the signs of sodium deficiency for Parkinson’s patients?

What are the functions of sodium in our bodies?

What are the causes of sodium deficiency?

One major cause of sodium deficiency is excessive sweating.

Thanks.

TEO KIM HOE


Dear Teo,

Serum sodium is an electrolyte in the blood and its deficiency is often a reflection of the hydration status as well as an indirect measure of its balance (blood versus excretion).

In PD we have not discovered any link between sodium and the neurodegeneration. We treat deficiency (usually an internist or family practice doctor) by identifying the cause and addressing it. Abnormal sodium in anyone including PD patients can be seen with symptoms including dehydration, seizures, mental status issues (confusion). Abnormal electrolytes can theoretically worsen the clinical symptoms in a patient with a neurodegenerative disease such as PD and that is why we aggressively correct these problems when identified. Serum sodium, if very deficient, has to be corrected slowly to prevent damage to the brainstem (central pontine myelinolysis).

Dr Michael S. Okun, M.D.

Safe level of Nutrients

Dear Doctor,

Nutrients, i.e. vitamins and minerals, are important for those with PD. They won’t cure PD or slow its progression. However, there are some nutrients that are not suitable for PD patients, even harmful. They are Folic Acid, Chromium, Copper, Ferritin, Magnesium, Selerium and Zinc.

Why is it so? What are their normal acceptable levels in our body? At what level would it be considered harmful for PD patients and how to reduce it to a safe level? How do we monitor the level and how often (i.e. periodically or yearly)?

TEO KIM HOE


Dear Friend,

All essential vitamins and minerals are necessary for people with PD. None of these are “optional” — they are absolutely vital to maintain life and health. Your doctor should conduct an annual physical examination that includes bloodwork; this will show whether any deficiencies exist, and the doctor will then determine the best way to make up the deficiency. Other than this, I cannot generalize; health needs are highly individualized and specific to each person. Your doctor is the best person to address personal issues regarding blood levels of minerals.

Best regards,
Dr. Kathrynne Holden, MS, RD


Nutrition for PD Patients

Dear Doctor,

How do we achieve the right balance/compromise between nutrition and PD treatment, as it can cause a patient to develop weight loss and under-nutrition?

How do we optimize/manage nutrition for a PD patient? What are the side effects of the PD medication that will increase the risk of malnutrition? PD is a complicated disease that affects each person differently but there are needs for nutrition to sustain the body and stay healthy.

Kindly advise.

TEO KIM HOE


Dear Teo,

These are very good questions because many people with PD become malnourished.

Here are some of the possible causes:
- nausea
- loss of the senses of smell and taste
- loss of appetite; sometimes due to medications, sometimes due to depression
- loss of manual dexterity
- eating very slowly
- unable to finish meals; often because chewing and swallowing becomes tiring
- fear of choking
- difficulty in swallowing

To optimize nutrition, it is important to firstly determine whether any of the above conditions occur. If so, then the approach must depend upon managing that condition. For instance, if depression is the cause, then the first approach will be to manage the depression. If due to inability to manage eating utensils, then the first approach will be to locate plates, cups and utensils that are designed for those with limited dexterity; and to provide “finger foods” as often as possible.

Thus, it is important to consult a dietitian, for personal help. The dietitian will assess the reason for the poor nutrition and design an eating plan that overcomes the limitations. For extra calories, add nourishing between-meal snacks of about 100-200 calories. These should be low in protein — fresh fruit or juice; a fruit smoothie made with soy or rice milk, vegetables, rice cakes or bread with a little mayonnaise or a teaspoon of peanut butter, and salads. Generally, it is a good idea to begin slowly, adding only 200-400 calories a day and increasing gradually, so as not to stress the system.

Best regards,
Dr. Kathrynne Holden, MS, RD


Supplements in PD Treatment

Dear Doctor,

As PD is our “lifetime partner”, i.e. it is a “not going away” disease, we need nutrition as a weapon to battle the disease from its progression, in other words, to slow down the disease.

Besides exercises to strengthen our muscle stiffness, rigidity and mobility, nutrients are important for us to arm ourselves to fight PD. As PD has motor and non-motor symptoms, nutrients will help patients to stay healthy and keep fit.

However the more we exercise, the more nutrients we need to protect ourselves from oxidative stress, whether or not we are athletes. I understand that most PD patients have deficiencies or decreasing antioxidants, folic acid and Vitamin B12 or 6 and these deficiencies occur in normal old adults too.

As a Dietitian, could you tell us how nutrition can be helpful for us with PD? Why is nutrition an area of concern for PD patients’ health?

What are the specific nutrients that could help PD patients’ health i.e. slow gastrointestinal tract, constipation, bloating, excessive phlegm, saliva drooling, swallowing difficulty, nausea, insomnia and loss of appetite?

All the sicknesses mentioned above are the side effects or risks of taking levodopa for PD treatment.

Why are PD patients at increased risk for malnutrition? Most of them are suffering from weight loss, insomnia, low blood pressure, slow movement, depression and constipation?

What are the nutrition-related diseases? Malnutrition increases the risk of bone facture and loss of immune system that protects us from the risks of infection.

Kindly advise me what is the optimal nutrition level for PD and how to maintain this nutrition level. What about taking nutritional supplements i.e. vitamins and minerals?

Is a yearly blood test our vitamin level and exercises helpful for nutrition?

Why is a combination of levodopa (for treating PD) and protein will cause problems to our bodies’ absorption level? Therefore we have reflex acid, phlegm deep in the throat and drooling saliva from the mouth. How to avoid them?

What are the medications available to treat these sicknesses?

What is the optimal time to take levodopa to reduce the conflict with protein?

Kindly brief them.

TEO KIM HOE


Dear Teo,

Good nutrition is important for everyone, but there are specific concerns with PD. Many people get less exercise, thus the muscles begin to shrink, and bone loss occurs. People are also more apt to experience falling as PD progresses, and with weaker muscles and thinner bones, they are less able to prevent falls, and more likely to break bones when they do fall. Constipation occurs more frequently with PD, and is best managed by including plenty of fiber and fluids in the daily diet, along with as much exercise as is possible.

People with PD have the same need for vitamins, minerals, and macronutrients as everyone else. Just as the rest of the population, they need annual physical examinations, including blood and urine tests, to determine whether any deficiencies exist. Regarding normal levels, your doctor is the best source of information, and I recommend that you discuss this with him or her.

Only a few supplements are of importance in PD. Iron supplements and vitamin B6 in amounts larger than 10-15 mg can interfere with levodopa absorption; these should be taken separately from levodopa by about 2 hours.

Otherwise, the supplements you mentioned are fine; and all of them are best taken after meals, either breakfast or dinner should be okay. They should not interfere with any of the PD medications nor cause any unwanted PD symptoms.

There are many other concerns, and I recommend you email the National Parkinson Foundation for a copy of “Nutrition Matters.” Go to: http://www.parkinson.org/ click on “Publications.”

Here, you’ll find the free series of excellent booklets. I recommend them all; but for your purposes, “Nutrition Matters” should answer your questions. There is a form available for you to order as many copies as you need; or you can telephone, if you prefer.

Best regards,
Dr. Kathrynne Holden, MS, RD


Sorry, I don’t routinely prescribe vitamins for PD. Therefore, I do not routinely monitor them. Some of them may be good for general health and well being but have not been definitively proven to help PD. CoQ10 and creatine are currently under study. We will know about these two drugs very soon. But for the rest, they have not been proven.

Yours,
Dr. Hubert H. Fernandez


Dear Doctor,

There are some vitamin supplements not suitable for people who have suffered a stroke, i.e. Boron, Chromium, Copper, Magnesium, Manganese, Molybdenum, Selenium and Zinc.

Please kindly enlighten the matter soonest.

Thanks.

TEO KIM HOE


Dear Teo,

None of these are contraindicated in PD.

If manganese is ingested in high quantities, however, it is known to cause Parkinsonism.

High copper content in the liver and brain (but usually due to an enzyme abnormality, not due to heavy ingestion) can be the result of a rare inherited Parkinson-like disorder (Wilson’s disease).

Yours,
Hubert H. Fernandez


Dear Mr. Teo,

Sorry about your illness.

Stroke shares risk factors with coronary diseases such as dyslipidemias, hypertension, diabetes, obesity, nutritional deficiency and high homocysteine, etc. These risk factors can be prevented and modified by dietary intervention (sodium restriction), supplement (especially vitamin B group, folic acid, vitamin E, magnesium, calcium and fish oil), lifestyle modification such as exercising regularly, stop smoking (which you have already done).

Chromium functions as an insulin cofactor, meant to reduce diabetes risk. As for Selenium, low selenium intake is suspected to increase the risk of coronary heart diseases. The other minerals that you have mentioned: Boron, Molybdenum, Manganese, Copper and Zinc have controlled blood levels and so far there are no medical reports about these minerals increasing the risk of stroke. However, if you have these reports, please send them to me.

Best Regards and please take care,
Kridakorn Watcharachotpimai, M.D., ABAAM.


Dear Dr. Kridakorn,

I would like to inform you that I had a minor stroke last week and have now recovered to normal.

I was told that some of my add-life prescriptions are not suitable for stroke patients. They are Boron, Chromium, Copper, Magnesium, Manganese, Molybdenum, Selenium and Zinc.

Please kindly enlighten the matter soonest.

Yours faithfully,
TEO KIM HOE


Dear Mr. Teo,

There is a journal about Manganese and PD. Usually we will get high exposure if we work in some industries such as the steel industry, and not from a diet or supplements.

Wilson’s disease is an abnormality in copper metabolism which is a rare genetic disease. The copper level in your blood is low, hence normal.

One of the causes of Parkinson’s disease is over in oxidative damage and low in antioxidants. Some mineral such as Copper, Selenium and manganese are an important part in antioxidant enzyme production (SOD or superoxide dismutase) which is a protective mechanism.

Our brain is very sensitive to free radicals especially if you need to take Sinemet to help increase energy production for brain cell which mean these will increase free radical production as well. So we need to balance your antioxidants and control your oxidative stress.

In your next visit for the anti-aging program, I would suggest for you to do a comprehensive anti-aging program which includes tests for oxidative damage, total antioxidant capacity (not only the levels in the blood) and risks of health disease. Other minerals, such as Boron, are important for bone mineral density. Supplemental nutrients have more benefits than what I have listed here, and they include energy production, memory improvement, immunity, etc.

Best regards and take care,
Kridakorn Watcharachotpimai, M.D., ABAAM.


None of these vitamins have an evidence-based record in PD so I cannot advise you. I have not seen a tremendous improvement with these sorts of regiments in my patients.

I recommend a multi-vitamin regiment for patients who are interested.

Dr Michael S. Okun, M.D.


Dear Mr. Teo

I do not routinely recommend vitamins and other chemical substances (such as selenium, copper, etc) to my patients as there is no direct evidence that they help in PD treatment.

Dr. Chew Nee Kong
Kuala Lumpur


Dear Doctor,

After my recent blood test on antioxidant, mineral and vitamin profile, I am taking vitamin supplements to improve them. I was told that some of the vitamin supplements are not suitable for my PD. They are as follows:

Boron chelate 1 mg, Copper chelate 5 mg, Manganese chelate 2 mg, Selenium chelate 200 mcg, Zinc chelate 70 mg, Chromium chelate 500 mcg, Magnesium 100 mg, Molybdenum chelate 50 mcg, Vanadum chelate 10 mcg.

Kindly elaborate and advise.

Thanks.

TEO KIM HOE


Dear Friend,

If you are deficient in any of these, then you must remedy the deficiency, or you will be sick. You must follow your doctor’s advice; I cannot gainsay his/her counsel.

Best regards,
Dr. Kathrynne Holden, MS, RD

Level of Iron in the Blood

Dear Doctor,

I have a blood test recently and it was shown that I have a high level of Ferritin 217 µg/L (10 -120) and low T.I.B.C 44.4 µmol/L (45.0 – 70.0).

I am worried about the increase/reduction respectively of my iron profile. Kindly elaborate on the cause and what medication to minimize/increase their respective levels.

Thanks.

TEO KIM HOE


Dear Friend,

There are many, many possible reasons for such iron levels in your blood. It would be improper for me to speculate as to the cause. You must discuss this with your physician, who has access to your complete medical records. He or she can properly diagnose the cause and explain it to you. Write back and let us know the results.

Best regards,
Dr. Kathrynne Holden, MS, RD


Dear Doctor,

This is the reply from my doctor:

“Ferritin is a protein which is produced from the liver and used as an indicator of total body iron storage. High ferritin level can be found in many conditions such as iron overload, liver disease, inflammatory disease, malignancy and aging.

T.I.B.C. reflects the iron status in the body and a low level can be caused by iron overload, chronic disease and a low protein diet.

According to your results: slightly high ferritin, slightly low T.I.B.C.; these might be caused by iron overload, aging and too low protein in your diet (so far, from the health check-up report, we did not find a chronic disease, malignancy or liver disease).

The way to improve this condition is by exercising, increasing protein in your diet (but low on red meats and organ meats).”

Kindly elaborate and advise.

Thanks.

TEO KIM HOE


Dear Friend,

Your doctor, having access to your medical history and records, has given you the best possible advice. Again I must say that it would be improper for me to elaborate on this report without complete information. Please follow your doctor’s counsel, which is based on his/her examination of you and interpretation of your medical records.

Best regards,
Dr. Kathrynne Holden, MS, RD

Effects of Hormone on PD

Dear Doctor,

I read an article as follows and became curious on the effects of estrogen on males:

Both sexes seem to have varying amounts of estrogen and androgen – women have more estrogen, males have more androgen, but each has some of the other’s primary sex hormone.

What is the role of estrogen in males’ development of PD?

Can estrogen worsen our PD?

Kindly enlighten me on this subject and it will be very helpful for other PD patients.

Thanks.

TEO KIM HOE


Dear Teo,

It is unknown what effect estrogen has on the development of PD and especially unknown in males. Testosterone is converted in the body to estrogen so that is a factor that must be considered. Finally there are studies in women suggesting estrogen could be protective or have a symptomatic benefit in PD. Much needs to be researched on this topic.

Dr. Michael S. Okun, M.D.

Supplements and Hormone Therapy

Dear Doctor,

Why are some vitamin supplements and hormone therapy are unsafe certain times? There are side effects that cause our blood pressure level to be abnormal and some other effects. They need to be monitored by a doctor regularly. I am one of the sufferers. Kindly brief them.

Thanks.

TEO KIM HOE


Dear Teo,

You need to be more specific. Please list the particular vitamins, supplements and hormone therapies of concern to those with PD and I will answer if able.

Best regards,
Dr. Kathrynne Holden, MS, RD


Dear Doctor,

The hormone therapies are DHEA-S, PSA, Testosterone, Estradiol, Free T3, T4 and TSH. Vitamin supplements and minerals are Boron, Chromium (blood), Copper (blood), Manganese, Vanadium, Selenium, Zinc (blood). The doctor has to monitor the blood pressure level on patients who receive this treatment. Side effects would occur at certain times.

Kindly elaborate.

TEO KIM HOE


Dear Teo,

Some hormones may cause edema (fluid retention in the tissues) which can increase blood pressure; thyroid hormone can have many possible side effects, including a rise in blood pressure. The minerals you named would not ordinarily be expected to cause a rise in blood pressure; I assume your doctor is monitoring your overall condition and considers these a factor. PSA, as I understand it here in the west, is not a hormone, but the name of a laboratory test called Prostate Specific Antigen. T3 and T4 are also the names of tests, used to determine thyroid function, not hormones.

Best regards,
Dr. Kathrynne Holden, MS, RD


Dear Mr. Teo,

I also do not routinely recommend heavy metals (copper and manganese) to my Parkinson’s patients. There is no firm evidence that this treatment helps in Parkinson’s.

In fact, exposure to heavy metals is known to be one of the predisposing factors for Parkinson’s.

Dr. Chew Nee Kong
Kuala Lumpur


Dear Mr. Teo,

I am not sure whether the hormone therapy has any effect of lowering your blood pressure. But what is certain is that I do not recommend such treatment to my patients, if they do not have any hormonal disorder.

Dr. Chew Nee Kong
Kuala Lumpur


Dear Doctor,

I am glad to inform you that my dizziness has gone completely after taking SERC 16, betahistine dihydrochloride 16 mg one dose, three times daily.

I am still taking my PD medications and vitamin supplements and hormone therapies. There is nothing wrong with taking the vitamin supplements and hormone therapies together with PD medications, in consultation with the doctors.

The dizziness was caused by the PD medications.

Regards,
TEO KIM HOE


Dear Teo,

I am glad that you are feeling better but actually, we don’t know if there is really nothing wrong with taking vitamins and hormones in PD. The only way is for this to be proven through diligent clinical trials. So far, all properly conducted clinical trials on vitamins (such as vitamin E, etc.) have not shown to be efficacious in PD. There is promise however, with creatine and CoQ10.

Yours,
Dr. Hubert H. Fernandez

Hormone therapy with PD

Dear Doctor,

Please kindly comment on hormone and micronutrient therapy. Is it helpful for PD patients?

You can surf the website for more information:

Wellness Centre at Bumrungrad Hospital International (No. 210, Sukhumvit 1 (Soi Ruennrudee), Wattan, Bangkok 10110 Thailand)

www.e-vitallife.com

Best regards,

TEO KIM HOE


Dear Teo,

It is difficult for me to give a good opinion, because I have never visited Bumrungrad facilities; but it appears to me to be a very sound and comprehensive program. I like the fact that individuals are seen by an entire health care team — physician, pharmacist, laboratory specialists, nutritionist, exercise physiologist. I think this is particularly important for those with PD.

Regarding your hormone and nutrient therapy, if you have had the thorough testing described on the website, and been prescribed these by a Bumrungrad physician, then it seems to me that you are in very good hands.

You might ask the doctor about the amounts of vitamin A, and find out whether iron is included, just to be on the safe side.

Best regards,
Dr. Kathrynne Holden, MS, RD


Dear Doctor,

I have read that hormone replacement therapy (HRT) may have protective effects vis-à-vis PD. I do realize HRT carries risks but risks aside, have you seen evidence that it is protective against this disease or that it can possibly slow the progress of PD?

Thanks so much!

TEO KIM HOE


Dear Teo,

We have looked at the effects of both estrogen and testosterone in PD.

I must admit that I think the evidence for both is weak.

There are several studies (including one that I wrote) showing that patients on estrogen may have had a slower motor and cognitive decline.

But these are all epidemiological studies, not prospective clinical trials on estrogen. And the results of the studies have not been uniform.

On the other hand, Dr. Okun has reported the beneficial effects of testosterone but these are small and open-label studies. When he did the double-masked, placebo-controlled trial, this benefit was not different from the placebo.

Thus, in my opinion, we have no solid proof, one way or another, that estrogen or testosterone treats PD symptoms and that its side-effects need to be seriously considered before starting either drug.

Yours,
Dr. Hubert H. Fernandez

Blood Test on Micronutrients and Hormone Therapy

Dear Doctor,

Is it helpful for PD patients to do blood test on micronutrients and hormone therapy?

Micronutrients include laboratory evaluations on antioxidants, vitamins and minerals.

TEO KIM HOE


Dear Friend,

I think it is very important to establish a baseline for iron, homocysteine, B12, B6, folate, and riboflavin. As for hormones, that would be up to an endocrinologist; however, there have been some studies regarding both estrogen and testosterone, as they relate to women and men with PD. Here, you might address your question to “Ask the Doctor.” Dr. Okun has done research in the area of testosterone. Go to: http://www.parkinson.org/ click on “Discussion Forums” click on “Ask The Doctor.”

Best regards,
Dr. Kathrynne Holden, MS, RD


Dear Doctor,

Are hormone therapy and laboratory evaluations on antioxidants and micronutrients helpful for PD patients?

It includes Vitamins C, A, Q10 and minerals. Your early reply will be appreciated.

Thanks.

TEO KIM HOE


Dear Teo,

The only one with preliminary positive evidence of the above that I endorse for my patients is Co-Q10. The others are not solidly proven.

Dr. Michael S. Okun, M.D.
Post a comment
Write a comment:

Related Searches