According to the best estimates, forty percent of people with
Parkinson's disease use some form of "alternative" therapy. To some,
alternative therapies are just so much snake oil, while to others,
these approaches offer the promise of relief. In this article, these
treatments will be discussed while trying to separate the hype from
the reality.

What are alternative therapies? The answer is not clear cut. For
some, the term refers largely to herbal medicine, high-dose vitamins
and nutritional supplements, homeopathy, and acupuncture. These are
the four most commonly cited alternatives to "Western" medicine,
which is characterized by FDA-approved medications and surgery.
Others, including the study that arrived at the forty percent
estimate, include massage, meditation, and movement exercises, which
usually complement, rather than replace, standard antiparkinsonian
therapy.

Herbal Medicines
There are probably as many herbal remedies as there are standard
medications in the entire Western medicine cabinet, and no sweeping
generalizations about them, positive or negative, are accurate. Many
FDA-approved medicines are (or once were) derived from plants that
have demonstrated long-term safety and effectiveness for the
treatment of one condition or another. On the other hand, there are
many herbal "remedies" for which no scientific rationale exists, and
which are no better than placebo against the conditions they allege
to treat. Finally, there are many more remedies that may or may not
be helpful, but for which no good evidence either way currently
exists.

One herbal remedy suggested for treating PD is fava beans, which
contain levodopa. A few small studies have indicated that some
patients may help to control their symptoms with fava beans. A major
problem with this approach, as with many herbal remedies, is that the
active ingredient is present in varying concentrations in different
crops; therefore, it is challenging to maintain a steady dose.

Some herbal remedies such as belladonna have anticholinergic
properties, similar to trihexyphenidyl (Artane®) or other
anticholinergics that are prescribed for PD. Other proposed herbal
remedies, however, including ginseng, ginkgo, and many more, do not
offer any proven benefit in PD. While many of these ineffective
remedies are safe, others are not. Kava, for instance, is often
advocated to relieve stress. Kava should not be used by PD patients,
not only because it has been linked to severe liver damage in dozens
of people taking it, but also because it interferes with dopamine
activity in the brain.

High-dose Vitamins and Dietary Supplements
No study to date has confirmed the effectiveness of any vitamin on
the course of Parkinson's disease. The largest trial of its kind,
called the DATATOP study, showed that vitamin E was ineffective in
slowing disease progression. Despite this finding, half of the
patients using alternative treatments for PD take vitamin E, and
surprisingly, at a dose that is only half that used in the study.
While it is important to maintain adequate levels of vitamins in the
diet, and certain supplements may help with other conditions, it is
also possible to get too much. For example, doses in excess of 15
milligrams per day of vitamin B6 (pyridoxine) may interfere with the
uptake of dopamine.

Coenzyme Q10 has been shown to have an effect on PD, although there
is some controversy as to whether it truly slows disease or simply
alleviates symptoms. In either case, the amount needed is
substantial. The effective dose was shown to be 1,200 milligrams per
day, far above the 60 to 90 milligrams recommended by some "holistic"
medicine web sites.

Calcium supplements may improve bone density, an especially important
benefit in people with PD, who are more likely to fall and run the
risk of breaking bones.

An informal survey of web sites indicates a host of other
recommendations for treating PD, almost none of which have any
justification in clinical trials or theoretical understanding of the
disease process. These include avoiding coffee, despite the fact that
coffee has been associated with reduced risk for disease.

Homeopathy
A homeopathic medicine is one in which a vanishingly small amount of
some ingredient is diluted repeatedly in water, which proponents say
stimulates the immune system. The claim that the resulting medicine
has any effect at all has never been substantiated in well-controlled
trials for any condition. There are no homeopathic treatments for
Parkinson's disease that have been proven effective.

Acupuncture
Acupuncture has been used for centuries in China; however, its
effectiveness is difficult to test in a clinical trial. To date, no
placebo-controlled trials have shown that acupuncture can treat the
motor symptoms of PD, although some evidence suggests it may help in
sleep disturbance.

Massage, Exercise, and Movement Therapy
In contrast to many other alternative therapies, massage, exercise,
and movement therapies do not promise quick fixes to people living
with Parkinson's disease. Instead, these approaches are based on the
common-sense notion that paying attention to the body's needs, and
keeping in shape, are part of good self-care. Aerobic exercise
programs stress cardiovascular fitness as well as full range of
motion, which is especially important in a movement-limiting disease
like PD. Structured movement therapy programs, such as yoga and tai
chi, may improve balance as well as promote a feeling of well-being.
A good, relaxing massage may be a shortcut to feeling better when you
are feeling bad.

Conclusion
It has been said that there really is no "alternative" medicine.
Those treatments whose effectiveness has been demonstrated in well-
designed clinical trials deserve the name "medicine," whatever their
nature. Those that have not been tested in this manner do not deserve
the name. In the end, the best advice is also the most common—
whatever treatments you are currently using or contemplating, be sure
to discuss these with your physician.

By Richard Robinson – WE MOVE