Alzheimer's, ADHD, Parkinson’s and other Neurodegenerative disorders

Paul L. Reller L.Ac. / Last Updated: August 03, 2017


The lack of an effective treatment protocol for Alzheimer's, Parkinson's, and other neurodegenerative diseases points to the need to integrate Complementary Medicine into the treatment strategy

How does standard allopathic medicine treat these increasingly common neurological syndromes of Alzheimer's, Parkinsonism, and other slowly progressive neurological diseases and disorders grouped under the unfortunate title Dementia? If you go the website of the National Institute of Neurological Disorders (see link below in additional information), you will see that modern medicine does not have a cure, or even a dependable effective treatment yet. Almost all experts agree that standard treatment provides only marginal improvements.

The allopathic approach still involves finding a chemical that blocks one symptom-causing mechanism. The complexity of these neurodegenerative disorders demands a more involved therapeutic protocol. In Parkinson's Disease, L-Dopa has long been the key drug used in treatment. L-Dopa synthetics supply increased dopamine to the brain, but we now know that the problem is not a simple deficiency of dopamine to the specific brain centers involved, but a complex dysfunction at a number of dopamine receptor types. Scientists exploring the physiology of these dysfunctions have found a variety of factors that work synergistically in the brain to create these dysfunctions. Obviously, a variety of treatment strategies are necessary to bring this co-dependant physiology back into line. Allopathic medicine still wants to find one chemical to affect one piece of the puzzle rather than correcting the whole puzzle. This will result in nothing more than temporary relief of few of the many symptoms. In Alzheimer's treatment, four drugs are commonly used, Aricept (donepezil), Exelon (revastigmine), galantamine and memantine, and the benefits are typically so small that most patients and their families do not notice any real benefit. New drugs being developed and tested allopathically target reduction in amyloid beta plaques, but such drugs, e.g. Aducanumab by Biogen, have shown success in reducing this plaque in the brain, yet this has failed to reduce the symptoms of advanced Alzheimer's significantly, with only some slight evidence that neurodegenerative decline is slowed, and alarming adverse effects of headaches and intracranial swelling! Obviously, even if such drugs are approved, a broader treatment to actually restore brain health and function will be needed. We must stop pretending that such targeted allopathic approaches will provide the whole magic solution to such complex pathologies. Integrating holistic care with restoration of healthy brain function, utilizing a comprehensive package of care with CIM/TCM, is the sensible approach, and involves no risk or side effects. Many patients now realize that just blocking a symptom is not a cure, and just such a comprehensive approach to restoration of health of the central nervous system is absolutely necessary, whether you are taking drugs to decrease symptoms or not. CIM/TCM, or Complementary and Integrative Medicine such as Traditional Chinese Medicine, provides an array of synergistic treatments that can be successfully utilized in short courses of treatment, individually tailored to each patient's needs and desires.

The growing awareness of the Alzheimer's disease and prevalence in the United States has led to a huge investment into new drugs. The most popularly prescribed drug, Aricept (donepezil), though, was approved by the FDA in 2010 against the advice of the FDA review committee, purely due to the lack of alternative cures or treatments. This drug is a cholinesterase inhibitor, designed to increase the amount of acetylcholine in the brain by blocking its rate of breakdown, or catabolism. The FDA and the NIH (National Insitutes of Health) state that Aricept only helps control the symptoms of Alzheimer's disease, but does not cure it, and the benefits are marginal. At a low dose, the common side effects include nausea, diarrhea, loss of appetite, frequent urination, muscle cramps, nervousness, depression, confusion, changes in behavior, insomnia, and excess tiredness. These side effects have generated much criticism, as most of the patients are elderly and their quality of life is already impacted by such health problems. In fact, due to the frequency of these health problems in the Alzheimer's population, the drug is rarely blamed. In 2012, the patent protection was set to expire for Aricept, and so the FDA approved a new patent protection of the same drug at a much higher dosage (an increase from 5 to 23 milligrams, called Aricept 23). A single drug trial was used to justify this new higher dosage, with just 1400 patients involved, conducted by the maker Pfizer/Eisai. This clinical trial noted that the higher dosage led to substantially more nausea and vomiting, alarming many physicians, as many of the patients prescribed the drug would be in poor health and struggling in nursing facilities (see and article on these issues in the March 23, 2012 New York Times entitled Drug Dosage Was Approved Despite Warning). Dr. Steven Woloshin, professor of medicine at Dartmouth Institute for Health Policy and Clinical Practice, stated: "It doesn't really have much benefit, but does substantially more harm." Dr. Woloshin noted that Pfizer had made false claims in advertising to doctors and on the label, claiming that drug had improved clinical and overall functioning when that was not the case. The clinical trial showed only a slight improvement in cognitive measures, and no improvement in global measures. Dr. Woloshin and his colleague Lisa M. Schwartz alerted the FDA to these false claims, and only then was the request for a correction made. Dr. Sidney Wolfe, director of the Public Citizen's Health Research Group, alarmed at the risks of the drug Aricept 23, and lack of efficacy in the single clinical trial, asked the FDA to remove the drug from the market. Both clinical and statistical reviewers for the FDA recommended against approving the higher dosage of Aricept, but the FDA approved this drug against the reviewer's opinions.

To counter these negative reports and warnings concerning the chief cholinesterase inhibitor marketed for treatment of moderate Alzheimer's disease, Novartis Pharmaceuticals introduced a transdermal patch to deliver the drug rivastigmine (Exelon), a cholinesterase inhibitor. This delivery system utilizes a small topical dose, and increases this dosage each month until side effects are noted, with the patch changed daily. Unfortunately, adhesive skin patches often do not stay in place, and clinical trials of Exelon patches note the same adverse effects as Aricept, with higher dosage, or accumulation in the blood, resulting in nausea, vomiting, weight loss, diarrhea, loss of appetite, increased gastric acid secretion (heartburn), tachycardia, and neurological effects. While the patients utilizing the topical patch had fewer adverse effects than those taking a rivastigmine pill, where 23 percent experienced nausea and vomiting, 8 to 10 percent of patients using the patch in the single clinical trial conducted stopped taking the medication due to side effects. This trial also showed that patients with poor liver function had a 60 percent lower clearance rate of the drug, leading to accumulation and overdose, and long-term adverse effects are insufficiently evaluated. The clinical trial failed to evaluate patients with kidney problems, but laboratory evidence shows that with kidney dysfunction a 60 percent lower clearance of the drug also occurs. The problems with these synthetic cholinesterase inhibitors involves variance with delivery in using a skin patch, potential for erratic dosage and accumulation in the blood, and problems metabolizing the drugs in the elderly with subclinical liver and/or kidney dysfunction. Warnings on the company website state that at higher dosages (or blood level accumulations) the Exelon patch is associated with significant gastrointestinal adverse reactions, including nausea, vomiting, diarrhea, anorexia/decreased appetite and weight loss. Caregivers are instructed in the drug insert to carefully monitor for these more severe side effects and alert the prescribing physician to adjust the dosage or discontinue the drug temporarily in this event.

Even if these cholinesterase inhibiting drugs work, and are tolerated, utilizing Complementary and Integrative Medicine (CIM), in the form of acupuncture, herbal and nutrient medicine, not only offers that patient the potential of utilizing a lower dosage of the drug, but also may help to counter the adverse effects, minimizing nausea, weight loss, tachycardia, heartburn, and helping to restore liver function, or optimizing liver function to insure that the drug is metabolized properly. A number of effective aids to acetylcholine function are proven to work in CIM, including the heavily researched actelycholinesterase inhibiting herbal chemicals Huperzine A and Vincristine (vinca alkaloids). A combination of aids to acetylcholine production, such as Alpha-GPC, these herbal acetylcholinestase inhibitors, neuroprotective herbal chemicals such as resveratrol, and short courses of acupuncture proven to stimulate key centers in the brain, provides a package of complementary care with no adverse side effects.

To date, the few approved pharmaceuticals for the treatment of Alzheimer's and Parkinson's diseases are presenting considerable adverse effects compared to poor long-term benefits. Patients, as well as a small number of medical doctors, are becoming aware, though, that herbal cholinesterase inhibitors, such as the FDA approved Huperzine A, an extract from the Chinese herb Huperzia serrata, a species of clubmoss, and galantamine, a chemical from a Chinese herb Lycoris radiata (Shi suan), licensed as an effective anticholinesterase inhibitor, as well as Salvia miltiorrhiza (Dan shen), and Anemarrhena asphodeloides (Zhi mu), Gentiana rhodantha, Swertia punica (Zi Hong Chang Ya Cai), Mangiferrin indica, all of which contain mangiferin (see clinical link below), may be as effective as Aricept and Exelon, as shown in clinical trials at the University of California (cited in Additonal Information). Neither Aricept or Huperzine A by itself is proven to have a statistically significant effect on cognitive scores in the short term, although their effects are statistically about equal (S.L. Rogers et al, Donezepil Study Group, Neurology 1998;50:136-145). The adverse effects from the herbal anticholinesterase inhibitors are minimal at best, even with a high dosage, though. With a more comprehensive treatment strategy in Complementary and Integrative Medicine (CIM/TCM), these cholinesterase inhibiting effects of huperzine and other Chinese herbal chemicals may be enhanced, and constitute a small part of the sensible holistic treatment strategy. Neurodegenerative diseases demand a more comprehensive and thorough treatment protocol, as they are not easy to treat, and a comprehensive protocol may be delivered in short courses of acupuncture stimulation with an individualized step-by-step herbal and nutrient protocol.

Another class of drugs increasingly prescribed for the treatment of Alzheimer's disease are NMDA glutamine receptor inhibitors, specifically memantine, which is marketed by various companies under a variety of names. In January of 2014, a multicenter study comprised of 29 University Medical Schools and other health facilities in the United States was published in the Journal of the American Medical Association, and showed that memantine had no significant effect in slowing the progression of Alzheimer's disease, while 2000 IU of d-alpha tocopherol Vitamin E did. Many experts state that this study presents the first really proven aid to slow the progression of the disease, and also indicates the importance of a plant-based whole grain diet (the nutritional source of Vitamin tocopherols). NMDA receptors are a class of glutamate receptors in the brain, and have been associated with neurodegenerative disease for some time. Some types of glutamate, such as monosodium glutamate, and a host of other glutamate chemicals created by the food industry to stimulate increased desire and addiction for processed food, have apparently upset the balance of glutamate receptors that are so important to brain function. Simply blocking a type of pathological gluatamate receptor has not produced the desired results, though. Supplying the brain with the building blocks for healthy glutamate receptor metabolism, and stimulating improved function in the brain, has demonstrated great potential value, though. The combination of L-glutamine, P5P (active Vitamin B6), and inositol hexacotinate (active form of Vitamin B3), provides the brain with such building blocks, and Vitamin B12, active folate (5MTHF), and phosphatidylcholine and serine, may also help. This type of treatment, combined with a holistic approach, may help the brain to restore its naturally programmed function and balance over time. Such therapeutic approaches are more complicated than just taking one pill, but the promise of improved health and function are real. The research is now sound supporting these therapies, and the only problem is acceptance and and admission by medical doctors that these protocols are proven to work. Instead, we have had duplicitous lies. For instance, the Chinese herbal chemical resveratrol has been widely used by M.D. specialists, but they tell the patients that this herbal chemical is just something found in red wine, while the actual medicine is extracted from the Chinese herb Polygonum cuspidatum (Hu zhang). Should our doctors be telling us mistruths and lies?

With the failure to find any pharmaceutical remedy of merit for neurodegenerative diseases, off-label, or unapproved, drug therapy has unfortunately been prevalent. While the prescription of pharmaceuticals in ways not approved by the U.S. Federal Food and Drug Administration is legal for medical doctors, the marketing of these drugs for unapproved purposes is illegal, as is establishing treatment guidelines within the healthcare industrial complex for such unapproved use and prescription. With lax enforcement of this public protection, the prescription of a class of drugs called antipsychotics, as wall as benzodiazepines, was widely accepted, especially in nursing homes. As adverse effects mounted, and a large number of scientific studies demonstrated harm, as well as lack of real treatment efficacy, FDA warnings were finally issued. For example, in 2005, the U.S. FDA issued an alert that atypical antipsychotic medications, increasingly marketed with appealing names, demonstrated an increased risk of death, from a variety of underlying causes, and issued a black box warning for the drug Risperdal (Risperidone). Prior alerts and revised label warnings concerned the increased risk of Metabolic Disorder, hyperglycemia and diabetes for this drug. Despite these increased warnings, this antipsychotic medication was increasingly prescribed, with expanded prescription not only to unwary elderly in nursing homes, but also to children, supposedly to treat ADHD (Attention Deficit and Hyperactivity Disorder) as well as autism.

The U.S. FDA found in 2008 that Risperdal (risperdone) accounted for nearly 27 percent of all antipsychotic medications prescribed in the United States from 2005 to 2008 (rising from 2 percent of market), after exclusivity protections were granted to its manufacturer, protecting profits much like a patent. In addition, during this period, the U.S. FDA found that now 25 percent of this explosive growth in the prescriptions were to children, with almost 22 percent prescribed by Child Psychiatrists. Not only the usual common adverse effects were seen with this antipsychotic medication, such as anxiety, aggressive behavior, agitation, memory and attention problems, restlessness and insomnia, but also an array of neurohormonal effects, such as abnormal growth of breast tissue in males and females, unusual breast milk secretion, episodic muscle weakness, tic, tremor, and problems with urination. In clinical trials, insomnia affected 26 percent of patients studied, with movement disorders also affecting over 20 percent, and headache and dizziness affecting 14 and 11 percent. This antipsychotic medication caused parkinsonism in 6 percent of patients in the clinical trials, yet suddenly became very popularly prescribed for "dementia-related psychosis", or behavioral problems. With such risk of serious adverse effects, it seems certain that the large number of prescriptions, mainly to the elderly and children, was not sponsored by reliable and responsible medical doctors. In 2014, a judgment of $1.2 billion for failing to communicate Risperdal's risks and aggressively marketing it for off-label use was upheld in an Arkansas Supreme Court appeal by the holder of the exclusive rights, Janssen Pharmaceuticals, who had assumed that once Johnson and Johnson lost patent, that laws governing generics would protect it. Risperdal is just one of the numerous atypical, or second generation, antipsychotics, along with Abilify (Aripipazaole), Seroquel (Quetiapine), Zyprexa (Clonazapine), Invega (Paliperidone) and Clozapine. A 2008 study at the University College of Pharmacy, in Kingston, Rhode Island, U.S.A. found that mounting evidence of these atypical antipschotic medications in recreational drugs cocktails then existed, with Seroquel being the most abused drug in this sense. Studies since then have confirmed the widespread use of antipsychotic drugs used to enhance opiates, cocaine and methamphetamine in studies of prison and jail populations. The widespread prescription of these drugs, some of the most widely prescribed drugs in the United States in the last decade, is ignoring many potential problems.

In 2010, with the proof of efficacy of early diagnostic tests for Alzheimer's disease, there was a rush to market new drugs. The problem with the pharmaceutical drug rush, though, is that the complexity of neurodegenerative disease is high, and we still haven't defined the array of causes. Biologic medicines are focusing on blocking enzymes that prevent the formation of beta amyloid protein plaques in the brain, but the latest drug trial by Eli Lilly (semagacestat) found that the new drugs do reach the brain in sufficient dosage, and do block the correct enzyme metabolism, but actually worsen the condition rather than improve it (see the link in Additional Information to an article on this subject). Dr. Lon Schneider, a leading researcher from the University of Southern California, states: "We don't know what the drug targets for Alzheimer's disease are. We don't know because we don't know the causes of Alzheimer's." Dr. P. Murali Doraiswamy, an Alzheimer's researcher at Duke University believes that: "our current views may be too simplistic." A common belief in the rich field of neurodegenerative research is that the causes are many, the mechanisms are complex, and reversal of neurodegeneration will require a complex treatment protocol. Complementary and Integrative Medicine supplies a rich diversity of treatment protocols supported by current research, and treatment should start with prevention and early intervention. The good thing about Complementary and Integrative Medicine (CIM/TCM) is that this therapeutic approach is actually good for the patient and without significant risks or side effects. General health will improve when the patient utilizes the skills and knowledge of the Licensed Acupuncturist and herbalist to prevent or treat these neurodegenerative diseases.

In response to the failure of any pharmaceutical drug strategy to significantly affect the neurodegeneration of advanced Alzheimer's disease, an experimental strategy utilizing implanted electrodes in the brain is being tried. Years of observation on patients volunteering for this therapy will be required to judge efficacy, and a number of prominent university medical schools are participating in clinical trials, including Johns Hopkins University, the University of Toronto, the University of Florida, Arizona's Banner Health System, and Ohio State University. Dr. Douglas Scharre, a Ohio State University neurologist who is participating, stated in an interview (Lauran Neergaard; AP): "We're getting tired of not having other things work." This sentiment reflects the growing frustration of neurologists with a complete lack of efficacy with standard and new pharmaceuticals. This implanting of electrodes has already been tried with Parkinson's disease and other neurological disorders, but the challenge in Alzheimer's is great, as the neurodegenerative plaques accumulate in many areas of the brain, and deep brain stimulation (DBS) can only be applied in selected areas. The initial choice for placement is the fornix, a hub of memory, but implants into the frontal lobe are also being tried. The hope is that DBS will eventually show some mild improvement for advanced Alzheimer's for some symptoms of the disease. Of course, this stimulation does not bring the brain back to a healthy state, and integration with Complementary Medicine seems to be an intelligent choice for patients seeking to do everything they can to slow or reverse this complex neurodegeneration.

There is an underlying link to many of the common health problems now affecting up to a fifth of the population, and this concerns gradual focal degeneration of the central nervous system. Whether your child is affected by attention deficit and hyperactivity disorder, you are bothered by problems with attention span, or your parents are diagnosed with Alzheimer's or a Parkinson's disorder, or even Glaucoma, the health concern is a complex and multifaceted problem that concerns the health maintenance of the tissues and function of our brain.

The most well known of these neurodegenerative diseases is Parkinson's Disease, which is actually not a specific disease, but a group of neurodegenerative disorders technically called Parkinsonism. Parkinsonism is still not understood despite extensive research and theory that has been conducted since the first extensive treatise on the subject by the British physician James Parkinson in 1817. A number of attempts to define the disorder by basing medical theory on a particular pharmaceutical drug have failed miserably, and stifled research into the multifaceted aspects of neurodegenerative disease. Parkinsonism is defined by the Stedman's medical dictionary as: "A neurological syndrome usually resulting from deficiency of the neurotransmitter dopamine as the consequence of neurodegenerative, vascular, or inflammatory changes in the basal ganglia, or a syndrome similar to parkinsonism appearing as a side effect of certain antipsychotic drugs." The key to this definition is the multifaceted origin of the disease in neurodegeneration, vascular problems, and inflammatory dysfunction.

Key Environmental Concerns

A key issue in the complex subject of causes of Parkinsonism is the potential for this disease to be caused by chemicals. The medical dictionaries point out the fact that antipsychotic drugs, which are now frequently prescribed for conditions other than psychosis, may cause parkinsonism as a side effect. This class of drugs, antipsychotics, are given attractive names and now prescribed to a majority of our elderly in nursing homes and assisted living facilities. Often, the excess use of antipsychotic drugs is deemed necessary to control the erratic behavior of our elderly in nursing facilities when a well-staffed and efficient care program is not available. In other words, when profiteering health companies cut costs by reducing staff and cheapening the environment, they then increase costs by overprescribing expensive antipsychotic drug regimens. An alternative to this miserable outcome would be to promote non-profit nursing facilities for our elderly that utilize increased trained staffing, and healthy environments that reduce behavioral problems, and offset the costs by reducing the drug consumption and eliminating the profit motive. The relatives of these excessively drugged elderly wonder why their loved ones mental states are deteriorating, and the chronic excessive prescribing of antipsychotic drugs with cute names may be the reason.

An example of such bad behavior is the case of the 2013 $2.2 billion settlement by Johnson and Johnson to settle a case with the U.S. federal government for illegal off-label marketing and and illegal kickback system with such nursing home corporations as Omnicare (itself settling prosecution claims of a massive kickback scheme for $98 million in 2012, and again for $120 million in 2013), centered on the anti-psychotic drug Risperdal Consta. Many elderly patients were prescribed this drug for no good reason, and it may have caused Parkinsonism, or Alzheimer's disease. On top of that, massive costs to Medicare and the taxpayer, as well as insurance companies, which raised the cost or policies for most customers, was involved. Since Johnson and Johnson made over $20 billion in profit from 2003 to 2010, the settlement was a great deal. This is only one of now many such settlements for manipulation of prescriptions of anti-psychotic medications. To see the settlement agreement between the U.S. Department of Justice and Omnicare in 2012, click here: On Nov. 4, 2013, Johnson and Johnson agreed to an additional settlement of $149 million, on top of the prior agreement for illegal marketing schemes of Risperdal for $2.2 billion, for allegations concerning this massive kickback scheme between Omnicare and nursing home prescribers. Since these settlements avoid admission of guilt or proscecution, though, and are reported only in the business sections of newspapers, magazines, and internet news sites, there will be little public awareness or actual deterrence of such behavior, which has proved profitable despite these massive settlements to the U.S. Justice Department.

Various environmental neurotoxins have also been widely studied as contributors to these common neurodegenerative diseases, and their unnatural increase in occurrence, including Lead, Mercury, Polyvinyl chloride (PVC), and Polychlorinated biphenyls (PCB). PCBs are found in electrical components, motor and hydraulic oils, flourescent lights, cable insulation, thermal insulation such as fiberglass, felt, foam and cork, adhesives, oil-based paints, caulking, plastics, and floor finishing products. Polychlorinated dibenzo-p-dioxins, or organchlorines, are also now the focus of much scientific concern, and these dioxins are a particular threat as they attract to fatty tissues, store there, and do not break down easily, releasing a low dose of harmful chemical that gradually causes neurodegenerative disease in the brain, which is composed of much fatty tissue. Of particular concern are organochlorine pesticides. Paraquat, the most widely used herbicide in the world for some time, has an analog chemical called cyperquat, which is a chloride of MPP+ (1-methyl-4-phenylpyridinum) that has been shown to be neurotoxic, interfering with oxidative phosphorylation in mitochondria of brain cells, and causing Parkinson's neurodegeneration, depleting ATP, the primary fuel for these cells, and leading to neuron apoptosis, or cell death. Depletion of ATP and introduction of MPP degrades the ability of the ubiquitin proteasome system (UPS), the essential system of tagging and degrading abnormal proteins in our cells, such as the so-called "sticky proteins", or beta-amyloid clumps of misshapen and abnormal proteins. Cyperquat is still used as an herbicide, and is just one example of numerous organochlorines used in pesticides and an array of industrial products, such as flame-retardants, plastics, solvents, etc. with varying degrees of toxicity. Organochlorine pesticides are particularly problematic, because they are ingested in food and water, or breathed during spraying, do not easily break down, are lipophilic and accumulate in fatty tissues, and have been proven to contribute to neurodegeneration, cancer, infertility, endometriosis, and other diseases. Few studies of tissue accumulation of organochlorines and dysfunction have been performed, and studies of exposure and blood serum levels do not reveal this threat.

Another widely used herbicide and pesticide, Rotenone, is also implicated in causing Parkinsonism neurodegeneration, but is considered safe since it breaks down quickly and easily and is poorly absorbed by the human gastrointestinal tract. This safety assessment is questioned by many experts, though. Since Rotenone is derived from a plant source it is marketed as an organic herbicide for the garden, giving many customers a false impression of safety. Rotenone is also widely used in commercial food production to reduce mite infestations on chickens, and by the fish farming industry to kill various species of invasive fish. Contact with the chemical before it is broken down, or complex compounds that may be created by the chemical in its use, have potential to cause neurodegeneration. While these chemical scenarios have not yet been studied enough to create legal banning of the pesticide, the risk is real. A 2013 meta-review of all published scientific study, by the Parkinson Institute, and Foundation IRCCS of Pavia, Italy, concluded: "The literature supports the hypothesis that exposure to pesticides and solvents is a risk factor for Parkinson's Disease." The study found that the risk was increased by exposure to any chemical pesticide, herbicide, or solvent, but the risk for exposure to paraquat was a 2-fold increase, or doubling of risk. The list of potential chemical causes or contributors to neurodegeneration is now long, and our ability to decidedly link these chemicals to a particular case is problematic in a legal sense, inhibiting effective regulation or the disincentive for use via lawsuits. The ubiquitous pollution of our foods, soils, and water with such agents may be integral to the onset of Parkinson's disease in a great number of people, though.

Of course, our immune and detox systems protect us from these environmental and food chemicals and the cellular damage they may cause to a great extent. In many patients, imbalance of these systems itself is shown to potentially create a neurotoxic mechanism that leads to a degenerative condition. Poor health of the immune and detox systems is thus a double threat. Utilizing Complementary Medicine to enhance the health of the immune and detox systems int the body is a sensible approach to prevention. Many herbal and nutrient aids may also prevent or alleviate the specific pathological mechanisms associated with these chemicals. For instance, since MPP+ depletes ATP, interferes with oxidative metabolism, reduces levels of dopamine and norepinephrine (adrenalin), inhibits catecholamine synthesis (cortisol), and inactivates tyrosine hydroxylase, a number of nutrient and herbal medicines may work to decrease these harmful effects. ATP cofactors (specific forms of vitamins B1 and B2), antioxidants, dopaminergic herbs, the amino acid L-tyrosine, vitamin B12 and P5P, and aids to adrenal health and function may correct these pathological metabolic processes, especially when combined with the correct herbal formulas and acupuncture stimulation. While debating the origin of the individual's disease is not going to achieve a cure, patients with these disorders, their families and friends, and all of us, need to understand that such chemicals should be taken out of our environment. In the meantime, cleaning up the mess internally is a healthy option as well.