Parkinson's, Alzheimer's, ADD and Other Neurodegenerative Disorders

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


Parkinson's, Parkinson-like disorders, Alzheimer's, Primary Progressive Aphasia, and Other Neurodegenerative Disorders

Whether the patient has early signs of a neurodegenerative disorder, mild and manageable symptoms, or has progressed to severe manifestations such as Parkinsonism and Alzheimer's disease, the key to both prevention and treatment in any stage is understanding and adopting a health regimen that restores healthy function and tissue to the brain. Health problems with the nervous system are no different than health problems with the digestive or cardiovascular system, and you should not be put off by stigma or fear of acknowledging these problems. A wealth of research is now available concerning these now common conditions, and this scientific evidence is what guides Complementary Medicine to provide individualized care that is centered on the health of the central nervous system. Of course, like any common health problem, the best time to treat is early in the pathology. The central problem to this type of health care is the complexity of factors that combine to create the pathology. Effective treatment with holistic medicine involves attention to all of the contributing health problems that combine to create the neurodegenerative condition.

In 2013, two large studies of neurodegenerative dementia were published in the esteemed British medical journal The Lancet, clearly showing that rates of dementia have dramatically dropped in the last 2 decades in populations studied in Great Britain and Denmark. This was attributed to a variety of health factors, or improvements in the general health, diet and lifestyles of this group of aging participants. No specific reasons for this improvement were found in the studies. Experts in the United States, such as Dr. Dallas Anderson of the National Institute on Aging, and Dr. P. Murali Doraiswarmy of Duke University Medical School, hope that these same trends will be shown in the United States, as well. The rates of dementia in these studied populations were still 6.5 percent of the total aging population, though, and are expected to be higher in the United States. The number of serious cases of neurodegenerative dementia worldwide is expected to more than double by 2050, reaching an expected 227 million clinically diagnosed cases. Since no pharmaceutical medications have been shown to be effective, these experts in Alzheimer's and Parkinsonism surmise that a variety of factors concerning improved patient understanding and improvements in holistic health in the last two decades are the reason for this improvement in specific geographic areas in Europe. In 2014, a meta-analysis of health records headed by the University of Cambridge, in the United Kingdom, and built upon data from a prior meta-analysis at the University of California in San Francisco, showed that half of all future cases of Neurodegenerative diseases such as Alzheimer's and Parkinsonism could be prevented by a holistic program of prevention, including treatment of sleep disorders, obesity, Metabolic Syndrome, Mood Disorders and Cardiovascular disease. This clearly points out that a holistic health approach, and utilization of holistic medicine and physician advice, is the key to this prevention of neurological degeneration, or dementia. Gaining understanding and utilizing Complementary Medicine is the key to this approach. Over 100 million citizens of the European Union utilized Complementary Medicine in 2012, with over 80,000 physicians practicing acupuncture, and over 50 million patients utilizing herbal medicine, according to a study by the group CAMbrella.

Many studies have been conducted to discover both genetic and environmental factors associated with the gradual development of neurodegenerative diseases such as Parkinsonism and Alzheimer's disease, and these do overlap to a great extent with epigenetic contributors and de novo genes, which may be affected by the environmental factors of either the patient or the immediate parent. We have seen some clear patterns emerge in environmental studies of the health history of patients over time. For instance, in 2003, a large long-term study of a specific sub-set of the U.S. population, Japanese-Americans whose family migrated to the U.S. in the twentieth century, by experts at the University of Virginia, found that exposure to pesticides and manufacturing chemicals at work were highly associated with later onset of Parkinsonism (PMID: 14579122). They also found that dietary factors clearly were associated, including excess processed carbohydrates and lack of health polyunsaturated fats, as well as poor gastrointestinal health, with constipation and overweight conditions highly associated. Factors that did not predict later onset of Parkinsonism were coffee intake, smoking habits, dieting, saturated and monounsaturated fat consumption, protein intake, dietary cholesterol, and intake of essential nutrients such as Vitamins A, B, C beta-carotene, riboflavin, niacin, cobalamin, alpha-tocopherol, and pantothenic acid. Clearly, the modern diet with more processed foods and less plant-based whole food diets, and lack of healthy unprocessed oils and fats, and whole grains, was highly associated with neurodegenerative disease. Taking typical vitamin and multivitamin supplements probably had little effect, as did common health protocols such as avoiding coffee and cigarettes. Such studies as these are very revealing. More attention should have been directed at unhealthy environmental chemicals, promotion of a fresh, local plant-based whole food diet that included many whole grains and natural fats, and more attention to Metabolic disorders. Research in the last decade has largely confirmed that poor sleep quality is also highly associated with later onset of Parkinsonism and neurodegeneration. For instance, study at Denmark's Center for Healthy Aging and the Danish Center for Sleep Medicine found that REM Sleep Behavior Disorder (RBD) may be one of the key early signs of Parkinson's disease. This disorder involves restless sleep during REM cycles, and waking with disturbing dreams. Achieving healthy sleep cycles could be a key factor in prevention, but simply taking sleep medication to correct insomnia only achieves more continuous sleep, not healthy sleep cycles, and in fact, chronic taking of sleep medications is proven to disrupt healthy function of the brain during our sleep cycles. Restoration of natural homeostatic mechanisms and addressing the underlying causes of insomnia and poor quality sleep with Complementary and Integrative Medicine, while more difficult than just taking a pill, may be very valuable to prevention Parkinsonism and Alzheimer's disease, as well as resolution of sleep disorders such as nocturnal bruxism and restless leg syndrome.

In 2011, the National Insitutes of Health (NIH), National Institute on Aging and the Alzheimer's Association announced that diagnostic guidelines had been widely accepted that divided the disease into three stages, Preclinical, Mild Cognitive Impairment, and Alzheimer's Dementia. It is recommended that patients suspected of developing preclinical (no obvious symptoms) or mild cognitive impairment take measures to prevent or slow the development of the neurodegeneration to Alzheimer's Dementia. Appropriate testing guidelines are still being developed, but will include a PET scan and analysis of cerebral spinal fluid (CSF). PET scans (positron emission tomography) may reveal reduced glucose uptake in areas of the brain, perhaps associated with insulin resistance, and altered levels of amyloid beta and tau proteins in the CSF will be detected with study of the cerebral spinal fluid, perhaps associated with advanced glycation endproducts (AGEs). These findings indicate key pathological mechanisms of Alzheimer's and Parkinson's diseases. MRI studies may confirm physical atrophy of areas of the brain as well. In addition, changes in cognitive function, as well as signs of underlying diseases linked to the pathology should be considered when determining risk of a preclinical stage or early cognitive impairment. Learning about these subjects helps the individual patient understand how to best approach preventive measures. Patients diagnosed with preclinical disease or mild cognitive impairment may choose to integrate effective treatments in Complementary Medicine to prevent the progression of the disease without side effects or fear of adverse outcomes with harsher therapies. If drug therapies are necessary, these side effects and adverse consequences of long-term drug therapy may be alleviated with Complementary Medicine. The National Institute on Aging and the Alzheimer's Association admit that effective drug regimens have yet to be developed, and do recommend some treatment protocols of Complementary Medicine.

Recent research is now uncovering a variety of tests that reveal when these neurodegenerative conditions are developing, allowing patients to start reversing this complex pathophysiology at an early stage. The NIH states that Alzheimer's and other neurodegenerative diseases, such as Parkinson's, start developing 10-20 years before any health problems are evident. The New York Times, in an article on July 14, 2010, outlines the new diagnostic criteria, and the problems inherent in this new set of definitions of Alzheimer's and cognitive impairment disease: A simpler explanation is found in an article on the same day in the Los Angeles Times:,0,1811001.story. We see from these articles that the two main problems with early diagnosis is 1) there is currently no treatment for early neurodegenerative disease in standard medicine, and 2) there is an expected reluctance to be diagnosed with an early stage of neurodegenerative disease. The first problem can be overcome by utilizing Complementary Medicine and the wealth of research and treatment protocols, which are explained on this web article. The second problem has been helped by the upcoming elimination of the pre-existing clauses in health insurance by the Obama health care reform. The most important problem, though, may be the way the public views neurodegenerative conditions, and the fear of being diagnosed with such a problem. This article is intended to educate the patient population on the fact that neurodegeneration is a fact of life that most of us will encounter with aging to some degree. The positive way to handle such health problems is to understand them and do the right things to maintain one's optimum health, rather than to wait in the dark for the problem to become severe enough to make it very difficult to treat. The fact that it is now estimated that a high percentage of the aging population will be affected by Alzheimer's, Parkinson's, or one of the other neurodegenerative diseases that are potentially debilitating should be a wake up call to the general population that we should all work to understand and prevent these health problems.

The array of neurodegenerative diseases includes a number of disorders that come with aging, and an array of accompanying health problems. Primary Progressive Aphasia (PPA) is one of these neurodegenerative disorders that often affect the patient soon after menopause, often affecting just the speech and memory centers in the left hemisphere first, but usually progressing to a more complex disorder, such as Alzheimer's later in life. Nonspecific degeneration is associated with PPA in 60 percent of advanced cases, affecting the superfical cortex of the brain, while Alzheimer's degeneration is seen in about 20 percent of advanced cases (plaque accumulation and tangles). Pick's Disease is also seen in about 20 percent of advanced PPA (specific types of cell inclusions called Pick's bodies). The various types of advanced neurodegeneration seen in autopsy studies of advanced PPA suggest that there is a variety of paths that the neurodegeneration may take. These paths imply that individuals have different health imbalances that contribute in various ways to progressive neurodegeneration. We also see classic Parkinsonian degeneration with Lewy bodies in the substantia nigra and other related areas, as well as diffuse Lewy Body Disease. Corticobasoganglionic Degeneration is another type of neurodegenerative disease, and these various classifications are diagnosed with the use of EEG, PET scans, and CT scans, as well as the signs and symptoms. The variety of presentations imply that the patient should try to understand the various health problems associated with neurodegeneration in the many scientific studies devoted to this complex health problem.

More and more sound scientific research validates the positive effects of acupuncture, herbal and nutrient chemicals on the central nervous system. For many years, experts have touted the importance of neuroprotective and antioxidant therapy to both prevent and treat neurodegenerative disorders. As research continues to reveal the pathophysiology of these complex neurodegenerative diseases, and the very slow progression that is now evident, Complementary Medicine is able to utilize these findings to improve the specific treatment protocols for each individual, whether they have been diagnosed with an early stage of disease, wish to prevent these diseases, or have clinical symptoms. Patient understanding of these neurodegenerative disorders is all-important, as well as an early pro-active approach. Health problems are the responsibility of the individual, not just the doctor, and choosing to integrate the knowledgeable Licensed Acupuncturist and herbalist is an intelligent choice in the realm of neurodegenerative disease and prevention.

Reducing the risk of neurodegenerative progression

With the realization that there is no single therapeutic measure found to be effective for the treatment of Alzheimer's, Parkinson's, and other debilitating neurodegenerative disease syndromes yet in 2010, and that these serious neurodegenerative disease are almost always diagnosed too late, the public is growing very concerned about reducing their individual risk as they age. In 2010, the National Institutes of Health sponsored a jury of 15 medical scientists with no vested interest in Alzheimer's research to explore all of the current evidence. This jury of experts found that strong evidence of risk was associated with two factors: 1) the use of synthetic estrogens and progestins in hormonal replacement therapies and birth control, which doubled the risk for Alzheimer's, and 2) the presence of an E4 variant of the ApoE gene, which tripled the risk (see the link to a New York Times article on this NIH panel below). The ApoE gene is a gene that expresses apolipoprotein, or proteins that bind to fats, and is expressed in the now familiar LDL, HDL, VLDL, and IDL, which are often mistakenly referred to as cholesterol. These chylomicrons contain cholesterol as 1-3% of their makeup, but are mainly composed of triglycerides and phospholipids. Apolipoprotein E binds to specific receptors on liver cells, and peripheral receptors. There is a strong link via these lipoproteins between cardiovascular disease, metabolic syndrome, and Alzheimer's, as well as diseases of immune dysfunction, such as autoimmune disease. Genes consist of alleles, or base pairs, and the E4 allele of ApoE is implicated in both atherosclerosis and Alzheimer's disease. In addition, some respected research organizations (e.g. Northwestern University) have indicated that Alzheimer's might be realistically called "Type 3" diabetes, or a new type of Metabolic Syndrome.

Research has shown that there is a strong connection between neuron failure in Alzheimer's disease and depleted myelin cholesterol (via ApoE deficiency) that has been linked to cholesterol depletion and poor expression of cholesterol as a result of chronic use of statin cholesterol blocking drugs, or as an adverse reaction to statins. Since synthetic hormone therapies and statin drugs are prescribed to a large percentage of the population, this has become an issue of concern, even to standard medicine. In addition, there is strong evidence linking accumulation of heavy metal toxins to neurodegenerative diseases, and most of these toxins exist as airborn lead and mercury molecules allowed into our air from coal fired power plants, smelters, chloralkili and concrete production. The instituting of clean coal technology has been woefully slow in the United States, and the highest levels of this type of pollution in the world has existed in the United States for a number of decades. In addition, the now widespread use of high fructose corn syrup, which purportedly introduces more mercury into the body, as well as contributing to a variety of metabolic pathologies, has also alarmed many experts. Adoption of clean coal technologies, elimination of high fructose corn syrup from processed foods, and a decrease in consumption of advanced glycation endproducts (AGEs) are ways to reduce risk of these neurodegenerative conditions. Use of safe chelation therapies may also be an effective preventive measure.

There are a number of healthy protocols that have been shown to reduce risk for neurodegenerative disease, and supported by the NIH panel in 2010. Increased regular exercise, a diet rich in fresh vegetables and whole grains, with less meat consumption, less sugar consumption, and healthy cognitive activities (exercising the brain and getting away from the television and idle internet browsing) have all shown to reduce risk. Reducing chronic inflammation, improving sleep quality, treating depressive disorders, and treating myofascial syndromes that may inhibit healthy blood flow to the brain, are also ways that are proven to reduce risk. Research done by the Scripps Research Institute in California, and supported by research across the world, has shown that mild use of marijuana in a patient's history is also associated with significant reduction of risk for Alzheimer's and Parkinson's diseases, and the THC actually prevents formation of lipoprotein plaque in Alzheimer's disease by preventing excess acetylcholinesterase activity. Stress reduction is highly recommended as well (refer to the article on this website to better understand stress). In other words, the treatment protocols and advice given by your Licensed Acupuncturist (minus marijuana use) for the last twenty years, especially one that incorporated the Tui Na physiotherapies into the treatment with acupuncture, herbal and nutrient medicines, provides an excellent overall protocol for reducing risk of neurodegenerative diseases. While no single herb or nutrient medicine has been found to be significantly effective on its own, and no large acupuncture clinical trials have been adequately designed as of yet, the information in this web article will show the potential for a broad protocol of a variety of treatments that have all been proven to show mild positive effect, and probably need to be taken together, as a thorough and holistic protocol, to show significant benefits.

Research presented at the 2011 Alzheimer's Association International Conference in Paris, France, by UCSF researchers led by Deborah Barnes PhD, noted that over half of Alzheimer's disease cases could potentially be prevented by treatment or prevention of chronic medical conditions along with diet and lifestyle changes. This worldwide study found that the biggest modifiable risk factors appeared to be smoking, lack of physical activity, depression, mid-life hypertension, diabetes or metabolic syndrome, and mid-life obesity. A lack of cognitive activity represented by low education and lack of cognitive challenges was also found to be a modifiable risk factor. In January of 2014, a multicenter study showed that 2000 IU of d-alpha tocopherol Vitamin E significantly slowed the progression of Alzheimer's disease, while one of the most promising pharmaceuticals, memantine, did not. Tocopherol Vitamin E is found in various whole grains, such as wheat and buckwheat, seeds such as flax and sunflower, and various vegetables, such as asparagus, sweet potato, and bell pepper, as well as soy and wheat germ oil, and may be taken as a supplement. Adopting a healthier lifestyle and utilizing Complementary and Integrative Medicine to help resolve chronic health issues is highly recommended to achieve these simple goals. While standard medicine has little to offer in real preventive medicine, much can be accomplished with a holistic regimen that utilizes acupuncture, herbal and nutrient medicine, and even soft tissue physiotherapies, to resolve metabolic problems, decrease stress and hypertension, and solve the problems associated with obesity, such as insulin resistance. The senior investigator with this large UCSF study, Dr. Kristine Yaffe MD, chief of geriatric psychiatry at SFVAMC, noted that the number of people afflicted with Alzheimer's disease is expected to triple over the next 40 years, and that the public should get serious about preventive measures.

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

How does standard allopathic medicine treat these neurological syndromes? 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. 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 dyfunctions. Obviously, a variety of treatment strategies are necessary to bring this codependant 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. Integrating this approach with restoration of healthy brain function utilizing a comprehensive package of care 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.

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, 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. 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 is 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 reveiwers 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, 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 take 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 inhbiting drugs work, and are tolerated, utilizing Complementary Medicine, 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.

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 below). 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 Medicine, 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.

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 facilites 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. 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.

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 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, agressive 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.

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 below 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 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.

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.