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

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

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The various treatment strategies and concerns in Complementary Medicine

Complementary and Integrative Medicine, and especially the array of therapies available from Licensed Acupuncturists and herbalists (CIM/TCM) that are familiar with these neurodegenerative diseases, present the patient with an array of therapeutic approaches that will make the standard pharmacological therapy more successful, alleviate symptoms of fatigue, insomnia and motor function. Short courses of frequent acupuncture stimulation with a more comprehensive but individualized course of herbal and nutrient medicine, along with soft tissue mobilization (Tui na), can improve life dramatically for patients with neurodegenerative disorders. A 2016 meta-review of the limited published studies of acupuncture in the holistic treatment of Parkinsonism, by experts at the King's College London Neurodegenerative Disease Research Group, and Middlesex University London, United Kingdom, concluded that the "therapeutic potential of acupuncture seems quite promising", noting that "acupuncture has been increasingly popular and has been used to treat patents with Parkinson's" (PMID: 26843036). The biggest obstacle is the support for this adjunct care by primary treating Medical Doctors, especially as patients with neurodegenerative disease that is advanced are often reluctant to have much therapy performed, and experience anxiety and fear.

CIM/TCM has much to offer all types of patients with Parkinson's, Alzheimer's, and other neurodegenerative diseases, at all stages of the disease progression. Of course, early diagnosis and treatment, and preventive medicine in these diseases, which are proven to manifest with signs and symptoms only after years of pathological changes in the brain, and the whole body, are most important, especially as standard medicine has almost nothing to offer therapeutically in the early stages and development of neurodegenerative diseases. Even at later stages, though, CIM/TCM should be utilized, as it actually provides relief and better quality of life, is relatively inexpensive, and without any potential of adverse effects, unlike the harsh medications used. Immune modulation, decrease of chronic inflammatory problems driving immune dysfunction, hormonal balancing, resolution of nutritional deficiencies, antioxidant therapies, enhanced cellular detoxification by boosting the glutathione metabolism, clearing of excess misshapen proteins from the cells and glial tissues, clearing of accumulations of toxins and heavy metal molecules from the brain tissues (chelation), clearing advanced glycation endproducts (AGEs) associated with plaque accumulations in brain tissue, aiding vascular health, and increasing metabolic supply for brain cells, are all strategies that have been scientifically studied and are being utilized in the Complementary and Integrative Medicine strategy. Coupled with manual therapies, such as needle stimulation, which is well proven in its ability to stimulate brain function and modulate immune inflammatory mechanisms, as well as the soft tissue therapies (Tui na) that may help by reducing cervical chronic inflammatory problems that push excess inflammatory mediators (see the article entitled Deep Tissue Massage and it's many benefits), as well as provide improved mobility and decreased pain and discomfort, this presents a comprehensive strategy for a very difficult array of problems to treat. All of this therapy may be daunting to the patient at first, and all of it may not be needed in the treatment protocol, but for patients with progressive severe neurodegenerative diseases, this intensive approach, coupled with the latest pharmacological medicines, may produce the successful outcome that is so elusive.

In 2014, researchers at Shanghai University of Chinese Medicine, and the Basic Medical College, in Shanghai, China, found in a meta-review of all published scientific studies of acupuncture to treat Alzheimer's disease, that 7 physiological mechanisms useful in the treatment protocol had been identified with acupuncture therapy. These beneficial effects were 1) regulation of neurotransmitters, 2) protective effects for neurons, 3) modulating expression of abnormal proteins, such as beta-amyloid, 4) improving levels of neurotrophic factors to aid healthy regrowth, 5) inhibiting chronic inflammatory damage in the brain, 6) regulation of intracellular signaling in the hippocampus, and 7) up-regulating the level of autophagy activity for damaged or diseased neural and glial cells. These researchers noted that while the complexity of Alzheimer's disease and problems with study design and funding currently prevented clear proof of ultimate clinical curative effects, the overwhelming evidence shows that acupuncture could play a very valuable role in the overall treatment protocol in the future (PMID: 23342786). These same benefits are applicable to patients with Parkinsonism and other neurodegenerative diseases. We see now the clear evidence that both immune and inflammatory mechanisms related to low-grade infection, as well as metabolic and hormonal dysfunction, lies at the heart of these slowly developing pathologies. Safe and effective treatment protocol must include holistic medicine.

The evidence for effective treatment with Complementary Medicine for both prevention and treatment of neurodegenerative diseases is mounting. The National Institute on Aging (NIA), a part of the U.S. National Institutes of Health (NIH), and the leading governmental research group on Alzheimer's and Parkinsons's diseases, has completed clinical human trials of Huperzine A (NCT00083590), an herbal constituent derived from a species of fir clubmoss called Huperzia serrata, which is a traditional Chinese herbal medicine and has been heavily researched in China for decades to prevent and treat neurodegenerative diseases. Huperzine A is an effective acetylcholinesterase inhibitor similar in scope to the pharmaceutical drugs galantamine (Reminyl, Razadyne, Nivalin), donepezil (Aricept), and rivastigmine (Exelon), although the herbal chemical is found to be reversible and selective, or what we term an evolved biomodulator. This herb Huperzia serrata, an arctic species, was used for centuries in China for the treatment of blood disorders, swelling, and fever, as well as senile dementia. The herbal constituent Huperzine A, a sesquiterpene alkaoid, was isolated from the herb and synthesized as well, by the Chinese, and has been prescribed heavily in China with very good results. Besides its modest effects on cognition, similar to the pharmaceuticals prescribed today, Huperzine A has also been found to have neuroprotective effects that go beyond the inhibition of acetylcholinesterase. Study at the Chinese Academy of Sciences in Shanghai, China (cited below), states that "potentially beneficial actions include modification of beta-amyloid peptide processing, reduction of oxidative stress, neuronal protection against apoptosis (programmed cell death), and regulation of expression and secretion of nerve growth factor (NGF) and NGF signaling." (PMID: 17056129). Such proven and important medicine can be easily and inexpensively included in the standard course of therapy with CIM/TCM, along with other promising standardized herbal chemicals, such as resveratrol and quercetin, berberine and curcumin, etc. While the dosage of these natural chemicals is kept low, and often the human organism has evolved limitations on utlization and rate of metabolism of natural medicinal chemicals, they provide proven benefits and just need to be part of a more comprehensive protocol. This strategy has been used in Complementary Medicine in China for thousands of years.

Studies have revealed that Huperzine A can penetrate the brain blood barrier easily, is potentially a more potent acetylcholinesterase inhibitor than its pharmaceutical counterparts, can increase the endplate potential at the neuromuscular junction to control tremor, can increase the levels of dopamine, norepinephrine and acetylcholine in the brain tissues significantly without affecting the 5HT neurotransmitter, and is proven to enhance cognitive function and memory in humans, without the side effects of the comparable pharmaceutical drugs. The only reason this phytochemical is not prescribed in the United States is that it is a natural herbal chemical that cannot be patented, and thus will not make billions of dollars for the pharmaceutical industry. This phyotchemical is available in formula as Vinpurazine, combined with Vinpocetine (Vinca minor extract) and rosemary extracts, other proven cognitive enhancers, from Health Concerns. It is recommended that the formula be taken with phosphatidylcholine, an active lecithin metabolite, to enhance the availability of choline and accelerate acetylcholine syntheis in the brain, as well as Inositol hexacotinate, a vitamin in the B3 family, that is a non-flushing version of niacin. Perhaps a more potent form of phosphatidylcholine is L-alpha-glyceryl-phosphorylcholine (Alpha GPC), also offered as CogniSpark by Health Concerns. To increase effectiveness, the nutrient medicines R-Lipoic acid and Acetyl-L-carnitine are also recommended in combination. The nutrient formula Neuron Growth Factors from Vitamin Research contains two forms of acetyl L-carnitine, combined with Gingko biloba, Gotu kola, and uridine (an essential growth factor for neuron axonal and dendrite growth). Uridine has been studied and proven to be effective for treatment of depression in combination with the omega3 fatty acids EPA and DHA by the Harvard Medical School, as well. These nutrient chemicals have been tested and proven to be independently effective for mild cognitive impairment, and studies to prove efficacy for their use in combination with current Alzheimer's drugs are being designed. The NIA has still not released its results from the phase II human clinical trial of Huperzine A, although we can surmise that the phytochemical is proven to be effective, or else it would not have been advanced to a phase 2 human trial. To summarize, a combination of Vinpurazine and CogniSpark (Health Concerns) with Neuron Growth Factors, Inositol Hexacotinate B3 (or ATP Cofactors), and R-Lipoic acid (Vitamin Research Products), may be prescribed for a few months to achieve some modest success in improving brain function and stimulating functional repair. While this may involve more pills and money than desired, the patient with advanced Parkinsonism or Alzheimer's disease is not going to experience great success without a more intense therapeutic protocol.

Resveratrol is also a chemical constituent of a Chinese medicinal herb that has undergone many clinical trials and is widely prescribed in China, and is now undergoing advanced human clinical trials in the United States, and is prescribed by many neurologists for treatment of Parkinson's. This phytochemical is most effective in a concentrated high dosage of a particular isomer of the chemical, all of which were developed in China. The effectiveness of the herbal chemical is dose dependant and a low dose is generally prescribed for many disorders as an antioxidant in the United States. A high quality product at a high dose is recommended for more advanced neurodegenerative states, and some professsional products now combine trans-resveratrol with quercetin, another proven aid to brain health as an antioxidant and detoxifying herbal chemical (Extension Resveratrol from Vitamin Research Products). Curcumin is another promising herbal chemical derived from Chinese herbal medicines, and has been researched in the U.S. and found effective. Currently, human clinical trials to prove efficacy in the treatment of Alzheimer's are being designed, and researchers at the Mayo Clinic Department of Neurology have stated that: "Several mechanisms of action have been proposed which may be relevant to Alzheimer's Disease based upon preliminary in vitro and in vivo data. Curcumin has been well tolerated in clinical trials investigating its use in other diseases. It is generally accepted as safe." Curcumin is found in its most concentrated form in the Chinese herb Curcumin longa (turmeric, or Jiang huang), but is also found in significant concentration in the roots of Curcuma zedoaria (E zhu), Curcuma aromatica (Yu jin), and Curcuma kwangsiensis (Zhong cao yao). Common food spice turmeric has little of these important chemicals such as curcumin in them, but medicinal plants, often picked wild and selected from specific areas of China where the soil and conditions are optimal, are rich in these medicinal chemicals. Optimized curcumin has been found in research studies to deliver more of this herbal chemical to the target tissues (e.g. LongVida), and combinations of enhanced curcumin with synergistic herbal and nutrient chemcicals have been created to improve effects. Dejavida (Vitamin Research Products) combines LongVida optimized curcumin with standardized green tea extract, niacinamide B3, cholecalciferol D3, and Serrapeptase proteolytic enzyme, all effective supplements for brain health with neurodegeneration. A combination of Extension Resveratrol and DejaVida for a month or two may prove an effective adjunct in the therapeutic protocol in the long run. Such treatment strategies, combined with short courses of acupuncture and electroacupuncture, and Chinese herbal formulas, provides a thorough and holistic approach to eventual recovery of brain health and function.

Gingko biloba is also an effective herbal medicine that has been heavily studied for the treatment of cognitive impairment and neurodegenerative disease. The Mayo Clinic researchers have stated: "Overall, there is weak evidence that Gingko biloba extract may provide modest cognitive benefit in some patients with Alzheimer's disease. Although pooling several small (and less rigorous) clinical trials of Gingko extract suggested a modest benefit, the recently published large, well-designed, clinical trial that employed current diagnostic criteria and outcome measures showed no overall benefit (used by itself at low dosage). No long-term data exists comparing Gingko with cholinesterase inhibitors or memantine, or evaluating Gingko biloba extract use in combination with those agents. Although case reports of bleeding problems exist (with no proof), as well as theoretical interaction with platelet inhibiting medications (the term theoretical is emphasized), it is currently widely used and seems to have a good safety profile." These M.D. neurologists make no effort to disguise their disdain for Complementary Medicine (see the NIH article link below), but yet do acknowledge the preliminary proof of modest efficacy and overall safety. In standard CIM/TCM practice, Gingko biloba is not the main treatment strategy, but may be combined in formulas or provided as an alcohol and glycerite tincture to improve the overall protocol, perhaps combind with Bacopa monnieri and Siberian ginseng (Eleutherococcus), all proven to aid brain function and which are all very benign herbs. The advantage of the tinctures is that they capture the lipid soluble chemicals better, which have more effect on the neurohormonal metabolism.

While the benefits from the isolated and concentrated high dosage of these active ingredients from Chinese herbal medicinals are easier to design clear clinical trials for, the bottom line is that in nature, a combination of herbal and nutrient chemicals is generally more effective in many ways. This is because nature has evolved complex chemical interactions that have proven to be effective in the survival and progress of animal species. These complex chemical groupings, and the effects of the chemical transformations that occur within the organism present enormous challenges to our scientific study. More importantly, the system of clinical trials in medicine we have designed and chosen are geared to clearly differentiate the effects of one particular pharmaceutical chemical molecule at a time. This does not actually negate the effectiveness of complex combinations of chemicals that are found in herbal medicines, and we do realize that sufficient dosage of these various herbal medicines in their natural form may have very significant positive outcomes.

The real problem is not the effectiveness of these herbal and nutrient medicines, but the ability to convince the patient population that they should take them at sufficient effective dosage for a long enough period of time to be effective, and to integrate into a comprehensive treatment protocol with acupuncture and tuina. Billions of dollars per year are spent by the U.S. population on nutrient supplements that are poorly regulated and generally of poor quality and show little effect. If a small portion of this money was instead directed to professional care in Complementary Medicine, the public health benefits would be dramatic. The intelligent patient will work with a knowledgeable TCM physician and take a research proven combination of herbal and nutrient medicines at a sufficient effective dosage for a prolonged period of time. Unfortunately, this rarely happens. When it does, we generally see a very significant improvement in clinical practice. In addition, much research utilizing functional MRI studies of the brain responses during acupuncture stimulation in the last 15 years has proven that acupuncture does indeed stimulate the key centers of the brain, and helps coordinate and modulate brain activity in ways that are proven to be effective in neurodegenerative states (see the research links to Harvard studies below). These studies now also prove that the type of stimulation is very important to the effect, and the choice of an acupuncturist that provides clear stimulation with correct control of this stimulation is very important. Acupuncture is not a completely mechanical treatment technique, and the ability and expertise of the acupuncturist is indeed very important. The patient must also realize that combining effective acupuncture stimulation while taking sufficient dosages of proven herbal and nutrient medicines can only help these medicines achieve greater overall effects on the brain.

One can see the potential in a therapeutic protocol that includes a variety of benefits for brain function and restoration when treating neurodegenerative disease, especially Alzheimer's. A prolonged protocol with Vinpurazine, Cognispark, Neuron Growth Factors, R-Lipoic acid, Resveratrol, EPAq omega 3 essential fatty acids, Turmeric (curcumin), and acupuncture, along with Tui Na physiotherapy, and potentially hormone balancing with bioidentical hormone stimulating topical creams, offers hope as an effective integrated adjunct therapy for these diseases. Of course, the disease progression is slow, and the progress with therapy in reversing this neurodegeneration may be slow as well. Starting treatment as early in the course of degeneration is most important, and early diagnosis is thus a great benefit to the patients. Waiting until the symptoms are so severe that behavior prevents effective use of a complex therapeutic routine is not reasonable.

For patients with more advanced disease who rely on medications such as L-dopa etc. the adverse "side" effects from medications can become ovewhelming, and studies show that compliance with pharmaceuticals is problematic. More and more studies show that a variety of sensible herbal and nutrient medicine can in fact alleviate or prevent some of these side effects, or even allow for lower dosage of the drugs to avoid harsh adverse health effects. The strategy of harsh polypharmacy is proving disastrous in medicine, especially for the aging population, and integration of herbal and nutrient medicines, acupuncture and physotherapy would provide a very safe and effective alternative to this harsh approach that is largely failing. A study in 2015 at the Lorestan University School of Medicine, in Iran, showed that betaine protects patients from oxidative stress generated by prolonged L-dopa (levodopa) use and use of benserazide. Such standard therapy is shown to intially improve symptoms in Parkinson's but eventually may contribute to accelerated degeneration. This study shows that common herbal and nutrient medicines are proven to alleviate an array of studied mechanisms in this regard, including excess expression of homocysteine, and soon we will see human clinical trials designed to provide more proof of such combinations (PMID: 26730328). Of course, there are a wide variety of nutrient and herbal medicines that could help in this integrative manner, and simply adding them to in limited form to pharmaceuticals may not be the best strategy. Individuallized and step-by-step goal-oriented approaches are sensible, and utilizing a knowledgeable Licensed Acupuncturist and herbalist or a Naturopathic Doctor will be more effective.

Of course, the most intelligent use of Complementary and Integrative Medicine in the arena of neurodegeneration is with the prevention of these disease mechanisms. Complementary Medicine offers the patient the ability to utilize very safe and effective therapeutic agents and treatments to prevent neurodegenerative disease, and the only side effect is all of the other health benefits that will be derived from this therapy. With more than one fifth of the U.S. population expected to experience some form of neurodegenerative problem in life, especially with aging, early utilization of Complementary Medicine would seen to be the best available approach to decrease risk of falling into this one in five category. By routinely seeking care from a competent Licensed Acupuncturist and herbalist, or TCM physician, one will often receive valuable preventive medicine and care without even being aware of this "side effect". One can see from the research cited in this long article that many common treatment protocols in CIM/TCM care are proven to prevent and benefit a variety of health issues that lie at the heart of these devastating neurodegenerative disorders.

The study of acupuncture as an adjunct therapy for Parkinson's disease

In recent years, the study of specific acupuncture stimulations in relation to the treatment of Parkinson's disease has increased due to improved means of testing brain function and specific effects on brain chemistry in various parts of the brain. This is largely due to the progress with use of fMRI studies combined with improved use of chemical analysis. Much of this research, of course, must be performed on laboratory animals (unfortunately), but has proven that acupuncture does exert specific beneficial effets that will benefit the patient with Parkinsonism. These studies will advance in the next few years to human clinical trials. In 2010, at the Capital Medical University in Beijing, China, Key Laboratory for Neurodegenerative Disorders, researchers found that electroacupuncture stimulation at 100 Hz on specific points significantly improved moter coordination in Parkinsonism subjects by normalizing the GABA content in the midbrain nuclei responsible for the typical tremors and motor dysfunction. This stimulation was shown to have no effect on GABA content in neurons of other parts of the brain, such as the globus pallidus. This type of electroacupuncture effect was shown to improve motor impairment by increasing GABAergic inhibition in the output nuclei of the basal ganglia (see study cited below). This type of electroacupuncture stimulation has been used for some years in China, but these recent research studies now confirm its efficacy.

This study in Beijing had also previously found that specific electroacupuncture stimulation showed neuroprotective effects on dopaminergic neurons in the substantia nigra, and beneficial modulation of substance P and glutamate decarboxylase in the midbrain, which would explain the positive effects on improved motor function in Parkinsonism seen in studies. These findings showed that restoration of homeostatic mechanisms of dopaminergic transmission were achievable with electroacupuncture stimulation. The benefits to the Parkinsons patient with this therapy may be significant, and exert restorative rather than chemical blocking mechanisms. Combining this electroacupuncture with various other restorative protocols in Complementary Medicine shows great promise in the slowing of, or reversing of, neurodegeneration in Parkinson's Disease.

In Europe and the United States, more and more University medical schools are funding study of acupuncture as adjunct care for Parkinsonism and Alzheimer's disease and focusing on improved function and general health, as well as relief of the more difficult comorbid disease mechanisms, such as anxiety, insomnia, gastrointestinal dysfunction etc. These studies are providing sund proof of efficacy as well. The array of benefits from acupuncture are varied and complex, but the most important consideration is the ease and standard practice of combining synergistic therapeutic protocols in the same treatment session, enhancing the effects of acupuncture needle stimulation and electroacupuncture with herbal and nutrient medicine, physiotherapy, and healthy advice and instruction for patent-centered therapies at home.

How Complementary Medicine may even help caregivers in the treatment of advanced Alzheimer's disease

A January 1, 2011 article in the New York Times demonstrates the current effective approaches in the treatment of advanced Alzheimer's disease, and findings that providing a better environment for the patient is much more effective than giving them pharmaceutical drugs to control behavior, which have been proven ineffective to a large extent, and often even worsen the patient's condition. This article details how progressive and effective care facilities adapt to patients by increasing individualized activities and improved environments that create positive emotional experiences for the individual patient. Catering more to the individual needs and desires of the patient was found to be much more effective than a rigid one-size-fits-all routine and increased control of the patient. Giving patients more independence and providing stimulation of emotionally soothing activities and routines proved very beneficial to both patients and caregivers, who themselves experience much stress. Programs of providing training and counseling in this regard for family members that provide home care also was proven able to delay the time that the patient had to be transferred to a specialized care center. The article is available by clicking here: http://www.nytimes.com/2011/01/01/health/01care.html.

Incorporating the care of Complementary Medicine physicians into the care of a relative with advancing Alzheimer's and Parkinson's diseases can be problematic. Combative and confused patients may be difficult to convince to go to a clinic to be treated. By learning how to handle these patients better at home, though, relatives may be able to more easily soothe apprehensions and convince the patient to attend treatments. Often, after the patient experiences the relaxation and calming effects of acupuncture, and even some physiotherapies, there is an emotional memory, though, that provides an incentive to go back to the clinic and be treated. This may not happen after the first few treatments, but an emotional memory and appreciation may develop. Patience and persistence may be the key. Addressing not only stress in treatment, but pain as well, may address some of the reasons why the patient is unhappy and responding with negative emotional outbursts and bad behavior. New research suggests that emotional memory and emotion-driven behavior persists after cognition deteriorates, and therapy that provides an emotional relief may stick with the patient even when cognitive memory fails.

With the aging of the U.S. population, an explosive growth in the area of geriatric nursing care is presenting us with significant alarm concerning the way the elderly patients in nursing care facilities are treated. A New York Times article on May 10, 2011, reports that the U.S. Health and Human Services (HHS) has revealed in an audit that about 1 in 7 patients in nursing homes were routinely prescribed an anti-pychotic medication that was charged to Medicare. The actual number of prescriptions may be much higher, as Medicare supplement insurance policies also cover the prescription of drugs, and patients with a high expenditure on pharmaceuticals have been denied payment for drugs that fell within the "doughnut-hole" of drug expenditures. This audit revealed that about 50 percent of these anti-psychotic prescriptions charged to Medicare in 2007 did not meet FDA guidelines for usage, did not meet the standards set by Medicare for prescription and payment, and have been deemed erroneous claims. In fact, this HHS audit found that 83 percent of these prescriptions were for off-label uses, meaning for conditions not approved by the FDA, and that 88 percent of these antipsychotic medications were prescribed to patients with dementia, despited FDA warnings of a higher risk of death and serious side effects in this population, and perhaps a worsening of the neurodegenerative dementia with use of antipsychotic medications. The government has investigated drug companies for illegally marketing these drugs, resulting in many billions of dollars in settlements in lieu of fines, and fines for illegal kickbacks by pharmaceutical companies paid to nursing care companies have also occurred. For example, in 2009, a pharmacy chain tied to nursing homes, Omnicare Inc., paid a settlement of $98 million to avoid fines and settle accusations that major drug companies paid hundreds of millions of dollars in kickbacks to get Omnicare to overprescribe antipsychotic medications. Often medical doctors are paid very little to prescribe care at these facilities, spending only minutes with patients, and prescribing a large number of drugs. Senator Charles Grassley, head of a commerce committee oversight panel on abuses in the health care industry, called for this audit, and stated: "These results are alarming. Medicare officials need to pay attention." In 2013, yet another enormous settlement in lieu of a criminal penalty was paid to resolve charges of illegal marketing and kickbacks to doctors who prescribe anti-psychotics off-label to elderly patients in nursing homes, with Johnson and Johnson agreeing to a $2.2 billion settlement to avoid prosecution or official acknowledgement of criminal guilt. Patients and their families need to address the issue of proper care of the elderly with dementias, and to do more to prevent these diseases from progressing at early stages. The implications are that drugs routinely prescribed to sedate and control the elderly patients may be responsible for the advancement of their neurodegenerative conditions, such as Alzheimer's disease.

Neurohormonal imbalance in Neurodegenerative disease

One intriguing theory as to the origins of the pathophysiological mechanisms that create the Parkinson's syndrome, that has resulted from the more holistic research in recent years, examining the various interrelated problems in the central nervous system, has been the theory that Parkinson's is the result of a neurohormonal imbalance related to melatonin and dopamine interactions. It has been discovered that dopamine supplementation may work to some extent because it has an effect on the circadian production of melatonin, and that deficient circadian melatonin production leads to hyperplasia in key areas of the brain through a variety of mechanisms, including the lack of antioxidant acitivity that melatonin provides. Since the neurotransmitters in the brain are constantly being produced and converted in a balancing manner, restoration of neurohormonal health may be a more productive strategy in the long term therapy than simple supplementation or inhbition of specific neurotransmitters. A 2008 summary of this scientific study from the Brownoski Institute of Behavioral Neuroscience in Victoria, Australia, states: "For the first time, abundant evidence is presented describing Parkinson's Disease (PD) as an endocrine disorder of melatonin hyperplasia. The role of circadian interventive therapies and internal desynchrony in the aetiology and progression of PD provides a new direction for understanding the underlying physiology of a disease which is currently in a state of impasse and provides new hope for those who suffer from its debilitating effects." Melatonin hyperplasia refers to a condition where melatonin producing cells are abnormal in number. This condition would occur when there is a deficiency of melatonin and increased need, or when the hormonal feedback system is stimulating a need for increased melatonin production.

Melatonin is both a hormone and neurotransmitter, and increases in melatonin production and secretion occur naturally in the circadian cycle of wake and sleep at night. In 2010, studies found that more than 10 percent of Americans suffer from insomnia, implying that circadian melatonin imbalance is perhaps a problem for a large number of people (35 million). Secretion of hormones and neurotransmitters in the brain, as well as metabolic conversion and creation of these molecules, is fundamental to healthy brain function. Both the nervous system and the endocrine system must be involved and coordinated in this process, making restoration of health a complicated problems. Research in recent years has explored this link between insomnia and neurodegenerative disease, as there is a very high rate of insomnia and sleep disturbances, such as sleep apnea and anxiety disorder, in the population identified with neurodegeneration. Simply taking melatonin has not been effective, as the much regulated neurohormonal system quickly adapts to supplementation and renders this ineffective after a short period of time. Combinations of herbs and supplements that aid the various balancing mechanisms have been researched because of this, and a combination of cofactor Vitamin B6, 5HTP, St. John's Wort, and melatonin, is one intriguing combination created by the company Vitamin Research. A comprehensive therapeutic protocol is recommended to achieve better sleep and melatonin metabolism, though, and utilization of acupuncture, herbs, nutrient medicine, and hormonal balancing may be needed for an eventual return of healthy neurohormonal function and balance.

Melatonin is produced in abundance by the pineal gland in the cycle of day and night, and this rhythm of secretion is controlled by various suprachiasmatic nuclei in the hypothalamus, the command center of the endocrine, or hormonal system. There is evidence of much occurence of deficient hypothalamic function in the aging population, often related to subclinical hypothyroid disorders and adrenal stress syndromes, and this could cause decreased melatonin bioavailability and stimulate melatonin hyperplasia. Melatonin has a variety of functions in the brain besides stimulating deeper sleep, and has remarkable antioxidant effects. These antioxidant effects are extremely important to maintaining healthy brain cells, as melatonin both stimulates free radical oxidant clearing, and creates melatonyl radicals in this process that combine with superoxide anions (charged mineral molecules) and detoxifies them. Melatonin also stimulates other antioxidant and detoxifying activities, stimulating increases in superoxide dismutase, glutathione enzymes, and glutathione, which is the fundamental detoxifying chemical in our body (read about glutathione metabolism in another article on this website). Researchers at the Hospital Neuro-Cardiologique in Lyon, France, in 2005, explain the complex role of melatonin in our bodies: "The circadian organisation of other physiological functions could depend on the melatonin signal, for instance immune, antioxidative defences, hemostasis, and glucose regulation. Since the regulating system of melatonin secretion is complex, following central and autonomic (nervous system) pathways, there are many pathophysiological situations where the melatonin secretion can be disturbed." (PMID: 15649735). This certainly implies that a thorough holistic treatment protocol is needed in melatonin imbalance, and with careful analysis and a multifactorial treatment tailored to the individual, melatonin production in the circadian cycle can be restored. While increasing melatonin bioavailability may not immediately relieve symptoms of Parkinson's disorder and other neurodegenerative disease, it is a key aspect of the long-term holistic therapy. Research has found that a modest dose of melatonin combined with other cofactors for bioavailability of neurotransmitter precursors, such as P5P and 5HTP, may be the best therapeutic approach, which are combined in the professional nutrient medicine Positrol (Vitamin Research Products). A companion to this supplement formula was advanced through research into the effects of L-Phenylalanine, and Syncholamine may be taken in the morning to improve daytime mood and brain function, or the formula Adrenosen (Health Concerns), with L-phenylalanine and PKA, may be taken with Positrol.

The most important neurohormone involved in circadian rhythms (variations during the 24 hour cycle) is cortisol, a glucocorticoid constantly secreted by the adrenal (tip of the kidney) gland. In hormonal analysis diurnal cortisol levels are very important, and often clearly relate to symptoms. With adrenal insufficiency, or adrenal stress syndrome, cortisol production may be sluggish, resulting in low cortisol during the day and excess production at night, which accounts for daytime sluggishness and insomnia, as well as a cycle of depressed affect during the day and anxiety in the evening and night. Cortisol is also intimately involved in maintaining blood pressure, glucose and fat metablism, muscle weakness due to impaired glucose uptake, protein catabolism, fat redistribution, limited immune responses, and variability in immune suppression and excess immune responses. TNf-alpha, a key immune mediator involved in cellular degeneration and neurodegenerative conditions, may be significantly inhibited by diurnal cortisol imbalance. Recovery of this systemic and chronic condition will not happen overnight. The patient needs to patiently work to restore diurnal melatonin and cortisol homeostasis, address adrenal insufficiency, correct subclinical hypothyroid conditions, and hypothalamic insufficiency. Of course, for those of us that fear neurodegenerative conditions, we need to address these subjects earlier in life, before the neurodegenerative condition becomes symptomatically severe. As we age and are challenged by menopausal and andropausal hormonal deficiencies we should have an analysis of hormonal balance and work to achieve better hormonal homeostasis. The utilization of relatively inexpensive tests to give a hormonal profile with analysis of active hormonal metabolites in saliva and veinous blood stick samples provide the patient and physician a clear objective basis for this rebalancing and restoration.

Recent research has uncovered a number of ways to help restore cortisol balance. A 2010 research study sponsored by the NIH at UCLA proved that deep tissue massage (called TuiNa in Traditional Chinese Medicine) dramatically improved cortisol levels and regulatory modulation (see the article entitled Deep Tissue Massage and it's many benefits on this website. Since cortisol is an adrenal hormone that operates in a feedback mechanism within the neuroendocrine system, therapy to balance hormonal homeostasis, with acupuncture, topical bioidentical hormone creams, and herbal and nutrient medicines, as well as stress reduction therapies, are all important aspects of a comprehensive protocol that may be individually tailored to each patient. Inexpensive tests utilizing saliva samples to measure active hormone metabolites may be utilized to guide this type of therapy. The only way to find out how well this approach works is to try it.

Hypothalamic hypofunction or dysfunction has also been implicated in neurodegenerative disease in other ways than melatonin imbalance. The hypothalamus, coupled with the pituitary, is the chief gland of the brain involved in neurohormonal balance, and the command center of the endocrine system. The glutamate and NMDA metabolism is integral to both hypothalamic function and is implicated in neurodegenerative disease. Excess glutamate metabolism was found to be involved in acute strokes and brain cell destruction in the past, and research showed that the long term effects produced cell death, or apoptosis. This spurred much research into the possibility that excess glutamate could be responsible for neurodegenerative cell damage and death. Today, NMDA glutamate receptor antagonists are used to treat various neurodegenerative diseases. These same drugs were found to affect the hypothalamic functions, and hypothalamic dopamine and corticosteroid metabolism, as well as pathologies related to hypothalamic dysfunction and hormonal imbalances of prolactin. Excess glutamate metabolism was found to hyperstimulate the hypothalamus and result in stress-induced high circulating prolactin and corticosterone. Today, much research has revealed that many patients may suffer form a subclinical hypothalamic deficiency, or hypofunction, that is related to various hormonal imbalances seen clinically. More physicians are treating the hypothalamic dysfunction in a system of hormonal restoration with bioidentical hormones, herbs, nutrient medicine, and acupuncture. Further research may show the potential for benefits in such hormonal restoration as it effects the dysfunction of glutamate metabolism in regards to neurodegenerative disease.

Another aspect of neurodegenerative pathology related to hormonal deficiency and imbalance is the subject of estrogen deficiency and its role in mitochondrial dysfunction. The mitochondria are small parts of the cell that produce much energy from glucose. It has been well established that the mitochondrial dysfunctions are responsible for much of the oxidative stress that leads to neuron degeneration. In 2008, researchers at the University of Southern California Program of Neuroscience found that estrogens signal a number of pathways of cell protection and enhance mitochondrial function (see the link in additional information at the end of this article). Estrogens were found to maintain calcium homeostasis, enhance glycolysis (glucose usage), sustain and enhance mitochondrial functions, protect against free radical oxidative damage, and aid cholesterol metabolism and clear beta-amyloid stick protein accumulation. All of these mechanisms enhanced natural neural defense and maintenance, and explains why many women suffer from neurodegenerative disorders post-menopausally. Some neurodegenerative disorders are seen at a relatively early age postmenopausally, such as primary aphasia, and could be highly related to the estrogen deficiency. The estrogens are a family of hormones that include the abundant estriol, and the more active estrone and estradiol. Synthetic estrogens in hormone replacement are problematic, with much research revealing the array of risks and side effects, but natural bio-identical hormone therapy is becoming very common now. These estrogens must be balanced in the body, and also balanced with the hormone progesterone. Progesterone itself is now proven to aid neural health, with large studies proving, for example, that progesterone administered after traumatic brain injury reduces mortality and achieves a dramatically improved long-term functional improvement in cognitive functions. Achieving physiological normal production of estrogens and an estrogen progesterone balance could both prevent neurodegenerative conditions and treat them effectively. Of course, once neurodegeneration occurs, the treatment protocol should be more thorough, in order to address the many aspects of the cascade of problems seen in study. The research at USC also reveals that there is a danger of metabolic exacerbation with advanced neurodegenerative disease with the use of higher dose synthetic estradiol, since the same mechanisms that would drive improvement in healthy neurons may stimulate exacerbation in unhealthy ones. This is why the use of very low dose bioidentical estriol cream with careful monitoring and hormonal balance is believed to be a potential successful strategy.

Hormonal balancing, especially with restoration of the melatonin and estrogen metabolism, is thus the linchpin of a more thorough holistic protocol when trying to reverse neurodegeneration. No patient wants to hear that their disorder is highly complex and requires a complex treatment protocol, but with neurodegenerative disorders, there is usually limited success unless the patient accepts a complex holistic treatment strategy, and proceeds in a step-by-step manner, hopefully guided by a knowledgeable physician. When utilizing acupuncture combined with herbal and nutrient medicine, an initial course of 12 weeks is seen in most of the scientific studies. Of course, if the results are excellent before this period of 3 months, the treatment may be pared down. Each individual will have a different presentation and need.

Lifestyle, Diet and therapeutic regimens may be a key to successful prevention and therapy for neurodegenerative disorders

Healthy diet and exercise routines are very important in the prevention of Alzheimer's and Parkinsonian neurodegeneration, and possibly for other neurodegenerative diseases as well. As we age, or acquire health problems that could lead to a more serious neurodegenerative condition, we should increase our focus on an effective and efficient daily exercise routine and improve our diet. A Harvard study showed that the most physically active men cut their risk of acquiring a Parkinson's syndrome by 50%. Women showed a more modest beneficial effect from a lifestyle that included daily exercise. A University of Pittsburg study showed how exercise prevented degeneration of nerve cells that are normally destroyed by disease. Researchers concluded that increased oxidative metabolism was probably responsible for the mitochondrial preservation within the nerve cells. A diet rich in antioxidants along with a routine of simple exercise is thus a key in neurodegenerative medicine.

A 2010 study by Columbia University in New York followed 2,148 older adults in Manhattan with an average age of 77 years, for four years. None of these subjects had dementia, or signs of neurodegeneration, at the beginning of the study, but 4 years later 253 had been diagnosed with Alzheimer's disease, which is an amazingly alarming percentage (over 10%). Of course, these people did not just suddenly acquire neurodegeneration, as this is a very slow process, and we can also assume that a much greater percentage of the subjects had a level of neurodegeneration that did not result in a full Alzheimer's diagnosis. The study followed the diets of this diverse cross section of the population. It found that those persons that ate a diet with sufficient dietary folates, essential fatty acid balance, and Vitamin E metabolites fared well, while those who ate more red meat, organ meat (lunch meats), and fatty dairy products fared poorly. The study concluded that a diet rich in dark, leafy green vegetables, oil and vinegar dressings on salads with hearty greens, fresh nuts, fish, poultry, and fresh fruit lowered the risk of Alzheimer's by over 30 percent.

A University of Toronto study of carbohydrates and cognitive function found a 37% increase in memory and cognitive function occurred in a group of subjects that ate a porridge of barley each morning. Simpler carbohydrates resulted in short lived memory and cognitive benefit. Complex carbohydrates may thus be very important to supplying your brain with the necessary chemicals for neuronal health. While barley may be difficult for many to incorporate into their breakfast diet, steel cut oats, amaranth and various whole grains can be made into delicious warm cereal porridge. Barley sprout powder can be used as a morning supplement, slowly pouring a tablespoon of the powder into warm liquid in a blender. Research concerning the effects of Ritalin on increased memory, cognition and control of hyperactivity in the brain showed that this drug increased glucose metabolism in the brain by 50%. It is suggested that an increased level of glucose bioavailability from a complex carbohydrate diet could achieve similar results.

Omega 3 fatty acids are also important to incorporate into the diet. Studies of Parkinson's patients found a consistent imbalance between Omega-6 and Omega-3 fatty acids in key areas of the brain. Deficiency of the Omega-3 DHA and EPA were common, and linked to various theories of metabolic dysfunction concerning inflammatory regulation and lipid peroxidation. DHA and EPA mutually support each other in the function of vascualar renewal, and deficiency could result in a poor vascularization that contributes to neural cell death or poor neural receptor function. DHA is essential to brain development and growth, and deficiencies have been linked to poor fetal development of brain function. These essential fatty acids are obtained from both foods and supplements. Various fatty ocean fish, as well as some fresh water fish are high in these EFAs, and this preformed DHA increases level more quickly than the foods and herbs rich in alpha-linolenic acid, but this latter class of foods is more commonly eaten and dietary changes incorporating these foods is recommended. The DHA levels rise more slowly from foods and herbs containing the Omega-3 alpha-linolenic acid, but the eventual change may be more dramatic.

Scientists long invested in treatment of populations with malnutrition of Omega-3 and Omega-6 fatty acids highly recommend using a combination of fatty fish with spirulina, blue-green algae and chlorella, which are rich and balanced with these nutrients. Salmon, mackeral and sardine are the fish highest in Omega-3 fatty acids. Trout, herring, anchovy, butterfish and tuna are also high in content. Various cooking, baking and salad oils are high in content, including pumpkin seed oil, and toasted walnut oil. Tempeh and dark, leafy green vegetables, such as collard greens, spinach, kale, chard, some endives, etc. are also rich in alpha-linolenic acid, the precursor to the DHA and EPA. Herbs such as digupi, and xuanshen that clear deficiency heat, and chaihu and cheqianzi, which benefit the liver and kidney, as well as duhuo, sangshen, gouqizi and nuzhenzi are all commonly used in TCM formulas and are rich in linolenic and linoleic acids. Nutritional benefits are one of the side effects of Chinese herbal formulas, a beneficial side effect.

Studies have also shown that excess alcohol consumption is proven to have a detrimental effect on the mitochondrial function of neurons. It is strongly advised that alcohol consumption be kept to a minimum in these disorders. Often, the habitual alcohol consumption increases with the neurodegenerative disorders, since depression and anxiety often result. The informed patient will find healthier means of calming anxiety and dealing with depression. Here, too, herbs, acupuncture, and nutrient medicine can help the patient deal with these problems and ease the elimination or reduction of alcohol consumption. This does not mean that all bits of alcohol must be eliminated, though. Many herbal chemicals need to be extracted into an alcohol medium, or tincture, to be effective, and small amounts of alcohol pose no risk of ill effects.

Studies in 2013 at the Centers for Neurodegenerative and Vascular Brain Disorders and Translantional Medicine at the University of Rochester, Rochester, New York, found that problems with copper accumulation in the brain capillaries and parenchyma (neurons and glial cells) of the brain resulted in greater accumulation of amyloid-beta protein tangles that are highly associated with Alzheimer's disease. Unfortunately, this was not due to a simple excess or deficiency of dietary copper, but rather due to a problem with copper homeostasis (see study link below). Essential mineral homeostasis is highly regulated in the body, and minerals that have a higher electrical potential, able to supply free charged electrical ions easily, such as iron, copper and calcium, are of course regulated in a number of ways, including the control of absorption, transport and storage.

Copper is essential in the diet because it is a key constituent of the enzyme complex cytochrome C oxidase, and is found in higher concentration in the liver, bone and muscle. Copper is bound and transported with albumin in the blood to the liver, where it is bound to other specialized transporting molecules, such as ceruloplasmin. Excess copper is excreted via the bile. Copper also facilitates iron uptake and homeostasis, and is found in slightly higher concentration in the female. Copper deficiency is associated with anemia, neutropenia, bone abnormalities, osteoporosis, impaired growth, hyperthyroidism, abnormalities in glucose and cholesterol metabolism, and hyperpigmentation. Copper accumulation in the tissues is associated with Wilson's disease, a genetic abnormality, where symptoms include neurological, psychiatric and those associated with liver dysfunction. Chronic copper toxicity does not normally occur in humans because of the tight regulation of absorption, transport and excretion. The link between copper accumulation in the brain and Alzheimer's disease thus may involve both genetic and metabolic components, liver function, quality of the protein transporting molecules albumin and ceruplasmin, and aspects of copper homeostasis, such as regulation of the release of minerals from bone storage. Albumin, a carrier protein in the blood, binds about 15 percent of the copper in the circulation, but less tightly than ceruloplasmin, a protein enzyme that binds about 70 percent of the circulating copper.

Since ceruloplasmin is also associated with oxidation of iron into ferric iron, where it is tightly bound and transported with transferrin, problems with iron homeostasis and iron overload toxicity may also play a part potentially in problems with copper homeostasis. Elevated levels of ceruloplasmin may also be caused by hormone imbalance, oral contraceptive use, hormone replacement use, lymphoma, and chronic inflammatory disease. A 2008 study at the Oregon Health and Science University, in Portland, Oregon, found that the copper transporter ATP-ase, is essential in a number of aspects of copper homeostasis, as well as normal function and development of the central nervous system (CNS), and could be a key component in the link between copper accumulation and Alzheimer's disease.

Key herbal and nutrient medicines in the treatment of neurodegenerative disorders

Unlike synthetic pharmaceutical medicines, herbs usually contain a long list of synergistic chemicals that help your condition in a variety of ways. In this section, key herbs will be explained, but many of the beneficial actions of the numerous chemicals in the herbs will not be explained due to the need for brevity. Of course, in this complicated subject, brevity is a relative term. If you want, you may do further research on the herbs and chemicals contained within the herbs yourself. Often, a small group of herbs and nutrients will be listed in the description of the herb or nutrient, so that you may see how to increase the potential of treatment with a small formula of substances. Of course, therapy guided by a knowledgable professional will achieve the best results, tailoring the treatment to the individual, and proceeding step-by-step in a logical manner to achieve medical goals. Despite the large number of products needed in neurodegenerative therapy, which is a drawback that discourages most patients, those patients that proceed with herbal and nutrient therapy patiently and persistently are thrilled with the results over time.

Is there evidence that herbal medicine really works in the treatment of Parkinson's and neurodegenerative diseases? A growing body of evidence is proving that herbal medicine can work in a variety of ways to reverse neurodegenertion. There are currently 158 scientific citations on the NIH website PubMed concerning herbal medicine and Alzheimer's disease. See some of this great body of evidence by clicking here: http://www.ncbi.nlm.nih.gov/pubmed/18719316 and here: http://www.ncbi.nlm.nih.gov/pubmed/18324353?

Chinese medical schools and research institutes have been studying the pharmacology and efficacy of Chinese herbal treatments. A review of the promising integrative therapies in 2007 from the Institute of Neurosciences at the Fourth Military Medical University in Xi'an, China stated: (click to link to the U.S. PubMed database PMID: 17691984) http://www.ncbi.nlm.nih.gov/pubmed/17691984 Each year the science of herbal pharmacology progesses exponentially, although economic interests in the United States continue to promote an idea that the science of herbal medicine is still undeveloped. Below is some explanation for the various strategies that have been found useful in the therapeutic protocol.

  • Essential nutrients for cognitive function and nervous system health: patients with neurodegenerative disorders should start with a period of replenishment of key nutrients that may be deficient and thus necessary to reverse the disease. You do not need to take these nutrients constantly or forever, but replenishing the body's store and metabolism may be essential to the success of therapy. Vitamin B6 has been found to be deficient in 50% of the U.S. population, and is essential for dopamine production. Choline is necessary for proper transmission of nerve impulses and is a key component of the cholinergic system, as well as fatty acid metabolism in the neural mitochondria. Phosphatidylcholine is an active metabolite of lecithin, and has been proven in human trials to decrease neurodegenerative disease. To utilize choline as as supplement, inositol, Vitamin B12 (sublingual high dose), folic acid, and Vitamin B complex are essential. Inositol hexacotinate is a Vitamin B3 (no flushing effect), and is the preferred type of inositol in this type of therapy. Choline as a food source is available in egg yolks (lecithin source as well), legumes, milk, soy and whole grains, and the taking of choline and inositol supplement with these foods is recommended. DMAE, or dimethylaminoethanol, is another supplement that stimulates production of choline by the brain cells, and also may be very useful. Lecithin, a B Vitamin, is also helpful to increase choline bioavailability, and to aid nerve transmission. The Glutamic acid metabolism is a necessary part of the central nervous system function and GABA regulation, and is best enhanced by taking a combination of L-Glutamate, niacinamide and Vitamin B6 with Choline and inositol (or the combination of P5P, L-glutamine, and inositol hexacotinate). A complete essential nutrient formula may include Choline (phosphatidylcholine), inositol (inositol hexactinate), Vitamin B6 (P5P), L-Glutamine, Vitamin B12 (sublingual or intramuscular injection), folic acid (5MTF is the active form), DMAE and lecithin (phosphatidylcholine). Foods that are dopaminergic include steel cut oats, fermented soy (tempeh), lentils, barley, rice, alfalfa, avocado and fenugreek. A quality dried barley sprout supplement is highly recommended for its array of beneficial chemicals, which include three types of anti-inflammatory biologics, chlorophyll, PD41 and mucopolysaccharides, as well as being a rich source of healthy proteins, enzymes and Vitamin A. Barleygrass sprouts also contain SOD, super-oxide dismutase, to help clear heavy metal toxicities and their oxidant free radicals.
  • Omega-3 Fatty acids, EPA and DHA: a 2007 study listed below confirms that these essential fatty acids are often deficient in the Parkinson's, Alzheimer's and ADD patients studied. A study published in the medical journal Neurology in 2012, headed by Dr. Nikolaos Scarmeas of Columbia University, showed that a broad population study confirmed that individuals with a dietary deficiency of omega-3 fatty acids had significantly higher levels of the problematic beta-amyloid proteins AB40 and AB42 in circulating blood plasma, despite differing levels of saturated and monounsaturated fats, omega-6 fatty acids, and other key nutrients. An excess of the Omega-6 essential fatty acids in our diet (usually due to a high intake of red meat) contributes to a dysfunction of the cells and inflammatory regulation in key areas of our brains, but the key point in this study is that the stripping of omega-3 fatty acids in commercial oils and transfats may be largely responsible for the increased problematic beta-amyloid proteins that comprise the core of brain plaques in Alzheimer's patients. The Omega-6 fatty acids should be balanced with Omega-3 for optimal health of the metabolism in neurodegenerative disorders, but the inclusion of fats and oils with omega-3 fatty acids, and a decrease in consumption of processed foods, fast foods and transfats is perhaps the most important factor related to problematic beta-amyloid proteins. A relative deficiency of Omega-3 fatty acids may impede membrane fluidity at the dopamine receptor sites by allowing stiff membranes to form. The best source of Omega-3 fatty acids, DHA and EPA, is krill oil, concentrated and possessing a natural preservative, unlike fish oils and flaxseed oil. EpaQ by Health Concerns is recommended. This oil is so concentrated in the right type of essential fatty acids that just one or two small capsules per day is needed, instead of the tablespoons of fish oil required. If you are a vegetarian, or vegan, you may have a deficiency of omega-6 fatty acids. The balance of omega 3 and 6 is essential to optimum health. A healthy source of omega-6 fatty acids are the algaes, spirulina, chlorella and blue-green algae (chlorella is also effective as a chelating agent to clear heavy metal accumulations).
  • Rhodiola rosea or Hong jin tian: imnproves dopamine optimization and serotonin bioavailability. Dopaminergic herbs include Muira puama, Murcuna pruriens, Salvia miltiorrhiziae (Dan shen), Alismatis orientalis (Ze xie), and Uncaria tomentosa (Gou teng or Cat's claw). Dapamine receptor sites will be enhanced through the nutrient Sam-E. Dopamine is a neurotransmitter that accounts for 90% of the catecholamines in the nervous system and is a precursor to norepinephrine and epinephrine, key adrenal neurohormones. Adrenal insufficiency could result in increased demand for dopamine as a precursor. Adrenal health can be enhanced by the use of a small formula called Adrenosen, from Health Concerns, that contains PKA, barley sprouts, wild mountain yam, schizandra berries and the hyacinth bean. In women, copper is in greater demand, and is sometimes deficient. The catecholamine oxidative metabolism of dopamine in the citric acid cycle of mitochondrial health, as well as oxidative conversion to norepinephrine, is dependant on a copper-containing enzyme, dopamine beta-monooxygenase. Copper in the diet is derived from organ meats, some seafood, dried beans, quality nuts and whole grains. Copper supplementation must include cofactors of zinc methionine (Opti-zinc) and folic acid to assimilate, but the 2.5 mg copper supplement (in the form copper amino acid chelate) should be taken about 2 hours after the zinc supplement to avoid competition in absorption. Rhodiola, muira puama, Cat's claw, SamE, Adrenosen formula, Essential Minerals, and zinc monomethionine (OpticZinc) would provide a course that is sure to improve dopamine optimization.
  • Uncaria Tomentosa or Cat's Claw: uncarine alkaloids (the Chinese herb Gou teng is analagous) have been studied and found to exert a beneficial effect on memory impairment induced by cholinergic dysfunction. Cat's claw is also dopaminergic and stimulating of the glutamate metabolism. Maca has been studied as a synergetic herb used in combination with Cat's claw to achieve enhanced effect (maca also contains uridine, an essential cofactor for mitochondrial neural glucose usage). Alpha-glyceryl-phosphoryl-choline, or Alpha-GPC, also aids the cholinergic system, acting as a precursor to acetylcholine, or ACh, and has been proven in studies to enhance memory and cognitive function. Inositol and Choline are often useful to enhance the treatment of cholinergic dysfunction, allowing for greater bioavailability of choline. To enhance assimilation of Choline, inositol, Vitamin B12 (sublingual large dose), folic acid, Vitamin C, and Vitamin B complex are helpful cofactors. Alpha-GPC is available in the Health Concerns product called Cogni-Spark.
  • Resveratrol, an active chemical found in the Chinese herb Polygonum cuspidatum, or Bushy knotweed, Hu zhang: this antioxidant is now well known and utilized, even by M.D.s, to protect dopamine neurons from degeneration. Patients report significant benefit soon after starting the herbal supplement. Perhaps due to this success there is now a plethora of misinformation about this chemical. Many doctors tell their patients that the chemical is extracted from red wine or grapes, when all studies show that the amount of this chemical in red wine is very small, and the companies marketing this herbal supplement obtain the chemical from the Chinese herb Polygonum cuspidatum. Newer studies cite the poor absorption of reservatrol from red wine and grapes to counter it's success. The truth is that a concentrated supplement from the herb prepared properly, or an extract in an alcohol tincture is effectively absorbed and utilized by the human body. http://www.herbalextractok.com/Herbal-Extract/Resveratrol-extract.html. The combination of resveratrol with another Chinese herbal chemical antioxidant, quercetin, is now available in standardized form, with Vitamin Research Products offering Resveratrol Plus.
  • Huperzine and Vinpurazine, from Clubmoss and Vinca Periwinkle: studies in Shanghai confirm that huperzine works better than tacrine or E2020 (the analogous drug used in the U.S. is Aricept), chemical anticholinesterases, to enhance memory and reverse neurodegeneration. The first group of drugs approved by the FDA to treat mild to moderate Alzheimer's are the acetylcholinesterase inhibitors, and huperzine is one of six herbal chemicals in Chinese herbs found to have significant anticholinesterase effects in scientific studies, and is also approved by the FDA now. http://www.find-health-articles.com/rec_pub_18573242 The Health Concerns product Vinpurazine combines these two herbal chemicals with rosemary extract to form a potent combination, which also clears excesses of chronic inflammation in the CNS cells. A companion formula to aid function and maintenance of brain cells is called CogniSpark, consisting of L-alpha-glyceryl-phosphyl-choline (Alpha-GPC), which should be taken with L-carnitine and R-lipoic acid before 6 pm. The benefits of Huperzine A have been found to be broad, with significant acetylcholinesterase inhibition, antioxidant effect, modification of the amyloid beta pathway to decrease tangles, and enhancement of the beta-catenin pathway of neurovascular regrowth and cell adhesion.
  • Quercetin: the herbal and nutrient chemical is much studied and has passed initial tests on laboratory animals with induced neurodegenerative disease with flying colors in a number of University Medical Schools around the world. Quercetin acts as a potent antioxidant and phytohormonal agent, and standardized quercetin in now widely used in nutrient and herbal supplements to improve brain health and function. This chemical has shown potent ability to enhance the cell detoxification effects with superoxide dismutase and glutathione, and increase the activity of acetylcholinesterase, as well as activate the innate cellular detox and antioxidant pathway via Nrf2 expression (see study links below).
  • Trypterygium wilfordii or Lei gong teng, and Scutellaria baicalensis, or Huang qin:studies have confirmed that these herbs will protect dopaminergic neurons from inflammatory processes and inflammation mediated damage by inhibiting microglial activation of inflammatory mediators. Many citations of research published by the NIH on the PubMed research database show significant benefit from Trypterygium wilfordii. PMID 12504865 shows that the herb is found to benefit dopaminergic degenerative neurons. PMID 16989518 shows that there is some mild toxicity to the herb and should be used only with professional guidance, but that it contains alkaloids useful in chronic inflammatory states. PMID 16989518 shows that safety and efficacy has been confirmed in human clinical trials in the United States and abroad. PMID 17240858 shows that the herb inhibits key inflammatory cytokines that are linked to chronic inflammatory states. There are many beneficial chemical effects of Trypterygium, including immunomodulation and the inhibition of TNF-alpha, and IL-12, cytokines suspected in the cause of many cases of neurodegeneration.
  • Alpha Lipoic Acid plus L-Carnitine: this combination will aid mitochondrial efficiency and clear buildup of sticky proteins that have been linked to Parkinson's and Alzheimer's pathologies. Sticky proteins are misshapen beta-amyloid extracellular plaque deposits, sometimes called tangles. Causes of the misshapen lipoproteins may be linked to toxic heavy metal accumulation, such as alumninum from cookware, along with accumulations of oxidant free radicals as the body tries to clear this accumulation. ALA helps to neutralize the effects of free radicals by enhancing the antioxidant benefits of Vitamins C, E, and glutathione. Carnitine is a B vitamin with a chemical structure similar to amino acids, whose main function is to help transport long-chain fatty acids, and also enhances the antioxidant effects of Vitamines C and E. Carnitine is produced in the body if sufficient amounts of B1, B6, lysine and methionine are available, and Vitamin B6 deficiency is common in the population. Vegetarians are more susceptible to deficiency, and a chief symptom of deficiency is confusion. The combination of these two nutrients helps antioxidant maintenance of neuron mitochondria as well as prevention of unwanted lipid proteins called sticky proteins, which are the subject of much research into the pathophysiology of Alzheimer's. Research has revealed that R-Lipoic Acid may be more effective, and Carnitine is included in the product Neuron Growth Factors (Vitamin Research).
  • SAMe, or S-adenosylmethionine, converts to methionine at D4 dopamine receptors sites, which becomes part of the healthy beta-amyloid protein structure at dopamine receptors. Dopamine receptor sites also need 5MeTHF, a folate and methyl donor for homocysteine, to methylate phospholipid membranes, and allow for healthier fluidity, or transport of molecules, across the membranes of dopamine receptors. 5MeTHF is deficient in the livers of patients with riboflavin, or Vitamin B2 deficiency, which is another common deficiency in the population, especially for patients who have used oral contraceptives, consumed excess alcohol, taken prolonged courses of antibiotics, or engaged in strenuous exercise. One of the signs of B2 deficiency is slowed mental response. 5MeTHF may also be deficient if the body has a folate deficiency, and dietary folic acid does not satisfy the demand for natural folate metabolism. A Vitamin B12 deficiency, also common in the elderly, contributes to this metabolic neurodegeneration. A combination of SAMe, Vitamin B2, B12 methylcobalamin, and 5MTHF folate is recommended to reduce sticky proteins and stiff membranes at dopamine receptor sites to insure healthier metabolism. To reduce beta-amyloid (Abeta) accumulation, or sticky protein plaques, the chemical S-allyl-L-cysteine from water extract aged garlic has also been proven effective. Astra Garlic is a formula from Health Concerns that is a synergistic blend of herbs for this effect. The Chinese herbs Yu jin and E zhu (curcuma zedoaria), which contain curcuma, have also been proven to break up and prevent beta-amyloid plaque accumulation. Regeneration is a formula from Health Concerns is a formula that contains curcuma and has a blend of herbs that could greatly benefit the Alzheimer's patient. Since the effects of curcuma are dose dependant, the herbalist sometimes prescribes a decoction of curcuma for a period of time, and this decoction has the added benefit of aiding digestion by increasing stomach and pancreatic secretions and bile flow, as well as being a proven anti-cancer agent. Short courses of these supplements and herbs may have a significant effect on neurodegeneration.
  • Bacopa Monnieri: Bacopa monnieri is a well-known and highly studied ayurvedic herb, called Brahmi, or water hyssop. Scientific studies show remarkable improvement in cognitive function with this herb. Many scientific studies in India have demonstrated that Bacopa has strong neuroprotective effects, antioxidant effects, and restoration of neural cell membrane enzymatic functions, including acetyl cholinesterase, decreased LPO (lipid peroxidation), and improvement in memory and cognitive function. Lipid peroxidation refers to oxidative degradation of lipids, where excess free radical reactive oxygen species take electrons from cell membrane lipids, resulting in neural cell damage. The decrease in LPO reflects an essential neuroprotective effect of the herb, aiding cell membrane function and health.
  • Mucuna pruriens: This herb contains a significant amount of L-Dopa (levodopa) and in double-blinded placebo controlled human trials compared to pharmaceutical L-Dopa, as the Universities of Southampton and Dusseldorf, and the Institute of Neurology in London (see study link below), this herbal extract in a powder worked better than pharmaceutical L-Dopa, and had a quicker response. Traditionally the herb, often in an alcohol glycerite tincture, was used to treat fatigue, impotence, lowered libido, and Parkinsonism.
  • Bioflavonoids, such as are found in Gingko biloba and many Chinese herbs: there are many bioflavonoid chemicals in the body, including quercetin, rutin, hesperidin, and eriodictyol, and bioflavonoids cannot be produced by the body, and are thus called essential nutrients. Depletion of our soil chemistry by modern farming methods has resulted in widespread deficiencies of bioflavonoids, which are linked to neurodegenerative disorders. These nutrient chemicals are important in microcurculation, antioxidant clearing, and cellular metabolism. A number of herbs are rich in bioflavanoids, which account for much of their success in therapy, the most well known being Gingko biloba. It is recommended that you ingest a variety of bioflavonoids to insure success. I recommend the herbal formula Flavonex, from Health Concerns, along with a tincture of fresh Gingko biloba leaf, and a diet that includes organic oranges, lemons, grapes, dried apricots, dried cherries, black currants, bell peppers, and dried buckwheat sprout powder. Vitamin C is an excellent cofactor to bioflavonoids, and the supplement formula Astra C, from Health Concerns, is highly recommended a part of the flavonoid regimen.
  • Antioxidants, especially CoQ10: Coenzyme Q10 is a vitaminlike substance that is also called ubiquinone, because it is needed by most cells in the body, hence ubiquitous. This chemical is essential to mitochondrial function and oxidative processes, and has long been an important part of standard medical therapy in Asia for treatment of Parkinson's, Alzheimer's and other neurodegenerative diseases. CoQ10 also aids circulation and microcirculation, stimulation of the immune system, prevention of cell aging or cell death, and tissue oxygenation. Deficiencies of CoQ10 are common, and are linked to such diseases as muscular dystrophy. Deficiencies may be caused by a number of common pharmaceutical medicines, including the cholesterol lowering statins, beta-adrenergic inhibitors prescribed for hypertension, tricyclic antidepressants, and anti-diabetic sulfonylurea drugs. More than 12 million patients are prescribed CoQ10 in Japan by their medical doctors. CoQ10 supplements vary considerably in quality and bioavailability, and enhanced forms, as well as sublingual powders are available. CoQ10-H2 is a form that is much better absorbed and significantly more active as a metabolite. CoQ10 is oil soluble and best taken with fatty or oily foods, especially sardines, mackerel and salmon, which contain the highest amounts of CoQ10 in foods. Peanuts, beef and spinach also contain CoQ10. Taking CoQ10 supplement with Krill oil, a potent source of essential fatty acids, especially EPA and DHA, or omega 3 and 6, is recommended as well.
  • Other antioxidants proven to protect dopamine neurons: epigallocatechin gallate in tea (camellia sinensis), especially quality green tea, is effective. Super oxide dismutase, or SOD, is a potent antioxidant the clear superoxides, which are a more harmful type of reactive oxygen species. A short course of copper/zinc SOD may be helpful, if you can find this supplement, but SOD is found in abundance in dried barleygrass powder, and this may be an easier supplement to find. Numerous large studies also point to the positive effects on memory from intake of barley, and properly prepared dried barleygrass contains an array of nutrients that make it a superfood. Gingko biloba standardized extract EGb761 was shown to be significantly neuroprotecive of dopamine depletion. Go to my article on antioxidants to learn more.
  • Glutathione metabolism and the nutrients needed to insure health: a deficiency of glutathione function is linked to many types of oxidative stress, and oxidative stress in the mitochondria of key nerve cells is a major part of the neurodegenerative process. To insure a strong glutathione metabolism it is recommended that liver function is optimal, and that a number of nutrients that are precursors to cellular glutathione metabolism are available in the body. These include, L-glutamate, N-acetyl-L-cysteine, and L-glycine. B12, active folate (5MTHF), and methylselenocysteine are also some of the essential aids to restoration of glutathione metabolism. Milk thistle and Schizandra berry are also beneficial to the glutathione metabolism of the liver. Studies of stroke patients revealed that those with deficient glutathione metabolism had a marked increase in oxidative damage in the hippocampus and corpus striatum. Excess glutamate metabolism may be responsible for some cellular damage in acute ischemic stroke, as the chemical floods the cells. In chronic pathology, it is believed that poor conversion of glutamate to glutathione may be responsible for excess glutamate metabolism. Simple taking of glutamate is a problem, and promoting of an improved glutamate metabolism is often needed, which is more complicated. Glutamates such as MSG, or monosodium glutamate, are now common in the food industry, and have resulted in the human organism acquiring specialized glutamate receptors in the brain and brainstem, often which interfere with normal brain function. To understand the key ways to restore glutathione function in your cells, and to understand how the glutamate metabolism may be made healthier and functional, you may refer to my articles entitle Glutatione Metabolism: restoration and function, as well as the article entitled Brain Health and Function. Unfortunately, helping your cells to detoxify and reverse excess oxidant stress is not a simple process, but it may be an essential task with neurodegenerative disorders.
  • L-Tyrosine: this amino acid is a precursor to dopamine and norepinephrine, which regulate mood and muscle firing, and are the key neurotransmitters deficient in function in Parkinson's and other neureodegenerative disorders. Tyrosine is used extensively by the thyroid gland and attaches to iodine to form thryroid hormones. Hypothyroid states, as well as deficient iodine states, could be related to deficient tyrosine, and this supplement could be a key part of therapy in both neurodegenerative disorders and hypothyroid dysfunction. Food sources include almonds, avocadoes, bananas, dairy, lima beans, pumpkin seed, and sesame seed. L-Tyrosine supplements should be taken with high carbohydrate meals, such as breakfast porridge, or with a small snack at bedtime so that the intake does not compete with other amino acids in the diet. Studies have demonstrated that increased tyrosine bioavailability can enhance dopamine synthesis in and release from nigrostriatal neurons if the firing rates of these neurons are accelerated, as in more advanced cases of Parkinson's degeneration, where the surviving cells are found to fire at increased rates to compensate. (Proc Natl Acad Sci USA 1980 Jul;77(7):4305-9 6254020 (PSGEB) E Melamed, F Hefti, R J Wurtman). As with all amino acids, concurrant use of active Vitamin B6, or P5P, will also enhance absorption and utilization.
  • R-Lipoic Acid: R-Lipoic Acid is rightly called the 'mitochondrial antioxidant', and many scientific studies (cited below) demonstrate its role in preventing or decreasing depletion of glutathione antioxidant compound (GSH). Lipoic acid is one of the most thoroughly investigated dietary supplements and most healthcare practitioners agree it is a preventive supplement of choice. R-Lipoic Acid is a more potent form – the more biologically active form – of alpha lipoic acid. As such, it offers more benefit with a lower dose. Lipoic acid serves to regenerate vitamins C and E, and helps maintain glutathione levels, a vital cellular antioxidant and liver protectant. It is a vascular and neuroprotective agent. The effects of R-Lipoic acid may occur after weeks of taking this supplement due to the positive indirect effects it produces.
  • 5HTP: there is some link between the serotonergic fibers in the striatal tissues of the basal ganglia and dopamine conversion and production in these 5HT (5-hydroxytryptophan) fibers in scientific study. Taking the 5HTP supplement (from Griffonia seed) may aid the dopamine metabolism. Study on animals found that the drug L-Dopa may be converted to dopamine within the 5HT fibers, and 5HTP possibly has some effect that may enhance the effectiveness for patients taking L-Dopa. 5HTP is also a precursor to melatonin, which is proven to be a potent neuroprotector for dopamine neurons. Both the amino acid L-Tryptophan, and 5-HTP, are precursors to serotonin and melatonin, and 5-HTP is able to pass the brain blood barrier to provide increased bioavailability of these important neurotransmitters. To enhance this metabolic bioavailability further, a blend of low dose 5-HTP, melatonin, P5P and St. Johnswort extract is recommended (re: Positrol from Vitamin Research).
  • St. John's Wort, Hypericum perforatum: this much maligned but effective dopaminergic and neuromodulating herb has been both proven safe for use and effective in the treatment of Alzheimer's and neurodegenerative disease. Prior reports that chemicals in St. John's Wort could alter levels of other pharmaceutical medications through competition in liver catabolism of the P450 enzyme pathway were shown to be overblown. Studies revealed that the effects of chemicals in St. John's Wort were modulatory of liver function, and that effects on the P450 enzyme pathway were modulated and normalized within two weeks of use to achieve a homeostatic effect despite catabolic competition from harsh pharmaceuticals. This was accomplished because a variety of chemicals in hypericum act to improve liver function. Of course, this also implies that the whole herb extract, and not pharmaceutical products with just the active ingredient enhanced, should be used. To see the current research on St. John's Wort, click here: http://www.ncbi.nlm.nih.gov/pubmed/16880827
  • Topical progesterone and pregnenelone creams: studies show that progesterone modulates dopamine release in the corpus striatum and the pregnenelone could modulate the dopamine transmission in the corpus striatum by causing changes in the activity of tyrosine hydroxylase and/or in the pre- and post-synaptic dopaminergic terminals. This neurosteroid mechanism could be a new kind of neurotransmitter systems modulation affecting dopamine metabolism significantly. (Neurol Res 2007 Jan 16; 17535560 (PGSEB)). Since estrogens also are integral to neuron mitochondrial health, estriol cream may also be useful. Use of these simple bioidentical hormone therapies could have significant effect, especially if there is a progesterone and estradiol deficiency. Testing and administration should be overseen by a professional, as we want to utilize low doses of bio-identical hormone creams, and do so in a balance manner. These same hormones may have negative impact if too high of stimulation is suddenly introduced in a neurodegenerative patient. Studies reveal that hormonal deficiencies are the key to the beginning of the neurodegenerative process, so patients should try to maintain healthy hormonal homeostasis as they go through menopause and andropause. These simple herbal products could be the key to prevention. In 2012, a study sponsored by the NIH and overseen by Emory University in Atlanta, Georgia, showed that administration of progesterone immediately after brain trauma dramatically reduces mortality and neural damage. Patients with moderate traumatic brain injury experienced greater functional improvement when progesteron was administered. This study confirms findings reported in China. Decades ago, a researcher at Emory University, Donald Stein, noted neuroscientist and professor of emergency medicine, found that laboratory animals with high levels of progesterone performed better in tests of memory and cognitive function. Dr. Stein and his associates noted that progesterone stimulates a number of processes in the brain, providing antioxidant, neuroprotective and neural rebuilding effects, especially the promotion of myelin production in damaged cells.
  • Vitamin D3 cholecalciferol: recent studies of Parkinson's patients found a significantly increased incidence of Vitamin D3 hormone deficiency over the general population, which also shows a high rate of deficiency in this important hormonal chemical (85% in some studies). While these results are not highly significant at this stage of investigation, supplementation with cholecalciferol might help the neurodegenerative patient. Cholecalciferol Vitamin D3 is the prohormone, and is generated each day in our skin with exposure to midday sunlight for 5-10 minutes. Take the pills or liquid D3 in the morning with breakfast, and also go for a walk in the midday sunlight with the face and arms exposed each day. D3 supplements are still of relatively low dosage, and both supplements and sun exposure without sunscreen is recommended. Even these methods, though, may not be enough, as the endproduct hormone D3 is dependant on healthy kidney and adrenal function. A complete regimen, with both supplementation, sun exposure, and a combination of acupouncture and herbal medicine to insure improved kidney and adrenal function is recommended.
  • Herbal formula to enhance brain circulation: circulatory aids are helpful both for brain circulation, as well as peripheral circulation in Parkinson's. Circulatory aid is beneficial to improve cognitive function, repair of the nervous tissues, increased benefits from the other herbal and nutrient medicines, and peripheral circulation. I recommend Cir-Q from Health Concerns. A number of professional herbal formulas address the stimulation of increased circulation in the brain, as well as cognitive and mood benefits, though, and the Licensed Acupuncturist and herbalist is able to provide an individually tailored herbal formula for each patient.
  • Red Mold Rice extract: a number of polylipids from specific fermented grains have been proven to affect lipid metabolism in a healthy way and now show promise in the treatment of Alzheimer's. A combination of effects, including reduction of amyloid beta-peptide plaque, called neurofibrillary tangles, as well as various antioxidant and antiinflammatory mechanisms were found in this herbal supplement. I prescribe the Health Concerns supplement Polylipid, as well as Red Mold Rice extract. This common nutrient food and natural food color in China was the source for the statin drugs created to lower cholesterol. To review the research, click here: http://www.ncbi.nlm.nih.gov/pubmed/18438657
  • Endocannabinoids: research around the world has confirmed that cannabinoids are not just chemicals found in marijuana, but actually are important chemicals used by the brain to regulate excessive activity of dopamine neurons in the corpus striatum. Studies at numerous universities found that patients that had used marijuana for some time in their life had a 30% decrease risk of acquiring Parkinson's. Stimulation of endocannabinoid cellular production, as well as the bioavailability of endocannabinoids from hemp seed in the diet, are being explored by scientists today. It could be that a topical cannabinoid cream that is oil based is the answer to immediate effect. Such a cream has been developed in England and is used to decrease neuralgia. Unfortunately, U.S. pharmaceutical lobbying has prompted the FDA to delay approval on the U.S. market of this benign topical medicine. There is no connection between the drug effects of THC in marijuana and this valuable herbal medicine.
  • Anticholinergic herbs: sometimes cholinergic dysfunction in Parkinson's can be calmed with anticholinergic chemicals, which have been used successfully at times by modern medicine. This treatment protocol runs counter to the anticholinesterase protocol, but in some cases has reduced acute symptoms related to cholinergic nerve stimulation. Some herbs have both anticholinergic chemicals and anti-cholinesterase chemicals, implying a modulatory effect on the cholinergic system. These effects will be milder than those produced by synthetic anticholinergic chemicals, but will have no side effect. The herbs that contain anticholinergic chemicals include the mulberry parts, leaf, bark, stem, and fruit, called Sang ye, Sang bai pi, and Sang shen, as well as Corydalis, or Yan hu suo, and Artemesia abrotanum, or Southernwood. Horse chestnut bark also contains an anticholinergic, and is beneficial for the health of the veins and veinous circulation. This herb is found in the Health Concerns formula, Formula V, along with butcher's broome and stoneroot. Some antichonlinergic herbs contain scopolamines, and are a little toxic, thus are rarely used, and monitored professionally. These include Jimsonweed and Anisodus tanguticus, or Zang qie. This type of therapy may be indicated for more advanced cases to control symptoms.
  • Immunomodulating herbs: recent research in neurodegenerative disease has led us to discover how the immune system is directly involved in a complex process leading to the persistence of degenerative failure of the process that protects our brain cells and glial support. While genetic research has failed to find specific genes that may be affected to reverse this disorder, the genetic research has delivered a lot of information important to therapy. For instance, the neurodegenerative condition called amyotrophic (muscle atrophy) lateral sclerosis (scarring of nerve tissue), or ALS, has revealed that mutations in the gene that produced cellular superoxide dismutase (SOD) results in a deficiency of this important antioxidant mechanism in about 20% of inherited cases of ALS. While no single genetic mutation has been found, 135 different mutations in the gene have been discovered that are associated with the ALS disease process. There is no single pharmaceutical agent that will correct this. The mutations discovered reveal that the SOD enzyme, which normally functions to clear free radical oxidants from the brain cells, now may be causing misshapen proteins in the cell nucleus of the neuron. The cause of the numerous genetic mutations is exceedingly complex, and the immune complement system has been heavily researched to find an imbalance in inflammatory mediators that could be driving these mutations. TNF-alpha is the immune mediator usually involved in driving excess mutations that lead to cancerous cells, and is the target of both much research, and now a novel approach to treatment of neurodegenerative conditions. Herbal research has also revealed how nature has created potent chemicals to modulate the activity of TNF-alpha, both by inhibiting its expression and by modulating the balance of immune chemicals that keep it in check. This highly evolved system of immunomodulation produces effective chemicals that are evolved to be free of the harsh side effects that the man-made chemicals create. A number of herbs are proven effective in this regard, and are now being tried and tested to determine the efficacy.
  • Carnosine and AGE block formula: Carnosine is an amino acid that is useful in the treatment for reduction of AGEs, or advanced glycation endproducts, which are implicated both in arterial plaques (atherosclerosis) and in neural plaques in neurodegenerative disease. Research in recent years has found the carnosine exerts potent inhibitory effects of excess glutamate and NMDA neurotoxicity (see link to the research below). NMDA glutamate receptor blockers or antagonists, as well as non-NMDA glutamate antagonists are now a widely used pharmaceutical for the treatment of various neurodegenerative conditions (re: Amantadine and other drugs). Carnosine and AGE block presents a safe and effective form or this treatment to use in the overall strategy.
  • Uridine: uridine is a nucleoside (RNA component) that is formed when uracil is attached to a ribose ring in health sugar metabolism. Uridine is an essential component for sugar utilization by neuron mitochondria, and has been touted as an effective aid in neurodegenerative states. Uridine is found in the Chinese Siberian ginseng, as well as the Peruvian herb Maca, and is now widely used as a supplement. Neuron Growth Factors (Vitamin Research) combines uridine with other essential aids to neuron health in a formula. Foods high in uridine content include natural brewer's yeast, sugar beets, unprocessed sugar cane or sugarcane extract, and organ meats (e.g. liver).
  • Green Perilla Leaf: research has revealed that various herbal and food chemicals activate the innate cellular detox and antioxidant pathway of Nrf2 expression. Green perilla leaf, a common vegetable used in Japanese cuisine, especially with types of sushi, is shown to be highly effective in this regard. Purple perilla leaf is a common herb used in Traditional Chinese Medicine, called Zi su ye. Studies have also revealed that the Chinese herb Ganoderma lucidum (Ling zhi, or Reishi mushroom) also achieves detox and antioxidant effects via the Nrf2 pathway activation. A 2006 review of herbal chemicals in potential drug-herb interactions, by the pharmaceutical giant Bristol-Meyers Squibb, in Princeton, New Jersey, U.S.A. concluded that "dietary phytochemicals can cause induction of drug metabolizing enzymes...including the nuclear factor erythroid-derived 2 (Nrf2) transcription factor." While the drug companies continue to try to find evidence of negative drug-herb interactions, the actual clinical evidence of harm is almost nonexistent. What this study reveals is that herbal and nutrient chemicals do exert significant induction of natural antioxidant and neuroprotective pathways, as confirmed by expert chemists at major pharmaceutical research facilities.