The Parkinson and Movement Disorder (PMD) Alliance hosted a webinar on the “Naturopathic Approach to PD” by speaker Dr. Laurie Mischley, a naturopathic doctor who has done extensive research into nutrient deficiencies found in Parkinson’s disease (PD). She spoke about naturopathic medicine, essential nutrients in PD, and other types of deficiencies that patients should also try to address, such as sleep and social interaction. We at Stanford Parkinson’s Community Outreach listened to the webinar and are sharing our notes.
The recorded webinar is available for viewing on YouTube.
Webinar Notes by Lauren Stroshane, Stanford Parkinson’s Community Outreach
“Naturopathic Approach to Parkinson’s Disease” – Webinar Notes
Speaker: Laurie K. Mischley, ND, PhD, MPH
Moderator: Indu Subramanian, MD
Presented by the Parkinson & Movement Disorder Alliance
December 4, 2019
What is a naturopathic doctor?
Dr. Mischley is a naturopathic doctor, which means she went to a 4-year medical school, including two years of basic sciences and two years of clinical training.
Her program was eclectic – “jack of all trades, master of none” – so she learned about pharmaceutical drugs, minor surgery nutrition, physical medicine (chiropractic adjustments, hydrotherapy), herbal medicine, Ayurveda, and traditional Chinese medicine.
She didn’t have much opportunity for specialization in school, but she knew that she wanted to work with the brain and learn more about brain health. She feels that a lot of naturopathic doctors are poorly trained in neurology, while a lot of neurologists are poorly trained in nutrition and other complementary therapies.
After 10 years of private practice, mostly with neurology patients, including multiple sclerosis, amyotropic lateral sclerosis, and epilepsy, Dr. Mischley received an NIH award to go into research and since then has primarily studied PD and nutrient deficiencies.
Conditionally essential nutrients in Parkinson’s disease
We know that, for example, pregnant women need more folic acid, and smokers need more vitamin C. Do people with PD have unique nutritional requirements? She thinks likely yes.
A case-control study she led in 2012 showed that patients with PD were more likely to be deficient in CoQ-10, compared to healthy controls. It did not establish whether taking CoQ-10 supplements is helpful, just established that there was a deficiency in 30% of patients with PD.
She did her Master’s thesis on lithium deficiency, which is actually a required nutrient! The human body cannot produce it and must take it in through food or water, similar to iodine. Maybe we should find a way to fortify people’s iodine status?
Brain cells need more of it than other body cells. People with PD were 75% more likely to have undetectable levels of lithium in their bodies. Hair is the only way to measure lithium, the inch closest to the scalp.
For those interested to read more, there’s a NYT opinion piece on this: “Should We All Take a Bit of Lithium?”
- PRO-PD scores
- To join the CAM Care PD study
- Brian Grant Foundation for great receipes
- Food for Thought video
- Online PD School
- PD-sniffing dogs at Park-9 and PadsForParkinson’s
- Dr. Mischley’s personal website
- Dr. Mischley’s Facebook page
Comment by Dr. Subramanian:
Laurie tends to be in a grey area between movement disorders neurology care and naturopathic medicine. Keep an open mind, take things with a grain of salt. If someone is trying to treat you with something that hasn’t been studied well, think critically. Ideally there should more collaboration between these two branches of medicine (western & naturopathic). It is important to have trust and dialogue, and to feel that you can be open with your neurologist if you are taking supplements or other alternative medicine, to make sure it does not conflict with your medications.
Comment by Dr. Mischley about exercise in the CAM-PD study:
With the caveat that some exercise is always better than none, participants who exercised 2 days a week did not show significant improvement in their PD symptoms or progression. Once they increased to 3 days of exercise per week, it really starts to count. Every day a week of increased exercise (at least 30 minutes), helps slow progression and improve symptoms. More is better.
What types of exercise are best? She was surprised by the results (adjusting for age, gender, age at diagnosis, years since diagnosis):
- PD spin classes
- Rock climbing (typically in a gym!)
- Yoga – can be practiced at all stages of disease
Swimming is likely beneficial, but wasn’t statistically significant in the study.
Q: Where can I get intranasal glutathione?
Dr. Mischley – From compounding pharmacies, but it is very expensive. It ends up costing >$350 a month, must be stored in a fridge, can be challenging during the day to find a place to lay down and snort it. Several companies have made an intranasal glutathione and offer it on Amazon, but given how hard it is to keep the high-quality pharmacy compounded version stable, she has no confidence that it would be in good shape by the time it arrived to you. It’s best to work with your physician and a compounding pharmacy, but it is going to be expensive.
Q: Do you recommend anacetyl cystein?
The aim of research with anacetyl cystein is to try to boost glutathione. Glutathione contains 3 amino acids. By boosting some of these, your body can increase production of glutathione temporarily. But it doesn’t continue to work if you keep trying to boost your glutathione this way. It is best to just take the glutathione itself.
Weirdly, and she has no explanation for this, two studies showed increases in glutathione from yoga!
Q: How much exercise is the optimal amount?
Try to do at least 30 minutes a day. We don’t know if two hours a day or one hour a day is better than 30 minutes. But we do know that six days a week is better than five days, and so on. It is important to consider safety and motor issues: find exercise that you can do safely and practically, so that you can build physical activity into your daily routine. Making your exercise something social is a great way to help address loneliness, too.
- Free for the first month, then $29 a month afterward
- Physical Therapist with exercises, cognitive challenges, workouts for PD
- This is a great place to start!
Physical therapists, especially ones with experience working with PD, can be a really great resource as well.
Q: Swimming and water exercises?
It did not show statistical significance in the CAM study. This doesn’t necessarily mean swimming is not useful; it might mean that not a lot of the study participants were swimmers, for instance.
Comment by Dr. Mischley: Replacing deficiencies
Sleep is also critical – for everyone, but especially for those with PD. Protect your sleep like your life depends on it. Read about sleep hygiene guidelines, such as avoiding caffeine and alcohol. Melatonin can be quite helpful, but often need a higher dose (generally 9-12 mg, ideally sublingual form, dissolving under the tongue). In her experience, cannabis is the best sleep aid for PD patients.
Dr. Mischley recommends all her patients watch this video on sleep and PD, by neurologist Dr. Jason Valerio.