About one percent
of Americans older than 65 have Parkinson's disease, which
causes tremor, muscle rigidity and movement problems. An underlying
cause is the slow loss of neurons that produce the neurotransmitter
dopamine, a brain chemical involved in movement. Current Parkinson's
therapy relieves symptoms but does not slow the progression
of the disease.
What is Parkinson's
disease and when does it appear?
According to the
Parkinson's
Disease Foundation:
"Parkinson's
disease (PD) is a disorder of the central nervous system that
affects between one and one-and-a-half million Americans.
Because it is not contagious and does not have to be reported
by physicians, the incidence of the disease is often underestimated.
PD may appear
at any age, but it is uncommon in people younger than 30,
and the risk of developing it increases with age. It occurs
in all parts of the world, and men are affected slightly more
often than women."
What new treatments
are being studied?
Recent research
has raised the possibility that people with Parkinson's might
have problems with structures called mitochondria, a spherical
or elongated organelle in the cytoplasm of nearly all eukaryotic
cells, containing genetic material and many enzymes important
for cell metabolism, including those responsible for the conversion
of food to usable energy. The researchers who performed this
study found that Parkinson's patients have reduced levels
of coenzyme Q10 in their mitochondria. This led the researchers
to investigate whether the antioxidant would be useful in
treating the disease.
How was the
study conducted?
The study involved
80 people who had been diagnosed with Parkinson's but had
not yet received treatment. The participants were randomly
assigned to take a daily dose of 300 milligrams (mg), 600
mg or 1,200 mg of coenzyme Q10 or an inactive pill called
a placebo. Patients were evaluated at the start of the study
and after one, four, eight, 12 and 16 months.
What were the
results of using coenzyme Q10?
The progression
of Parkinson's disease was significantly slower in people
taking the highest dose of coenzyme Q10. These patients experienced
a slower decline in all areas measured by the researchers,
including mental and motor skills, but the greatest effect
was in the activities of daily living. Compared to placebo,
the lower doses of the drug also seemed to slow Parkinson's,
but the differences were not statistically significant.
What about side
effects?
Treatment with
the antioxidant seemed safe as side effects were similar in
patients taking the supplement and the placebo.
What is coenzyme
Q10?
In the U.S., coenzyme
Q10 is classified as a dietary supplement rather than a drug,
so it is not regulated by the Food and Drug Administration.
The antioxidant is available at health food stores, but the
researchers advised Parkinson's patients not to take the supplement
until future studies have been conducted. The coenzyme Q10
currently on the market may not contain enough of the supplement
to be helpful to people with Parkinson's.
Were there any
negative conclusions drawn from the study?
Although treatment
with coenzyme Q10 seemed to slow the advance of Parkinson's,
patients taking the supplement developed disability that required
them to start taking conventional treatment as quickly as
those on the placebo. The researchers do point out, however,
that until near the end of the study, patients taking the
highest dose of coenzyme Q10 tended to need to start conventional
therapy later than those on the placebo. The greatest benefit
was in daily activities such as feeding, dressing, bathing,
and walking.
The results of
the study support the idea that problems with mitochondria
are involved in Parkinson's disease and provide an exciting
forum to continue study. The National Institutes of Health
funded the study, but Vitaline Corp. donated the coenzyme
Q10 and placebo wafers.
Archives
of Neurology October 2002; 59: 1523,1541-1550
While I am
not a great fan of using supplements as Band-Aids, by the
time someone has Parkinson's disease the horse is already
out of the barn, and coenzyme Q10 appears to be a useful supplement.
Co Q10 is normally made by the liver and is decreased when
someone is placed on statin drugs. A prescription for lipid
lowering statin drugs should always be accompanied with a
recommendation to take Co Q10, because if one is deficient
in it heart failure is more likely.
Co Q10 is also
a helpful adjunct in many cancer therapies.
However, in
terms of Parkinson's disease, prevention is clearly the best
option. The single best thing one can do is avoid pesticide
and insecticide exposure. The massive fogging for West Nile
virus that occurred this summer will absolutely increase the
future development of Parkinson's disease.
Increasing vegetable
intake with its high folic acid levels whichis easily achieved
by following the eating
plan, is another highly effective proactive step to prevent
Parkinson's disease.
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