2022: A New Year Filled with Hope for Gut Health

By the time you read this article, February is upon us. But my optimistic brain tells me that it’s not too late in the year to commit to a meaningful lifelong resolution: to better understand the connections between our gut health and Parkinson’s disease (PD).

Twelve years ago, I was diagnosed with life-altering, neurodegenerative young-onset Parkinson’s disease. Once I found out that there is no cure for PD, instead of wallowing in negativity, I vowed to find the best available therapies to slow its progress while still leading the most active life possible. In order to achieve that lofty goal, I knew I had to surround myself with positive people with the same diagnosis who had been successful at reaching this goal. My 12 years of Parkinson’s specific research has revealed an exciting discovery — that Parkinson’s may start in the Gut. So the focus of this article is: You are as healthy as your gut!

When and How To Begin the Nutrition and Diet for Parkinson’sWeek 1 after PD diagnosis is the right time to start assessing your immediate vitamin and mineral needs as well as deficiencies. For that, I suggest getting a referral from your neurologist or support group to either a licensed, registered dietician or nutritionist who specializes in treating Parkinson’s patients. This familiarity with Parkinson’s disease pathogenesis and pathways involved in its long-term progression enables your nutrition expert to design a customized diet and supplement plan to support the efficacy of your medication therapies as well as help you maintain the gains you achieve with physical therapy.

For example, we all know that people with Parkinson’s suffer from extreme fatigue, which could be caused by nutrient deficiencies related to a B-12 vitamin, iron deficient diet or a drug-nutrient interaction. Possible reasons behind fatigue are:

1. Low blood iron level due to low red blood cell count (iron deficient diet).

2. Permeable small intestinal lining which could lead to iron malabsorption (leaky gut), linked to stress, food toxins (gluten, casein, chemical dyes), or gut bacterial dysbiosis.

3. Hemochromatosis, a hereditary disorder caused by a mutation of a gene that controls how much iron you can absorb from the food you eat. I have this condition which wasn’t diagnosed until a few years before my Parkinson’s diagnosis. Thankfully there are new safe and effective means to remove excess iron from affected tissues under medical supervision.

4. Low Vitamin B12 due to either a vegetarian or vegan diet or a B-12 deficient diet.

5. Severe vitamin/ mineral/ calorie deficiencies leading to malnutrition.

6. Bleeding ulcer.

Please be aware that iron in food or in supplement form can interfere with L-Dopa medication absorption. Consult your neurologist and nutritionist team before starting an iron-rich diet or supplement. Spacing your L-Dopa medication time and iron-rich foods by one hour may not help if you suffer from Gastroparesis. In this condition, the stomach empties its food content into the small intestine more slowly than normal causing slow food and medication transit time and lower drug efficacy. What works for me is a low iron diet.

Within the first year of diagnosis, a GI-mapping stool test is useful to find out the diversity as well as the size of the gut microbial population called “gut microbiota.” The gut microbiota, also known as the “second brain,” includes 100 trillion bacteria, fungi, parasites, and viruses. This technologically advanced test reveals information needed in order to design a customized gut balancing program to alter the microbiota using things such as specific probiotics, special diets, and lifestyle changes.

What Do We Know About Where PD Starts in Our Body? Our gastrointestinal (GI) tract is a long tube where trillions of friendly and pathogenic bacteria, viruses, parasites, and fungi live with specific functions from protecting us against bacterial and viral attacks to delivering nutrients to bodily organs including the brain. PD is a progressive neurodegenerative disease that affects the central nervous system, especially the part of the brain that primarily controls the motor system. This explains the motor symptoms of PD including tremor, muscle stiffness, slow movement, and gait imbalance. However, many of the world’s three million people with Parkinson’s also suffer from non-motor symptoms such as rapid eye movement (REM) sleep deficits, cognitive impairment, orthostatic hypotension and commonly, gastrointestinal dysfunctions. Reportedly, as many as 80% of PD patients suffer from chronic constipation years prior to developing PD symptoms. Although the main pathological characteristic of PD is the accumulation of the protein alpha-synuclein, or Lewy bodies (LB), in the brain, some research has found LB in the intestinal walls of PD patients during autopsy. This may indicate that PD pathogenesis begins in the gut. At the least, evidence shows that gut microbiota imbalance plays a role in PD. Further research will hopefully lead to new treatments that delay the onset of Parkinson’s or even reverse it.

References: • Savica R, Carlin JM, Grossardt BR, Bower JH, Ahlskog JE, Maraganore DM, et al. Medical records documentation of constipation preceding Parkinson disease: a case-control study. Neurology. (2009) 73:1752–8. 10.1212/WNL.0b013e3181c34af5 • Abbott RD, Petrovitch H, Masaki KH, Tanner CM, Curb JD, Grandinetti A, et al. Frequency of bowel movements and the future risk of Parkinson’s disease. Neurology. (2001) 57:456–62. 10.1212/ WNL.57.3.456 • Braak H, Vos RAID, Bohl J, Tredici KD. Gastric alpha-synuclein immunoreactive inclusions in Meissner’s and Auerbach’s plexuses in cases staged for Parkinson’s disease-related brain pathology. Neurosci Lett. (2006) 396:67–72. 10.1016/j.neulet.2005.11.012

To learn more about gut healthand Parkinson’s disease, please attend the DAPS Educational Series meeting on February 28, 2022 at 11:00 a.m. at Preston Hollow United Methodist Church. Faye Elahi will be speaking further on the topic. Register for this event here: https://www.daps.us/events/educational-series-faye-elahi-ms-ma