Friday, December 14, 2007

Parkinson's disease

I'm often found hanging around a nursing home lately, and my observations confirm that women live longer than men, AND women live more years with disability than men. My casual diagnoses in the dining room based on who can independently and successfully get food to mouth also support the gender statistics on Parkinson's Disease--I'd guess 2 out of 3 old gents at the men's table struggle with it compared with 3 in 20 of the women.

Parkinson's Disease takes out the dopamine-producing motor neurons in the brain in charge of ease and fluidity of movement. Ms. B at my mother's table demonstrates all 4 of the most common symptoms: tremor, slowness of movement, stiffness, and postural instability. As she sits near motionless, slumped sideways in her wheelchair, she also speaks in a whisper-soft voice, another characteristic of Parkinson's. By leaning in close this evening, my ear near her mouth, I could barely make out her German-accented recitation of the recipe for walnut torte.* Unfortunately for Ms. B, the rest of her tablemates are hard of hearing, so I bellowed her words to them...and the rest of the room.

Good heavens, how to save the dopaminergic neurons of my substantia nigra? Be female (check), keep up the estrogen (check), avoid pesticides (hmm?), drink coffee (oh yeah), smoke cigarettes (well, I'll pass on that), and maybe take neuroprotective supplements (melatonin? Prevagen?).
*Walnut torte, per Ms. B, is heavy on butter, nuts, and whipped cream. This is my kind of dessert. We were all eating institutional orange sherbet at the time.


JeanMac said...

I don't know what to write - I feel so badly for you and Mom. Just wanted you to know you have support.

Ruth said...

I see so many people with movement disorders including Parkinson's. They hope they will regain their mobility with physiotherapy, but that is not the case. We often keep flowcharts for the doctor, monitoring tremor, rigidity, freezing so the medication effects can be evaluated. I had a patient who ate Fava beans every day because of their reputed levodopa content. It was a safe way to self-medicate I guess.

Femail doc said...

Thanks Jean for the support.

Ruth: Check this out from David Bender:
Favism Acute hemolytic anemia induced in genetically susceptible people by eating Fava beans. The disease is due to deficiency of the enzyme glucose 6-phosphate dehydrogenase in the red blood cells, which are then vulnerable to the toxins, vicine and convicine, in the beans. The condition affects some 100 million people world-wide, and is commonest in people of Mediterranean and Middle-Eastern descent.

So perhaps not such a safe way to self-medicate. And what are fava beans anyway? Have you ever eaten one? You probably have a delicious recipe for them...

Ruth said...

Wow...who would have thought a fava bean could cause that much of a problem in susceptible people! I have bought canned ones in our grocery stores a couple of times and didn't really care for them. They look just like any other legume and the ones I had were prepared from the dried bean. They are also known as broad beans.
Here is a Wiki link...

It says favism is caused by eating raw beans. (I know Wikipedia is not a scientific authority.)

Eric, AKA The Pragmatic Caregiver said...

If you're worried about neuroprotection, look at the NET-PD trials. Essentially, they're evaluating neuroprotection strategies in PD. Four agents have had mid-sized (N=200+) multicenter trials; creatine, CoQ-10, minocycline and a novel pharmaceutical, GP-1485. All four have shown to be non-futile, and are progressing to later-stage trials.

CoQ10 at the doses studied is a $100 or more proposition. The creatine is closer to $20.

Nicotine and caffeine are also associated with a reduced risk of developing PD.

Anonymous said...

I take Co-q 10 and quercitin. the latter is good for inflammation of the gastrointestinal area. I take
cooked favas but no meds.