Supplements for Treating Parkinson’s: A Scientific Perspective and Personal Update

“I never think of the future – it comes soon enough.” Albert Einstein

“We are made wise not by the recollection of our past, but by the responsibility for our future.” George Bernard Shaw

Describing Some of the Science Behind Using Supplements to Treat Parkinson’s: There are many ways to start and defend this section. One way would be to say there are hundreds of choices of supplements to “potentially” treat Parkinson’s. My concern about some of these substances is not that they don’t work but whether they are considered safe to consume and whether they have been tested for heavy metals and other potential toxins. Ayurvedic medicine for many centuries has targeted the brain. Personally and philosophically, it is hard to beat medicinal herbs and supplements used for centuries. Slowly, some of these compounds, e.g., Ashwagandha and tumeric/curcumin (and many others), are becoming mainstream over-the-counter products.

I like to use schematics and graphs to help me understand things. We are learning much about the pathways that support the development of Parkinson’s. There are a bunch of pathways; see the schematic below. Therefore, one valuable approach is to target a pathway, e.g., neuroinflammation, and take supplements that could contribute to down-regulating this process. Here is where it gets tricky for me. There are many different paths to starting Parkinson’s. Does that mean they all contribute some to the genesis of Parkinson’s? If so, can we assign a percentage for each in their role (implying that some of these pathways are more involved or important than others)? Or does this mean that a single path predominates in an individual who develops Parkinson’s and the others play very minor roles? But this is all speculation; the schematic shows the many different paths taken in the genesis and progression of Parkinson’s. Overall, we should strive to improve the general health of the brain and taking supplements to hopefully re-focus the disease transition that is occurring from Parkinson’s.

“What you do today can change all the tomorrow’s of your life.” Zig Ziglar

A Personal Choice for Using Supplements to Treat Parkinson’s: Some of you say to ignore supplements; all you need to do is eat right, exercise a lot, and sleep well (besides taking prescribed therapies). And I do value this opinion. I guess my reason for taking supplements is if they help in slowing down the progression of my disorder by, let’s say, 5-10%, then it is worth it [5-10% of 83 years (just a guess to how many years I may live) is (0.05) * 83 = ~4 years and (0.10) * 83= ~8 years. Adding those 4-8 years to your 83 years gives you a potential lifespan of 87 to 91 years]. Taking a chance by helping to improve my health is the main reason I am taking supplements.

My approach is to broadly target the use of supplements that can help and not hinder other pharmaceutical prescriptions that are known to be effective in treating Parkinson’s. So far, we have no cure for Parkinson’s. Thus, instead of waiting for this ‘miracle to happen,’ I take a focused approach to trying to manage my Parkinson’s. These compounds might help to treat the disorder. I am not afraid to add other supplements, remove some from the current stack, or go back and further refine my opinion about given compounds. Unless there is a dramatic change in motor score, one may not feel any different over time. That is a conundrum: how does one know whether a supplement works?

Consider this: if you have not increased your carbidopa/levodopa amount in several years, then might this be considered a prolongation of your life-time with Parkinson’s? Success? Are you slowing down the progression of your disorder by taking supplements? Or is that total nonsense?I do not have the answer. I am only an n = 1, but I know there are a lot of you out there doing the same thing, taking supplements with the hope that you are slowing down the beast named Parkinson’s. I admire your dedication and willingness to experiment. I wish you the best of luck in this pursuit.

“Finish each day and be done with it. You have done what you could. Some blunders and absurdities no doubt crept in; forget them as soon as you can. Tomorrow is a new day; begin it well and serenely and with too high a spirit to be encumbered with your old nonsense.” Ralph Waldo Emerson

Overview of a Selection of Supplements for Parkinson’s: What follows below can be split into two presentations. The first section presents the usual update of my treatment strategy for using supplements to treat Parkinson’s. If you have any questions, please write; I would be happy to provide feedback and support you have about any of these supplements described here. The following part is a list of some of the many supplements (given here is just a tiny percentage of what is available). This list is divided up into the categories from the schematic above [sections include Biological Action and Literature Citations, and Adverse Reactions (many of the adverse reaction responses were obtained from Google/AI-assisted searches)].

Supplement List, Daily Amount Taken, and the Source of Supplements:
Download the 4-page handout in PDF format (updated 12/29/2024) by clicking here.

Anti-Parkinson’s Prescription Drugs and Supplements:

Prescription* or Supplement	Biological Action	Adverse Reactions	Reference(s) [are at the end of the blog]
*Carbidopa/Levodopa	Levodopa is the precursor to dopamine, and Carbidopa is an inhibitor to help prevent the peripheral breakdown of Levodopa	It may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. It may cause involuntary movement problems, including shakiness, stiffness, or jerkiness.	Ahlskog, J.E. (2015)
*NeuPro (rotigotine dopamine agonist transdermal patch)	It acts as a dopamine receptor agonists, primarily binds to D1, D2, and D3.	The most serious adverse effects include compulsive behavior, gambling and hypersexuality.	Church, F.C. (2021)
CDP Choline (Citicoline)	It may impact dopamine synthesis, increase dopamine receptors, and reduce carbidopa /levodopa needed over time.	.Nausea, Constipation, Headache or Insomnia, Hypotension, Blurred vision, or Restlessness. Interestingly, the FDA held up the sales of the supplement (a few years ago) see letter here.	Agnoli et al. (1982) Cubells et al. (1988)

Anti-Neuroinflammatory Supplements:

Supplement	Biological Action	Adverse Reactions	Reference(s) [are at the end of the blog]
Taurine	Reduced in human PD vs. age-matched controls. It lowers microglial cell activation. Protects dopaminergic neurons and reduces neuropathy (in diabetes).	Long-term use has not been studied. It is safe when used as a medicine for up to 3 months. It may lower blood pressure by interacting with anti-hypertensive drugs.	Zhang et al. (2016) Che et al.(2018) WebMD citation Jangra et al. (2024)
Palmitoylethanol-amine (PEA)	Reduces microglial and astrocyte activation and oxidative stress. PEA has been found to reduce interferon-γ, tumor necrosis factor-α, and interleukin-17. It was also clinically shown to improve motor symptoms in advanced PD.	PEA may cause a heavy feeling in the stomach, and, when taken sublingually, may cause minor gastrointestinal disturbance. Recently, PEA was shown to be protective of the kidneys.	Brotini et al. (2017) Orefice et al. (2016) Landolfo et al. (2022) Hesselink et al. (2012 Dubey et al. (2024)
Palmitoylethanol-amine (PEA) + Luteolin, and PEA + Turmeric Curcumin	A clinica study has found that PEA and luteolin have complementary pharmacodynamic properties. They both are anti-inflammatory and can reduce oxidative stress.	There have been no long-term studies with PEA; however, Brotini et al. (2017) found that patients were on PEA for at least 12 months.	Cordaro et al. (2020)
Vitamin D3	vitamin D3 has anti-inflammatory effects: it reduces pro-inflammatory cytokines, inhibits NFκB pathway, modulates immune cell activity, and reduces leukocyte migration.	Too much vitamin D can cause high calcium levels, which can lead to nausea/vomiting, constipation, increased thirst, increased urination, and kidney disease.	Krajewska et al. (2022) Mousa et al. (2017) Leal et al. (2020)
Ceylon cinnamon	The bioactive substance, cinnamaldehyde, is converted to benzoate in the liver, which reduces both inflammation (NF-kB) and nitric oxide and also increases BDNF levels. Ceylon cinnamon provides dopaminergic neuronal protection and improved motor functions	If taking large quantities, ensure it is Ceylon cinnamon and not Cassia cinnamon (which contains the anticoagulant coumarin). Cinnamon can interact with antibiotics, diabetes drugs, and heart medicines.	Khasnavis et al. (2014) Paphan and Pahan (2015) Angelopoulou et al (2021)
Probiotic	Probiotics are mixtures of bacterial strains thought to be beneficial for the human gut microflora. Probiotics can modulate. the immune system lowers nF-kB activation and reduces a key marker of inflammation, C–reactive protein (CRP).	These probiotics have anti-inflammatory properties: Lactobacillus reuteri; Lactobacillus casei; Lactobacillus bulgaricus; Bifidobacterium; Kefir; Kombucha; Tempeh; Kimchi	Plaza-Díaz et a. (2017) Seo et al. (2021) Cristofori et al. (2021)

Anti-Aging Supplements:

Supplement	Biological Action	Adverse Reactions	Reference(s)
Acetyl- l-Carnitine (ALC)	It has neuroprotective properties, and it may boost cognitive function. ALC partially restored mitochondria function in aged rodents.	ALC can cause diarrhea, nausea, stomach pain, and vomiting, insomnia, increased blood pressure, lower blood sugars (so be cautious if you have diabetes).	Rosca et al. (2009)
a-Lipoic acid (ALA)	Alpha-lipoic acid is a cofactor for some mitochondrial enzymes and functions as an antioxidant in the brain. Aged-rodents were more responsive to ALA than younger animals.	ALA can lower blood sugar levels, so people with diabetes should take it only under the supervision of their healthcare provider.	`Shanaida et al. (2024)

Immune Function Supplement:

Supplement	Biological Action	Adverse Reactions	Reference(s)
Vitamin D3	Vitamin D3 can modulate immune cell function, promote the innate immune system while inhibiting the adaptive response, and inhibit an autoimmune response.	Too much vitamin D3 can lead to nausea and vomiting, poor appetite, and weight loss. constipation. weakness, kidney stones, and kidney damage.	Martens et al. (2020 Daryabor et al.(2023)

Anti-Oxidative Supplements:

Supplement	Biological Action	Adverse Reactions	Reference(s)
N-Acetyl Cysteine (NAC)	NAC and GLY are precursors to glutathione (GSH), the master anti-oxidative compound. Long-term use of NAC in a PD mouse model reduced neuronal loss, oxidative stress and improved motor abnormalities.	NAC has a free sulfhydryl group, and the ‘sulfur-like odor’ can make some people queasy. Otherwise, no evidence exists that NAC harms the body; however, further studies are needed to prove its safety.	Coles et al. (2018) Caridade-Silva et al. (2023) Hagen et al. (1998)
Glycine (GLY)	The key anti-oxidant in cells is GSH, which quickly oxidizes outside the cell to GSSG. GLY and NAC work to produce GSH, with GLU to complete the synthesis of GSH.	Side effects of GLY include Stomach discomfort. Soft stools. Nausea.	Kumar et al. (2022) McCarty et al. (2018) Kumar et al. (2023)
Acetyl-L-Carnitine (ALC)	It is an antioxidant that protects cells from oxidative stress by improving mitochondrial function and reducing free radical production.	ALC can cause diarrhea, nausea, stomach pain, and vomiting, insomnia, increased blood pressure, lower blood sugars (so be cautious if you have diabetes.	Wang et al. (2020) Grossini et al. (2023)
a-Lipoic acid (ALA)	ALA is a potent anti-oxidant due to its ability to scavenge free radicals, regenerate anti-oxidants, ,	ALA can lower blood sugar levels, so people with diabetes should take it only under the supervision of their healthcare provider.	Packer et al., (1995) Capece et al. (2022)

Sleep Assisting:

Supplement	Biological Action	Adverse Reactions	Reference(s)
Melatonin	The pineal gland makes melatonin. As we age, we produce less melatonin, which helps promote sleep and regulates the circadian cycle.	Side effects include vivid dreams or nightmares, depression, irritability, constipation, or decreased appetite.	Iftikhar et al. (2023) Ma et al. (2022)
Apigenin	The data on humans are limited, but in rodents, it increased the levels of sleep-promoting proteins (BDNF, CREB, and serotonin), and decreased the levels of stress-related proteins .	High doses of apigenin may cause stomach disturbances.	Kramer et al. (2024) Salehi et al. (2019)
Mg threonate (Magtein)	Magtein passes through the blood-brain barrier, promoting a higher sleep quality.	Adverse effects range from vomiting and diarrhea to cardiac arrhythmia and shortness of breath.	Ray (2024) Zhang (2022)

General Brain Health:

Supplement	Biological Action	Adverse Reactions	Reference(s)
Vitamin B Complex	B1 (thiamine), B6 (pyridoxyl phosphate), and B12 (cobalamin), are essential for maintaining a healthy nervous system.	Vomiting, diarrhea, and flushing of skin.	Calderón-Ospina t al. (2020)
Vitamin D3	Vitamin D3 is neuroprotective, helps the brain to successfully age, and low levels are linked to Parkinson’s.	Ranges from nausea and constipation to kidney disease and bone pain.	Anjum et al. (2018)
Magnesium threonate (Magtein)	Magnesium (Mg) helps your muscles relax and reduces motor defects in Parkinson’s.	Adverse effects range from vomiting and diarrhea to cardiac arrhythmia and shortness of breath.	Ray (2024)
Taurine	Taurine protects neurons from inflammation and apoptosis. It may also help maintain cognitive ability.	The safe range of taurine is not well understood, but excesses lead to vomiting, nausea, and liver pain.	Jangra et al. (2024)

Pro-Mitochondria:

Supplement	Biological Action	Adverse Reactions	Reference(s)
Vitamin B1	Vitamin B1, also known as thiamine, is a water-soluble vitamin. Thiamine is a cofactor for several mitochondrial enzymes that produce energy, leading to adenosine triphosphate (ATP) production. ATP is critical for mitochondrial energetics.	Thiamine is considered safe in excess, although it may cause an upset stomach. There are many following a high-dose protocol where up to 4 grams per day of thiamine is taken for treating Parkinson’s.	Mrowicka et al. (2023)
Vitamin B3	Vitamin B3 is also known as niacin, a water-soluble vitamin. Niacin is a cofactor for NAD synthesis, which is important for oxidative phosphorylation (i.e., energy).	High doses of niacin cause flushing (a tingling sensation in the face, neck, and chest). Those taking a statin should carefully consider the dose of niacin being taken due to a detrimental effect on the statin.	Williams et al. (2017)
Vitamin B6	Vitamin B6, also known as pyridoxal phosphate (PLP), is a water-soluble vitamin. PLP is a cofactor for several mitochondrial enzymes that are involved in energy production and DNA repair.	High doses of B6 may inactivate carbidopa, which could compromise the transport of levodopa through peripheral circulation. High doses can also cause peripheral neuropathy (tingling, burning, or numbness in the hands or feet).	Kannan et al. (2004)
Folic acid (vitamin B9)	Folate is a water-soluble B vitamin. It is critical for protein synthesis and is involved in the electron transport chain system, which is crucial for energy production.	Higher doses of folate (>1 mg/day) may cause stomach upset, nausea, diarrhea, irritability, confusion, and seizures.	Zheng and Cantley (2019)
Vitamin B12 (Colamin)	Vitamin B12, also known as cobalamin, is a water-soluble B vitamin. B12 is vital for mitochondrial function; thus, B12 is essential for aiding mitochondrial health, energetics, and function.	Usually, high levels of vitamin B12 do not pose a health effect. Large amounts of injected vitamin B12 can cause low potassium, heart failure, or even blood clots.	Mukherjee et al. (2023)
NAC and GLY	see above information
ALC	see above information
ALA	see above information

“Remember the past, plan for the future, but live for today, because yesterday is gone and tomorrow may never come.” Luke the Evangelist

References Cited Above:
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