Ask the Parkinson Dietitian
"The National Parkinson's Foundation, Inc."

About 50,000 Americans are diagnosed with Parkinson's disease each year, with more than half a million Americans affected at any one time. Many people in the early stages of the disease assume their symptoms are the result of normal aging and do not seek help from a physician. Parkinson's disease occurs when certain nerve cells, or neurons, in an area of the brain die or become impaired. The cause of this cell death or impairment is not known but significant findings by research scientists continue to yield fascinating new clues to the disease. The primary symptoms of Parkinson’s are tremor or trembling in the hands, arms, legs, jaw, and face; rigidity or stiffness of the limbs and trunk; bradykinesia or slowness of movement, and postural instability or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. As yet, there is no way to predict or prevent the disease. The disease is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time. Parkinson’s is not contagious nor is it usually inherited -- that is, it does not pass directly from one family member or generation to the next. What are the early symptoms of Parkinson’s? Early symptoms of Parkinson's disease are subtle and occur gradually. Patients may be tired or notice a general malaise. Some may feel a little shaky or have difficulty getting out of a chair. They may notice that they speak too softly or that their handwriting looks cramped and spidery. Friends or family members may be the first to notice changes. They may see that the person's face lacks expression and animation (known as "masked face") or that the person remains in a certain position for a long time or does not move an arm or leg normally. Perhaps they see that the person seems stiff, unsteady, and unusually slow. As the disease progresses, the shaking, or tremor, that affects the majority of Parkinson's patients may begin to interfere with daily activities. Patients may not be able to hold utensils steady or may find that the shaking makes reading a newspaper difficult. Parkinson's tremor may become worse when the person is relaxed. For most patients, tremor is usually the symptom that causes them to seek medical help. Other symptoms of Parkinson’s include: Depression. This is a common problem and may appear early in the course of the disease, even before other symptoms are noticed. Emotional changes. Some people with Parkinson's disease become fearful, insecure, irritable or uncharacteristically pessimistic. Memory loss and slow thinking may occur, although ability to reason remains intact. Difficulty in swallowing and chewing. Food and saliva may collect in the mouth and back of the throat, which can result in choking or drooling. Speech changes. About half of all persons with Parkinson’s have problems with speech. They may speak too softly or in a monotone, hesitate before speaking, slur or repeat their words, or speak too fast. A speech therapist may be able to help patients reduce some of these problems. Skin problems. In Parkinson's disease, it is common for the skin on the face to become very oily, particularly on the forehead and at the sides of the nose. Excessive sweating, is another common symptom and is usually controllable with medications used for Parkinson's disease. Sleep problems. How do Doctors Diagnose Parkinson's Disease? Even for an experienced neurologist, making an accurate diagnosis in the early stages of Parkinson's disease can be difficult. There are, as yet, no sophisticated blood or laboratory tests available to diagnose the disease. The physician may need to observe the patient for some time until it is apparent that the tremor is consistently present and is joined by one or more of the other classic symptoms. How is the disease treated? At present, there is no cure for Parkinson's disease. But a variety of medications provide dramatic relief from the symptoms. When recommending a course of treatment, the physician determines how much the symptoms disrupt the patient's life and then tailors therapy to the person's particular condition. Since no two patients will react the same way to a given drug, it may take time and patience to get the dose just right. Even then, symptoms may not be completely alleviated. Levodopa, is the most commonly used medication. Levodopa is not a cure. Although it can diminish the symptoms, it does not replace lost nerve cells and it does not stop the progression of the disease. Can diet or exercise programs help relieve symptoms? Eating a well-balanced, nutritious diet can be beneficial for anybody. But for preventing or curing Parkinson's disease, there does not seem to be any specific vitamin, mineral, or other nutrient that has any therapeutic value. A high protein diet, however, may limit Levodopa's effectiveness. Because movements are affected in Parkinson's disease, exercising may help people improve their mobility. Some doctors prescribe physical therapy or muscle-strengthening exercises to tone muscles and to put underused and rigid muscles through a full range of motion. Exercises will not stop disease progression, but they may improve body strength so that the person is less disabled. What are the benefits of support groups? One of the most demoralizing aspects of the disease is how completely the patient's world changes. The most basic daily routines may be affected -- from socializing with friends and enjoying normal and congenial relationships with family members to earning a living and taking care of a home. Faced with a very different life, people need encouragement to remain as active and involved as possible. That's when support groups can be of particular value to patients, their families, and their caregivers. For more information contact: The National Institute of Health Neurological Disorders Information Hotline at 1-800-352-9424. The American Parkinson’s Disease Association at 1-800-223-2732. The National Parkinson Foundation at 1-800-327-4545. Source: Adapted from information produced by the National Institute of Health. Neurological Disorders and Stroke Institute. P. O. Box 5801, Bethesda, MD 20824.