Gastric reflux is one of the non-motor symptoms of PD. It can cause irritation of the vocal folds and throat and can potentially cause voice hoarseness. It is possible that a person who has reflux doesn't have any symptoms of reflux that they recognize. For example, sometimes people feel as though they "have something stuck in my throat" after swallowing. These people may even seek a swallowing evaluation which turns out to be within normal limits. The reason is that when reflux irritates the vocal folds and throat area it can give the person the sensation that there is something stuck in their throat when, in fact, there is not. Another possible symptom of reflux is frequent throat clearing.
Parkinson disease itself can cause voice changes as well including soft voice, monotone voice, and hoarseness. Frequently people with PD have bowing of the vocal folds meaning that the vocal folds don't come together completely during talking. When the vocal folds do not close completely air can leak through resulting in a breathy or hoarse sounding voice. If you have reflux and vocal fold bowing the combination of these two factors can cause changes in your voice that could potentially interfere with functional communication.
If you think that you might be experiencing symptoms of reflux or changes in your voice you should consult with your physician. Successful management of reflux is usually a combination of medication and behavioral modifications. For example, it may be recommended to stop eating several hours before going to bed at night, eating more frequent smaller meals, raising the head of your bed, or making changes in your diet. A speech-language pathologist can advise you about behavioral modifications that may help you and can also advise you about receiving behavioral voice treatment to improve your communication abilities.
Sunday, August 29, 2010
Soft voice, slurred speech and masked face
Soft voice, slurred speech and masked face
Parkinson’s patients have difficulty with voice and speech. We have shortness of breath. We don’t speak loud enough. Our speech is almost unintelligible. Our face is expressionless (”poker-face”), so people thought we are not interested or unhappy, even though that is not truly how we feel.
In order to solve these problems, there are ways to improve the muscles around the mouth:
•Use tongue in your mouth to massage the muscles around the mouth.
•Gargle with water full on your throat and blow air through it without swallowing, twist your mouth to the extreme left, right, up and down, to strengthen the facial muscles.
•Blow air deeply into balloon to exercise the muscles around the mouth
Parkinson’s patients have difficulty with voice and speech. We have shortness of breath. We don’t speak loud enough. Our speech is almost unintelligible. Our face is expressionless (”poker-face”), so people thought we are not interested or unhappy, even though that is not truly how we feel.
In order to solve these problems, there are ways to improve the muscles around the mouth:
•Use tongue in your mouth to massage the muscles around the mouth.
•Gargle with water full on your throat and blow air through it without swallowing, twist your mouth to the extreme left, right, up and down, to strengthen the facial muscles.
•Blow air deeply into balloon to exercise the muscles around the mouth
comment
Just want to say what a great blog you got here!
I've been around for quite a lot of time, but finally decided to show my appreciation of your work!
Thumbs up, and keep it going!
Cheers
Christian, iwspo.net
I've been around for quite a lot of time, but finally decided to show my appreciation of your work!
Thumbs up, and keep it going!
Cheers
Christian, iwspo.net
comments
Posted by teo at 8:12 PM 1 comments:
Kevin said...
I understand that for someone who suffersfrom Parkinson, medication can be relieving and important for a good develpment. Sometimes the same happens Add therapy which some people trust in medication plus therapy, and some others believe that psychological work is the only solution. i believe therapy can help anybody, from parkinson to ADD.
Cheers
Kev
June 8, 2010 9:23 AM
Kevin said...
I understand that for someone who suffersfrom Parkinson, medication can be relieving and important for a good develpment. Sometimes the same happens Add therapy which some people trust in medication plus therapy, and some others believe that psychological work is the only solution. i believe therapy can help anybody, from parkinson to ADD.
Cheers
Kev
June 8, 2010 9:23 AM
secret recipe behind the mask
Hero,
You certainly don't look like a Parkinson's patient. Keep up the good work!
I'm Hua, the director of Wellsphere's HealthBlogger Network, a network of over 2,000 of the best health writers on the web (including doctors, nurses, healthy living professionals, and expert patients). I think your blog would be a great addition to the Network, and I'd like to invite you to learn more about it and apply to join at Wellsphere.com/health-blogger. Once approved by our Chief Medical Officer, your posts will be republished on Wellsphere where they will be available to over 5 million monthly visitors who come to the site looking for health information and support. There’s no cost and no extra work for you! The HealthBlogger page (http://www.wellsphere.com/health-blogger) provides details about participation, but if you have any questions please feel free to email me at hua@wellsphere.com.
Best,
Hua
July 31, 2009 10:33 AM
Post a Comment
Links to this post
Hero,
You certainly don't look like a Parkinson's patient. Keep up the good work!
I'm Hua, the director of Wellsphere's HealthBlogger Network, a network of over 2,000 of the best health writers on the web (including doctors, nurses, healthy living professionals, and expert patients). I think your blog would be a great addition to the Network, and I'd like to invite you to learn more about it and apply to join at Wellsphere.com/health-blogger. Once approved by our Chief Medical Officer, your posts will be republished on Wellsphere where they will be available to over 5 million monthly visitors who come to the site looking for health information and support. There’s no cost and no extra work for you! The HealthBlogger page (http://www.wellsphere.com/health-blogger) provides details about participation, but if you have any questions please feel free to email me at hua@wellsphere.com.
Best,
Hua
July 31, 2009 10:33 AM
Post a Comment
Links to this post
Saturday, August 28, 2010
Dry eye By Dr,Kathrynne
I use to have dry eyes and facial masked. I look tired and my eyes are dry.
I have tried eye drops but it is still dry and look tired.
Recently my eyes specialist inserted eye plug into my both eye and treated my problem.
I started smile and look energetic at all time.
Temporary or permanent silicone plugs can be inserted in the lacrimal (tear) drainage ducts in your eyelids to keep tears on your eye from draining away as quickly. Called lacrimal plugs or punctal plugs, they can be inserted painlessly while you're in the eye doctor's office and normally are not felt once inserted
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
513 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted 24 August 2010 - 10:01 AM
Dear Mr. Teo,
Thank you for this interesting observation. Dry eyes are not uncommon, particularly as we age; and also among those with PD. This is something that people may want to discuss with their doctors.
Best regards,
Kathrynne Holden, MS
I have tried eye drops but it is still dry and look tired.
Recently my eyes specialist inserted eye plug into my both eye and treated my problem.
I started smile and look energetic at all time.
Temporary or permanent silicone plugs can be inserted in the lacrimal (tear) drainage ducts in your eyelids to keep tears on your eye from draining away as quickly. Called lacrimal plugs or punctal plugs, they can be inserted painlessly while you're in the eye doctor's office and normally are not felt once inserted
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
513 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted 24 August 2010 - 10:01 AM
Dear Mr. Teo,
Thank you for this interesting observation. Dry eyes are not uncommon, particularly as we age; and also among those with PD. This is something that people may want to discuss with their doctors.
Best regards,
Kathrynne Holden, MS
My article
Thank you Teo that was an interesting article Mr. Loyd Tan was most certainly a devoted man to his religion, Family and the Parkinson group in Malaysia.
Teo you are also a busy man helping your friends and doing what you can to educate your people about Parkinson, I am sure you are appreciated.
The best of Health to you and your Family,
Deeann
HiDeeann,
Thank yu for your encouragement.
I find it is difficulty to deal people with PD unless there are changes on attitude that PD is an age aging disease and no treatment to be cured. In fact PD can be slow down by medication, exercises and positive on the disease that yu are not alone. In Topic: Is it dehydration or others?>
Posted 16 Aug 2010
Kathrynne Holden, MS, on 11 August 2010 - 05:20 PM, said:
Dear Mr. Teo,
It sounds like you got dizzy suddenly, and certainly dehydration could be a possibility. Dehydration is not uncommon when traveling, as it is often harder to remember to drink enough fluids.
If you were at an altitude higher than at home, this could also cause such dizziness. Higher altitudes mean there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Medications for PD can also cause dizziness, and possibly being in a new climate, combined with the medications, caused your sudden weakness. If the new climate was warmer, or colder, than you are used to, that could make a difference.
I would discuss this with your doctor, who is in a much better position to give you the personal direction you require.
,
Dear Dr. Kathrynne,
Thank you for your advise.
In fact dehydration is prevented if I have to rest at home a few days instead I go outdoor in the heated weather in order to adapt the changes of the climate from Cold to HOT.
As I was outdoor shopping in the winter I did not feel thirsty and less drinking for the past of three weeks from London,Paris,Rome and Spain.
Besides there were at different altitude when I flying back. I was from Higher altitudes to low and there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Regards
TEOKIMHOE Comments
Characters remaining: 400
Page 1 of 1
teokimhoe
12 Jun 2010 - 08:58
hello
Delete .Page 1 of 1 .
Teo you are also a busy man helping your friends and doing what you can to educate your people about Parkinson, I am sure you are appreciated.
The best of Health to you and your Family,
Deeann
HiDeeann,
Thank yu for your encouragement.
I find it is difficulty to deal people with PD unless there are changes on attitude that PD is an age aging disease and no treatment to be cured. In fact PD can be slow down by medication, exercises and positive on the disease that yu are not alone. In Topic: Is it dehydration or others?>
Posted 16 Aug 2010
Kathrynne Holden, MS, on 11 August 2010 - 05:20 PM, said:
Dear Mr. Teo,
It sounds like you got dizzy suddenly, and certainly dehydration could be a possibility. Dehydration is not uncommon when traveling, as it is often harder to remember to drink enough fluids.
If you were at an altitude higher than at home, this could also cause such dizziness. Higher altitudes mean there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Medications for PD can also cause dizziness, and possibly being in a new climate, combined with the medications, caused your sudden weakness. If the new climate was warmer, or colder, than you are used to, that could make a difference.
I would discuss this with your doctor, who is in a much better position to give you the personal direction you require.
,
Dear Dr. Kathrynne,
Thank you for your advise.
In fact dehydration is prevented if I have to rest at home a few days instead I go outdoor in the heated weather in order to adapt the changes of the climate from Cold to HOT.
As I was outdoor shopping in the winter I did not feel thirsty and less drinking for the past of three weeks from London,Paris,Rome and Spain.
Besides there were at different altitude when I flying back. I was from Higher altitudes to low and there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Regards
TEOKIMHOE Comments
Characters remaining: 400
Page 1 of 1
teokimhoe
12 Jun 2010 - 08:58
hello
Delete .Page 1 of 1 .
My Blog
fainting attack in parkinson's disease
Fainting attacks in Parkinson’s Disease
Fainting attacks are episodes of loss of consciousness that occur due to various reasons. It starts suddenly, usually within seconds and so fast that many patients fall onto the floor before they can react to it. The episodes are generally short, ranging from seconds to several minutes. Following the attack, patients usually regain consciousness. It can occur only once or more depending on how soon patients are brought to the hospital for treatment.
Fainting attacks, even if it occurs only once, are serious matter. Patients must be brought to the hospital immediately for two reasons. Firstly, they may indicate the presence of serious medical problems such as heart disease. Secondly, during the falls, some patients may be unlucky enough to develop internal injury. The most serious and potentially life-threatening is head injury with bleeding in the brain.
Fainting attacks do not just affect patients with Parkinson’s Disease (PD). It can happen in any patient, sometimes healthy people. Despite this, particular attention should be paid to PD patients because they have a higher risk of developing fainting attacks than anyone else. This is because most PD patients are elderly people who commonly have heart or brain diseases that can cause fainting attacks. In this article, I will discuss the various causes of fainting attacks among patients with such as follows;
a) Heart diseases
This is the most serious disease because heart problems can lead to immediate death. The usual heart problem that can cause fainting attacks is cardiac arrhythmia, which is a disorder of heart rhythm. Patients with cardiac arrhythmia get fainting attacks because the abnormal heart rhythm affects the normal heart function. This leads to reduced amount of blood and oxygen that go to the brain. As a result, the brain activity is disturbed and patients lose consciousness. Following the fall, patients regain consciousness within less than a minute.
Cardiac arrhythmia is a manifestation of several types of heart diseases. This could be a disorder that is called “sick sinus syndrome” that usually occurs in elderly people. In this disorder there is disruption of the electrical circuit in the heart due to ageing process. As a result, the heart rhythm is chaotic. The proper treatment for this problem is a heart pacemaker, whereby a battery sends electric signals to the heart in order to regulate the heart rhythm. Another type of heart disease is a heart attack that is caused by blockage of the blood vessels in the heart. Heart attack is also more common in the elderly people. In view of the strong tendency of elderly people to get heart diseases, anyone who has have a fainting attack must seek specialist treatment without delay.
b) Brain diseases
The most common brain disease that can cause fainting attacks is seizure or fit. This disorder is characterized by uncontrollable jerking of the limbs with loss of consciousness. The attack starts suddenly. Sometimes there are also dribbling of saliva, urine incontinence (passing urine without being able to control it) and bluish discolouration of the lips. Each attack usually lasts several minutes. Following the attack, the patient complains of headache and sleepiness. Sometimes, the patient becomes confused for up to one hour.
Seizure / fit can be either a disease on its own (epilepsy) or due to various other diseases such as stroke, brain tumour, brain infection, etc. The patient should be investigated immediately at the hospital and treated with drugs to prevent seizure from happening again.
c) Low blood pressure (postural hypotension)
This is condition which results in reduced amount of blood / oxygen going to the brain. Consequently, the patient loses consciousness. The fainting attacks typically occur when the patient is standing up from a sitting position or walking. The patient usually regains consciousness immediately following the attack (within less than one minute).
There are many reasons why a patient can develop postural hypotension. The most common cause in a PD patient is the medication itself (Madopar, Sinemet, Jumex, bromocriptine, Trivastal, etc). Occasionally, it is due to the PD itself. Other less common causes are dehydration (due to severe vomiting, diarhoea, bleeding in the stomach) and heart failure.
The treatment of postural hypotension depends on the cause. If it is due to Parkinson’s drugs, the dose of the drugs should be reduced. Usually, the dose of all other drugs is reduced before Madopar / Sinemet, because these two drugs are the most efficacious drugs in PD. At the same time, the patient is advised to sit on the bed or chair for about several minutes before standing up.
If these measures fail (and investigations have determined that there is no other causes such as heart failure), fludrocortisone can be used. This drug helps by elevating the blood pressure.
d) Low blood sugar (hypoglycemia)
In this condition, the blood sugar level is lower than normal (less than 2.5 mmol / l). As a result, patients lose consciousness. Hypoglycemia usually occurs in diabetic patients, either due to overdose of diabetic pills or missing the meal. In less severe cases, patients do not faint but develop symptoms such as dizziness, hunger, cold sweat and weakness of body.
Hypoglycemia is dangerous because it can kill a patient in a very short time. It is important to get a blood sugar level immediately to detect this condition. The immediate treatment of hypoglycemia is administration of sugar by giving sweet drinks (three to four teaspoons of sugar in a cup of water, Coca Cola, Pepsi, etc). If there is immediate access to hospital, the doctor can set up a drip to give sugar solution.
e) Sleep attacks
This is actually a very rare condition. During the attacks, patients just dose off without any warning. It happens at certain situation when people usually do not sleep, such as driving, doing computer work, having meals, etc. Sleep attacks are one of the very rare side effects of PD drugs.
f) Emotional problems
Occasionally, patients who have emotional problems may develop fainting attacks. It can be caused by extreme anger / sadness, e.g. hearing a very bad news. It should be emphasized that all other causes of fainting attacks must be excluded before the fainting attacks are attributed to emotional problem.
In conclusion, fainting attacks are serious disorder that are caused by various other potentially life threatening diseases. Patients should be immediately brought to the hospital for extensive investigations and treatment.
Posted by teo at 2:37 PM 2 comments:
James said...
The consequences that cause the disease can lead to death, and so this disease is painful and people suffering from it suffers greatly by the constant pain caused by taking medications that are opioid narcotics such as Lortab , Vicodin, hydrocodone , which are very effective in suppressing the pain that causes the disease, we hope that people care and know findrxonline adequately informed as well as notes on your site.
January 19, 2010 2:10 AM
Negocio Rentable said...
I really like this blog, you are very good making them. I say that the issue discussed in this blog is quite interesting and of high quality
Fainting attacks in Parkinson’s Disease
Fainting attacks are episodes of loss of consciousness that occur due to various reasons. It starts suddenly, usually within seconds and so fast that many patients fall onto the floor before they can react to it. The episodes are generally short, ranging from seconds to several minutes. Following the attack, patients usually regain consciousness. It can occur only once or more depending on how soon patients are brought to the hospital for treatment.
Fainting attacks, even if it occurs only once, are serious matter. Patients must be brought to the hospital immediately for two reasons. Firstly, they may indicate the presence of serious medical problems such as heart disease. Secondly, during the falls, some patients may be unlucky enough to develop internal injury. The most serious and potentially life-threatening is head injury with bleeding in the brain.
Fainting attacks do not just affect patients with Parkinson’s Disease (PD). It can happen in any patient, sometimes healthy people. Despite this, particular attention should be paid to PD patients because they have a higher risk of developing fainting attacks than anyone else. This is because most PD patients are elderly people who commonly have heart or brain diseases that can cause fainting attacks. In this article, I will discuss the various causes of fainting attacks among patients with such as follows;
a) Heart diseases
This is the most serious disease because heart problems can lead to immediate death. The usual heart problem that can cause fainting attacks is cardiac arrhythmia, which is a disorder of heart rhythm. Patients with cardiac arrhythmia get fainting attacks because the abnormal heart rhythm affects the normal heart function. This leads to reduced amount of blood and oxygen that go to the brain. As a result, the brain activity is disturbed and patients lose consciousness. Following the fall, patients regain consciousness within less than a minute.
Cardiac arrhythmia is a manifestation of several types of heart diseases. This could be a disorder that is called “sick sinus syndrome” that usually occurs in elderly people. In this disorder there is disruption of the electrical circuit in the heart due to ageing process. As a result, the heart rhythm is chaotic. The proper treatment for this problem is a heart pacemaker, whereby a battery sends electric signals to the heart in order to regulate the heart rhythm. Another type of heart disease is a heart attack that is caused by blockage of the blood vessels in the heart. Heart attack is also more common in the elderly people. In view of the strong tendency of elderly people to get heart diseases, anyone who has have a fainting attack must seek specialist treatment without delay.
b) Brain diseases
The most common brain disease that can cause fainting attacks is seizure or fit. This disorder is characterized by uncontrollable jerking of the limbs with loss of consciousness. The attack starts suddenly. Sometimes there are also dribbling of saliva, urine incontinence (passing urine without being able to control it) and bluish discolouration of the lips. Each attack usually lasts several minutes. Following the attack, the patient complains of headache and sleepiness. Sometimes, the patient becomes confused for up to one hour.
Seizure / fit can be either a disease on its own (epilepsy) or due to various other diseases such as stroke, brain tumour, brain infection, etc. The patient should be investigated immediately at the hospital and treated with drugs to prevent seizure from happening again.
c) Low blood pressure (postural hypotension)
This is condition which results in reduced amount of blood / oxygen going to the brain. Consequently, the patient loses consciousness. The fainting attacks typically occur when the patient is standing up from a sitting position or walking. The patient usually regains consciousness immediately following the attack (within less than one minute).
There are many reasons why a patient can develop postural hypotension. The most common cause in a PD patient is the medication itself (Madopar, Sinemet, Jumex, bromocriptine, Trivastal, etc). Occasionally, it is due to the PD itself. Other less common causes are dehydration (due to severe vomiting, diarhoea, bleeding in the stomach) and heart failure.
The treatment of postural hypotension depends on the cause. If it is due to Parkinson’s drugs, the dose of the drugs should be reduced. Usually, the dose of all other drugs is reduced before Madopar / Sinemet, because these two drugs are the most efficacious drugs in PD. At the same time, the patient is advised to sit on the bed or chair for about several minutes before standing up.
If these measures fail (and investigations have determined that there is no other causes such as heart failure), fludrocortisone can be used. This drug helps by elevating the blood pressure.
d) Low blood sugar (hypoglycemia)
In this condition, the blood sugar level is lower than normal (less than 2.5 mmol / l). As a result, patients lose consciousness. Hypoglycemia usually occurs in diabetic patients, either due to overdose of diabetic pills or missing the meal. In less severe cases, patients do not faint but develop symptoms such as dizziness, hunger, cold sweat and weakness of body.
Hypoglycemia is dangerous because it can kill a patient in a very short time. It is important to get a blood sugar level immediately to detect this condition. The immediate treatment of hypoglycemia is administration of sugar by giving sweet drinks (three to four teaspoons of sugar in a cup of water, Coca Cola, Pepsi, etc). If there is immediate access to hospital, the doctor can set up a drip to give sugar solution.
e) Sleep attacks
This is actually a very rare condition. During the attacks, patients just dose off without any warning. It happens at certain situation when people usually do not sleep, such as driving, doing computer work, having meals, etc. Sleep attacks are one of the very rare side effects of PD drugs.
f) Emotional problems
Occasionally, patients who have emotional problems may develop fainting attacks. It can be caused by extreme anger / sadness, e.g. hearing a very bad news. It should be emphasized that all other causes of fainting attacks must be excluded before the fainting attacks are attributed to emotional problem.
In conclusion, fainting attacks are serious disorder that are caused by various other potentially life threatening diseases. Patients should be immediately brought to the hospital for extensive investigations and treatment.
Posted by teo at 2:37 PM 2 comments:
James said...
The consequences that cause the disease can lead to death, and so this disease is painful and people suffering from it suffers greatly by the constant pain caused by taking medications that are opioid narcotics such as Lortab , Vicodin, hydrocodone , which are very effective in suppressing the pain that causes the disease, we hope that people care and know findrxonline adequately informed as well as notes on your site.
January 19, 2010 2:10 AM
Negocio Rentable said...
I really like this blog, you are very good making them. I say that the issue discussed in this blog is quite interesting and of high quality
facial mask,tighten chin and forehead muscle tighten
People with Parkinson's have facial masked without smile.
The facial masked makes the chin tighten and have tighten forehead
They sleep with facial masked therefore the chin tighten and forhead tighten too,
Are they the symptoms of Parkinson's disease?
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
513 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Yesterday, 05:15 PM
That's a good question. Facial masking is very common among people with PD, especially as PD progresses. It is not, to my knowledge, a diagnostic factor, as it does not necessarily present in the early stages. But if masking, along with other factors such as balance and tremor are present, it might be considered in diagnosis of PD.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
The facial masked makes the chin tighten and have tighten forehead
They sleep with facial masked therefore the chin tighten and forhead tighten too,
Are they the symptoms of Parkinson's disease?
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
513 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Yesterday, 05:15 PM
That's a good question. Facial masking is very common among people with PD, especially as PD progresses. It is not, to my knowledge, a diagnostic factor, as it does not necessarily present in the early stages. But if masking, along with other factors such as balance and tremor are present, it might be considered in diagnosis of PD.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
dehydration,altitudes, and medication
Dear Mr. Teo,
It sounds like you got dizzy suddenly, and certainly dehydration could be a possibility. Dehydration is not uncommon when traveling, as it is often harder to remember to drink enough fluids.
If you were at an altitude higher than at home, this could also cause such dizziness. Higher altitudes mean there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Medications for PD can also cause dizziness, and possibly being in a new climate, combined with the medications, caused your sudden weakness. If the new climate was warmer, or colder, than you are used to, that could make a difference.
I would discuss this with your doctor, who is in a much better position to give you the personal direction you require.
,
Dear Dr. Kathrynne,
Thank you for your advise.
In fact dehydration is prevented if I have to rest at home a few days instead I go outdoor in the heated weather in order to adapt the changes of the climate from Cold to HOT.
As I was outdoor shopping in the winter I did not feel thirsty and less drinking for the past of three weeks from London,Paris,Rome and Spain.
Besides there were at different altitude when I flying back. I was from Higher altitudes to low and there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Regards
TEOKIMHOE Comments
Characters remaining: 400
Page 1 of 1
teokimhoe
12 Jun 2010 - 08:58
hello
Delete .Page 1 of 1 .
It sounds like you got dizzy suddenly, and certainly dehydration could be a possibility. Dehydration is not uncommon when traveling, as it is often harder to remember to drink enough fluids.
If you were at an altitude higher than at home, this could also cause such dizziness. Higher altitudes mean there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Medications for PD can also cause dizziness, and possibly being in a new climate, combined with the medications, caused your sudden weakness. If the new climate was warmer, or colder, than you are used to, that could make a difference.
I would discuss this with your doctor, who is in a much better position to give you the personal direction you require.
,
Dear Dr. Kathrynne,
Thank you for your advise.
In fact dehydration is prevented if I have to rest at home a few days instead I go outdoor in the heated weather in order to adapt the changes of the climate from Cold to HOT.
As I was outdoor shopping in the winter I did not feel thirsty and less drinking for the past of three weeks from London,Paris,Rome and Spain.
Besides there were at different altitude when I flying back. I was from Higher altitudes to low and there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Regards
TEOKIMHOE Comments
Characters remaining: 400
Page 1 of 1
teokimhoe
12 Jun 2010 - 08:58
hello
Delete .Page 1 of 1 .
Friday, August 27, 2010
Early onset -slower progression
It is difficulty to interpret what and how the symptoms of early onset-slower progression?
As PD is a bouquet disease and is individual that have motor and non motor symptoms.
They do not come at the same time or together it is individual and the timing is different too.
As for me my PD is genetic/inherited as I have two brothers are PD. They are at the rate of three and four of PD and are at fast progression. They are at the age of 56 and 76 years old.
I have the symptoms of PD when I was at younger age.
I was diagnosed at the age of 65 years old as PD
Due to my determination and perservation and knowledge of the disease and medication I learn to fight the disease to slowdown from its progression. I am lucky by Lord grace I manage to slowdown my motor symptoms by strenous exercises however I still have non motor symptoms I pray the Lord for wisdom to be able to overcome early. Kindly visit website (Heroteo- the chronicles of a parkinson's fighter ) .
5 people marked this post as helpful.
As PD is a bouquet disease and is individual that have motor and non motor symptoms.
They do not come at the same time or together it is individual and the timing is different too.
As for me my PD is genetic/inherited as I have two brothers are PD. They are at the rate of three and four of PD and are at fast progression. They are at the age of 56 and 76 years old.
I have the symptoms of PD when I was at younger age.
I was diagnosed at the age of 65 years old as PD
Due to my determination and perservation and knowledge of the disease and medication I learn to fight the disease to slowdown from its progression. I am lucky by Lord grace I manage to slowdown my motor symptoms by strenous exercises however I still have non motor symptoms I pray the Lord for wisdom to be able to overcome early. Kindly visit website (Heroteo- the chronicles of a parkinson's fighter ) .
5 people marked this post as helpful.
muscle tighten
Advanced Member
Group:
Members Posts:
248 Joined:
03-March 07 LocationMalaysia Posted Yesterday, 07:23 AM
People with Parkinson's have facial masked without smile.
The facial masked makes the chin tighten and have tighten forehead
They sleep with facial masked therefore the chin tighten and forhead tighten too,
Are they the symptoms of Parkinson's disease?
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
513 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 05:15 PM
That's a good question. Facial masking is very common among people with PD, especially as PD progresses. It is not, to my knowledge, a diagnostic factor, as it does not necessarily present in the early stages. But if masking, along with other factors such as balance and tremor are present, it might be considered in diagnosis of PD.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/http://www.nutritionucanlivewith.com/
0 Report
Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
#6 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
508 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 09:52 AM
Dear Mr. Teo,
If you are doing this under your doctor’s supervision, then certainly continue. Ordinarily, I would not expect gargling salt water to affect blood pressure, but each person may respond differently.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
Group:
Members Posts:
248 Joined:
03-March 07 LocationMalaysia Posted Yesterday, 07:23 AM
People with Parkinson's have facial masked without smile.
The facial masked makes the chin tighten and have tighten forehead
They sleep with facial masked therefore the chin tighten and forhead tighten too,
Are they the symptoms of Parkinson's disease?
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
513 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 05:15 PM
That's a good question. Facial masking is very common among people with PD, especially as PD progresses. It is not, to my knowledge, a diagnostic factor, as it does not necessarily present in the early stages. But if masking, along with other factors such as balance and tremor are present, it might be considered in diagnosis of PD.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/http://www.nutritionucanlivewith.com/
0 Report
Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
#6 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
508 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 09:52 AM
Dear Mr. Teo,
If you are doing this under your doctor’s supervision, then certainly continue. Ordinarily, I would not expect gargling salt water to affect blood pressure, but each person may respond differently.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
Dry eye and facial masked
Dry eye and facial masked
I use to have dry eyes and facial masked. I look tired and my eyes are dry.
I have tried eye drops but it is still dry and look tired.
Recently my eyes specialist inserted eye plug into my both eye and treated my problem.
I started smile and look energetic at all time.
Temporary or permanent silicone plugs can be inserted in the lacrimal (tear) drainage ducts in your eyelids to keep tears on your eye from draining away as quickly. Called lacrimal plugs or punctal plugs, they can be inserted painlessly while you're in the eye doctor's office and normally are not felt once inserted
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
508 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 10:01 AM
Dear Mr. Teo,
Thank you for this interesting observation. Dry eyes are not uncommon, particularly as we age; and also among those with PD. This is something that people may want to discuss with their doctors.
Best regards,
Kathrynne Holden, MS
I use to have dry eyes and facial masked. I look tired and my eyes are dry.
I have tried eye drops but it is still dry and look tired.
Recently my eyes specialist inserted eye plug into my both eye and treated my problem.
I started smile and look energetic at all time.
Temporary or permanent silicone plugs can be inserted in the lacrimal (tear) drainage ducts in your eyelids to keep tears on your eye from draining away as quickly. Called lacrimal plugs or punctal plugs, they can be inserted painlessly while you're in the eye doctor's office and normally are not felt once inserted
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
508 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 10:01 AM
Dear Mr. Teo,
Thank you for this interesting observation. Dry eyes are not uncommon, particularly as we age; and also among those with PD. This is something that people may want to discuss with their doctors.
Best regards,
Kathrynne Holden, MS
Dry eye and facial masked
I use to have dry eyes and facial masked. I look tired and my eyes are dry.
I have tried eye drops but it is still dry and look tired.
Recently my eyes specialist inserted eye plug into my both eye and treated my problem.
I started smile and look energetic at all time.
Temporary or permanent silicone plugs can be inserted in the lacrimal (tear) drainage ducts in your eyelids to keep tears on your eye from draining away as quickly. Called lacrimal plugs or punctal plugs, they can be inserted painlessly while you're in the eye doctor's office and normally are not felt once inserted
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
508 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 10:01 AM
Dear Mr. Teo,
Thank you for this interesting observation. Dry eyes are not uncommon, particularly as we age; and also among those with PD. This is something that people may want to discuss with their doctors.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
I have tried eye drops but it is still dry and look tired.
Recently my eyes specialist inserted eye plug into my both eye and treated my problem.
I started smile and look energetic at all time.
Temporary or permanent silicone plugs can be inserted in the lacrimal (tear) drainage ducts in your eyelids to keep tears on your eye from draining away as quickly. Called lacrimal plugs or punctal plugs, they can be inserted painlessly while you're in the eye doctor's office and normally are not felt once inserted
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
508 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 10:01 AM
Dear Mr. Teo,
Thank you for this interesting observation. Dry eyes are not uncommon, particularly as we age; and also among those with PD. This is something that people may want to discuss with their doctors.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
crashes or down episodes
Some doctors have a reasons not to prescribe PD medication to early on set young patients as they lose their effectiveness over time. The medication only treat the symptoms.
I have experienced on and off medications.
I started with small amount and started wearing off for effectiveness in few months as it treat the symptoms not the disease.
I learn to accept live with fear of the crashes or down episodes and pray a cure for the disease soon
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
508 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 10:03 AM
I, too, pray for a cure for PD. You have a very positive attitude, and that is a great asset when managing PD symptoms.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith
I have experienced on and off medications.
I started with small amount and started wearing off for effectiveness in few months as it treat the symptoms not the disease.
I learn to accept live with fear of the crashes or down episodes and pray a cure for the disease soon
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
508 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 10:03 AM
I, too, pray for a cure for PD. You have a very positive attitude, and that is a great asset when managing PD symptoms.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith
Saturday, August 21, 2010
Is drinking sea salt benefits you
I have experienced T.I.A and dizziness caused by Parkinson's medication as well as dehydratin due to changes of weather from cold and heated climate as well as sideffect on parkinson's medication.
Is drinking sea salt helpful for your low blood pressure?
Regards
TeoKimHoe
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
496 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 04:36 PM
Dear Mr. Teo,
Salt, even sea salt, can be a concern. It depends on your overall medical history. As you have had a transient ischemic attack, along with dizziness and PD, I would not be willing to advise you one way or the other. Only your personal physician is in a position to determine whether added sodium is likely to be beneficial.
For dizziness caused by hypotension (a sudden drop in blood pressure), it is often recommended to drink plenty of water. This increases the blood volume and may help to maintain a more even blood pressure. I would ask your doctor if increased use of fluids might be beneficial for you.
Best regards,
Kathrynne Holden, MS
--
Is drinking sea salt helpful for your low blood pressure?
Regards
TeoKimHoe
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
496 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 04:36 PM
Dear Mr. Teo,
Salt, even sea salt, can be a concern. It depends on your overall medical history. As you have had a transient ischemic attack, along with dizziness and PD, I would not be willing to advise you one way or the other. Only your personal physician is in a position to determine whether added sodium is likely to be beneficial.
For dizziness caused by hypotension (a sudden drop in blood pressure), it is often recommended to drink plenty of water. This increases the blood volume and may help to maintain a more even blood pressure. I would ask your doctor if increased use of fluids might be beneficial for you.
Best regards,
Kathrynne Holden, MS
--
Tuesday, August 17, 2010
Is it dehydration or others? (3)
Dear Dr. Kathrynne,
Thank you for your advise.
In fact dehydration is prevented if I have to rest at home a few days instead I go outdoor in the heated weather in order to adapt the changes of the climate from Cold to HOT.
As I was outdoor shopping in the winter I did not feel thirsty and less drinking for the past of three weeks from London,Paris,Rome and Spain.
Besides there were at different altitude when I flying back. I was from Higher altitudes to low and there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Regards
TEOKIMHOE
It sounds as though you have found your own answer, congratulations.
Best regards,
Kathrynne Holden, MS
Thank you for your advise.
In fact dehydration is prevented if I have to rest at home a few days instead I go outdoor in the heated weather in order to adapt the changes of the climate from Cold to HOT.
As I was outdoor shopping in the winter I did not feel thirsty and less drinking for the past of three weeks from London,Paris,Rome and Spain.
Besides there were at different altitude when I flying back. I was from Higher altitudes to low and there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Regards
TEOKIMHOE
It sounds as though you have found your own answer, congratulations.
Best regards,
Kathrynne Holden, MS
Monday, August 16, 2010
sleep disorder by Dr.Mark R.Conmes R.PH
I have sleep disorder for the past of five years after taking the Parkinson's medication.
My doctor prescribed me Seroquel 12.5 mg, Lexapro 5mg and Besquil 0.5 mg taken before bedtime.
Besides I take another one Besquil 0.5 mg in the afternoon daily.
I am so far not trouble with sleep.
Would I addicted with the medication?
Any alternative medications are safer?
Kindly advise
TeoKimHoe
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 MComes RPH
Advanced Member
Group:
Ask the Pharmacist Moderators Posts:
66 Joined:
22-February 10 Posted Today, 02:49 PM
The addiction potential of theses Meds is very low. I really don't see a problem with that. As far as any other possible Meds, I say, " if it works, why change."
This obviously an issue you have been dealing with for some time now and is you finally have a good combo of Meds that work, I would stick with it.
I will let you know, for best results, take these medications about the same time every day. This way you maintain a
constant level in your system that will give you the greatest benefit.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org
My doctor prescribed me Seroquel 12.5 mg, Lexapro 5mg and Besquil 0.5 mg taken before bedtime.
Besides I take another one Besquil 0.5 mg in the afternoon daily.
I am so far not trouble with sleep.
Would I addicted with the medication?
Any alternative medications are safer?
Kindly advise
TeoKimHoe
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 MComes RPH
Advanced Member
Group:
Ask the Pharmacist Moderators Posts:
66 Joined:
22-February 10 Posted Today, 02:49 PM
The addiction potential of theses Meds is very low. I really don't see a problem with that. As far as any other possible Meds, I say, " if it works, why change."
This obviously an issue you have been dealing with for some time now and is you finally have a good combo of Meds that work, I would stick with it.
I will let you know, for best results, take these medications about the same time every day. This way you maintain a
constant level in your system that will give you the greatest benefit.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org
Sunday, August 15, 2010
Words by Dr.Kathrynne
Kathrynne Holden, MS, on 04 August 2010 - 11:32 AM, said:
Dear Mr. Teo,
Thank you for sharing your experiences and your lifestyle with us. Your exercise regime is most inspiring, and an example for us all. I completely agree that exercise is as important as medications in helping to manage PD, and in your case, exercise has even helped you to reduce the amount of medications needed. Congratulations on your successful efforts to combat PD!
Dear Mr. Teo,
Thank you for sharing your experiences and your lifestyle with us. Your exercise regime is most inspiring, and an example for us all. I completely agree that exercise is as important as medications in helping to manage PD, and in your case, exercise has even helped you to reduce the amount of medications needed. Congratulations on your successful efforts to combat PD!
user of alprazplam by Dr.Okum
Dear Okun,
Is there any likelihood that a person's long term use of alprazolam (Xanax,seroquel,lexapro,besquil, silinox)
might cause tremors,Essential tremor, Familial tremor, Hand tremor?
Is it leading to a possible diagnosis of parkinson's disease?
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Dr. Okun
Advanced Member
Group:
Ask the Doctor Moderators Posts:
581 Joined:
19-January 07 LocationUniversity of Florida Posted Today, 04:11 PM
We do not believe it leads to PD.
It may however enhance an already present tremor like essential tremor or physiological tremor.
Michael S. Okun, M.D.
Is there any likelihood that a person's long term use of alprazolam (Xanax,seroquel,lexapro,besquil, silinox)
might cause tremors,Essential tremor, Familial tremor, Hand tremor?
Is it leading to a possible diagnosis of parkinson's disease?
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Dr. Okun
Advanced Member
Group:
Ask the Doctor Moderators Posts:
581 Joined:
19-January 07 LocationUniversity of Florida Posted Today, 04:11 PM
We do not believe it leads to PD.
It may however enhance an already present tremor like essential tremor or physiological tremor.
Michael S. Okun, M.D.
Saturday, August 14, 2010
What are differences?
Unlike with Alzheimer's patients and other dementias, patients with parkinson's don't lose their memory.
Unlike with stroke patients with parkinson's don't lose their physcial strength but lose body flexibility and coordination.
Unlike with stroke patients with parkinson's develop trouble with planning, making decisions and controlling their emotions, and often exhibit changes in personality.
They are members of motors and non motors symptoms.
Why they are differences?
Kindly elaborate
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
469 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 06:38 PM
Dear Mr. Teo,
Although Alzheimer's disease, stroke, and Parkinson's disease are all neurological disorders, they are all quite different diseases. Because they have different causes, they thus have differing effects.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
0
Unlike with stroke patients with parkinson's don't lose their physcial strength but lose body flexibility and coordination.
Unlike with stroke patients with parkinson's develop trouble with planning, making decisions and controlling their emotions, and often exhibit changes in personality.
They are members of motors and non motors symptoms.
Why they are differences?
Kindly elaborate
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
469 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 06:38 PM
Dear Mr. Teo,
Although Alzheimer's disease, stroke, and Parkinson's disease are all neurological disorders, they are all quite different diseases. Because they have different causes, they thus have differing effects.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
0
Friday, August 13, 2010
Is it dehydration or others?
It was happening on my third days after my europe winter (December) tours. I was without rest as I was busy with my health checkup in the hospital from one place to another.
I came down from the tsxi I was dizziness and luckly my wife was behind she supported me when I
was suddenly weak and my both legs could not support.
The nexy day evening it happened again during my dizziness in my room even my both hand hold firmly at the edge of the desk I sat down with my buttock on the floor. I was awake and stand up after the sat down. I had sweat heavly.
I was checked in the hospital for checkup; My blood pressure is normal. No explanation given for the sat down. I checked out the next day.
Question:
Is it dehydration?
Is it the climate interaction with my PD medications resulted the side effects of the sat down.
I stay in tropical country and was away for three weeks on Europe tour. Is it latitude distance difference north and south?
Kindly elaborate
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
#2 Dr. Okun
Advanced Member
Group:
Ask the Doctor Moderators Posts:
572 Joined:
19-January 07 LocationUniversity of Florida Posted 10 August 2010 - 02:07 PM
Dizziness and neurological symptoms in PD can result from a variety of causes and combinations (dehydration, autonomic issues, stress, altitude, change of environment). It is safest to be examined and have a doc look at you. In many cases a tilt table will be used to look for autonomic problems. If it only occurred on that trip your doctor may elect after diagnosis to just watch you conservatively.
Michael S. Okun, M.D.
I came down from the tsxi I was dizziness and luckly my wife was behind she supported me when I
was suddenly weak and my both legs could not support.
The nexy day evening it happened again during my dizziness in my room even my both hand hold firmly at the edge of the desk I sat down with my buttock on the floor. I was awake and stand up after the sat down. I had sweat heavly.
I was checked in the hospital for checkup; My blood pressure is normal. No explanation given for the sat down. I checked out the next day.
Question:
Is it dehydration?
Is it the climate interaction with my PD medications resulted the side effects of the sat down.
I stay in tropical country and was away for three weeks on Europe tour. Is it latitude distance difference north and south?
Kindly elaborate
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
#2 Dr. Okun
Advanced Member
Group:
Ask the Doctor Moderators Posts:
572 Joined:
19-January 07 LocationUniversity of Florida Posted 10 August 2010 - 02:07 PM
Dizziness and neurological symptoms in PD can result from a variety of causes and combinations (dehydration, autonomic issues, stress, altitude, change of environment). It is safest to be examined and have a doc look at you. In many cases a tilt table will be used to look for autonomic problems. If it only occurred on that trip your doctor may elect after diagnosis to just watch you conservatively.
Michael S. Okun, M.D.
Thursday, August 12, 2010
letter from Dr. Kathrynne Holden
Dear Dr Kathrynne
Thanks a lot for your comments. I am clear about the trace elements now.
I'd like you to know that I appreciate your kind efforts in providing the information to Mr Teo and all other Parkinson's patents. I know Mr Teo and his wife very well. All of us notice that you answer patients' questions in a caring and humble manner - which I believe reflects your personality.
Dr Chew
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
0 Report
Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
#6 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
463 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Yesterday, 04:14 PM
Dear Dr. Chew,
It is a privilege to do what I can to assist those with PD and it is a pleasure to read about and learn from people like Mr. Teo, who set an example for us all.
Best regards,
Kathrynne Holden, MS
--
Thanks a lot for your comments. I am clear about the trace elements now.
I'd like you to know that I appreciate your kind efforts in providing the information to Mr Teo and all other Parkinson's patents. I know Mr Teo and his wife very well. All of us notice that you answer patients' questions in a caring and humble manner - which I believe reflects your personality.
Dr Chew
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
0 Report
Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
#6 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
463 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Yesterday, 04:14 PM
Dear Dr. Chew,
It is a privilege to do what I can to assist those with PD and it is a pleasure to read about and learn from people like Mr. Teo, who set an example for us all.
Best regards,
Kathrynne Holden, MS
--
Is it dehydration or others? by Dr, Kathrynne Holden
It was happening on my third days after my europe winter tours.
I was suddenly weak and my both legs could not support me even my both hand hold firmly at the edge of desk I sat down with my buttock on the floor. I was awake and climb up after the sat down.
I was checked in the hospital for checkup; My blood pressure is normal. No explanation given for the sat down. I checked out the next day.
Question:
Is it dehydration?
Is it the climate interaction with my PD medications resulted the side effects of the sat down.
I stay in tropical country and was away for three weeks on Europe tour. Is it latitude distance north and south?
Kindly elaborate
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
463 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Yesterday, 05:20 PM
Dear Mr. Teo,
It sounds like you got dizzy suddenly, and certainly dehydration could be a possibility. Dehydration is not uncommon when traveling, as it is often harder to remember to drink enough fluids.
If you were at an altitude higher than at home, this could also cause such dizziness. Higher altitudes mean there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Medications for PD can also cause dizziness, and possibly being in a new climate, combined with the medications, caused your sudden weakness. If the new climate was warmer, or colder, than you are used to, that could make a difference.
I would discuss this with your doctor, who is in a much better position to give you the personal direction you require.
Best regards,
Kathrynne Holden, MS
I was suddenly weak and my both legs could not support me even my both hand hold firmly at the edge of desk I sat down with my buttock on the floor. I was awake and climb up after the sat down.
I was checked in the hospital for checkup; My blood pressure is normal. No explanation given for the sat down. I checked out the next day.
Question:
Is it dehydration?
Is it the climate interaction with my PD medications resulted the side effects of the sat down.
I stay in tropical country and was away for three weeks on Europe tour. Is it latitude distance north and south?
Kindly elaborate
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
463 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Yesterday, 05:20 PM
Dear Mr. Teo,
It sounds like you got dizzy suddenly, and certainly dehydration could be a possibility. Dehydration is not uncommon when traveling, as it is often harder to remember to drink enough fluids.
If you were at an altitude higher than at home, this could also cause such dizziness. Higher altitudes mean there is less oxygen available, and until your body adapts, it can result in weakness, shortness of breath, or dizziness.
Medications for PD can also cause dizziness, and possibly being in a new climate, combined with the medications, caused your sudden weakness. If the new climate was warmer, or colder, than you are used to, that could make a difference.
I would discuss this with your doctor, who is in a much better position to give you the personal direction you require.
Best regards,
Kathrynne Holden, MS
doing therapy makes smile by Dr.Kathrynne Holden
Is it doing facial therapy help you to lossen your facial muscles and relief from stiffness?
Is it helpful for your slurred speech and face with smile?
Kindly clarify
Regards'
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
463 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 05:42 PM
Dear Mr. Teo,
This is not my area of study; however, the NPF forum “Talk To A Speech Clinician” is available. The speech clinicians study voice, throat and facial exercises, and may be able to provide the answers you seek. Go to:
http://forum.parkins...ndex.php?/index
Is it helpful for your slurred speech and face with smile?
Kindly clarify
Regards'
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
463 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 05:42 PM
Dear Mr. Teo,
This is not my area of study; however, the NPF forum “Talk To A Speech Clinician” is available. The speech clinicians study voice, throat and facial exercises, and may be able to provide the answers you seek. Go to:
http://forum.parkins...ndex.php?/index
sex and T.I..A by Dr,Okun
Dear Dr.Okun,
I have motor and non motion changes after I had T.I.A.
Erectile dysfunction inability to achieve an erection suitable for sexual intercourse.
Hormone thereapy could not help.
Bad vison prevented me driving at night and sunlight slow down my driving
Question
Is there sny chance for second T.I.A?
Why there are changes in motor and non motor symptom of PD after the minor stroke?
Late wake up in the morning and tired on morning walk but gym exercises are at usual
Any alternative?
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Dr. Okun
Advanced Member
Group:
Ask the Doctor Moderators Posts:
571 Joined:
19-January 07 LocationUniversity of Florida Posted Today, 01:17 PM
You have written before on this topic. Unfortunately without an in person examination TIA or stroke like issues and PD issues are complex.....I would not do it justice to try to answer on this board. I am sorry.
Michael S. Okun, M.D.
I have motor and non motion changes after I had T.I.A.
Erectile dysfunction inability to achieve an erection suitable for sexual intercourse.
Hormone thereapy could not help.
Bad vison prevented me driving at night and sunlight slow down my driving
Question
Is there sny chance for second T.I.A?
Why there are changes in motor and non motor symptom of PD after the minor stroke?
Late wake up in the morning and tired on morning walk but gym exercises are at usual
Any alternative?
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Dr. Okun
Advanced Member
Group:
Ask the Doctor Moderators Posts:
571 Joined:
19-January 07 LocationUniversity of Florida Posted Today, 01:17 PM
You have written before on this topic. Unfortunately without an in person examination TIA or stroke like issues and PD issues are complex.....I would not do it justice to try to answer on this board. I am sorry.
Michael S. Okun, M.D.
Wednesday, August 11, 2010
Is it dehydration or others? by Dr,Okun
It was happening on my third days after my europe winter (December) tours. I was without rest as I was busy with my health checkup in the hospital from one place to another.
I came down from the tsxi I was dizziness and luckly my wife was behind she supported me when I
was suddenly weak and my both legs could not support.
The nexy day evening it happened again during my dizziness in my room even my both hand hold firmly at the edge of the desk I sat down with my buttock on the floor. I was awake and stand up after the sat down. I had sweat heavly.
I was checked in the hospital for checkup; My blood pressure is normal. No explanation given for the sat down. I checked out the next day.
Question:
Is it dehydration?
Is it the climate interaction with my PD medications resulted the side effects of the sat down.
I stay in tropical country and was away for three weeks on Europe tour. Is it latitude distance difference north and south?
Kindly elaborate
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Dr. Okun
Advanced Member
Group:
Ask the Doctor Moderators Posts:
564 Joined:
19-January 07 LocationUniversity of Florida Posted Today, 02:07 PM
Dizziness and neurological symptoms in PD can result from a variety of causes and combinations (dehydration, autonomic issues, stress, altitude, change of environment). It is safest to be examined and have a doc look at you. In many cases a tilt table will be used to look for autonomic problems. If it only occurred on that trip your doctor may elect after diagnosis to just watch you conservatively.
Michael S. Okun, M.D.
I came down from the tsxi I was dizziness and luckly my wife was behind she supported me when I
was suddenly weak and my both legs could not support.
The nexy day evening it happened again during my dizziness in my room even my both hand hold firmly at the edge of the desk I sat down with my buttock on the floor. I was awake and stand up after the sat down. I had sweat heavly.
I was checked in the hospital for checkup; My blood pressure is normal. No explanation given for the sat down. I checked out the next day.
Question:
Is it dehydration?
Is it the climate interaction with my PD medications resulted the side effects of the sat down.
I stay in tropical country and was away for three weeks on Europe tour. Is it latitude distance difference north and south?
Kindly elaborate
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit
--------------------------------------------------------------------------------
#2 Dr. Okun
Advanced Member
Group:
Ask the Doctor Moderators Posts:
564 Joined:
19-January 07 LocationUniversity of Florida Posted Today, 02:07 PM
Dizziness and neurological symptoms in PD can result from a variety of causes and combinations (dehydration, autonomic issues, stress, altitude, change of environment). It is safest to be examined and have a doc look at you. In many cases a tilt table will be used to look for autonomic problems. If it only occurred on that trip your doctor may elect after diagnosis to just watch you conservatively.
Michael S. Okun, M.D.
Monday, August 9, 2010
selenium, manganese and copper with PD
Dear Kathrynne
Sorry, I am not that clear about your opinion on the trace elements (selenium, manganese, copper). Are these trace elements recommended for PD patients? If so, what is the rationale for this?
Thanks for your advice.
Dr Chew Nee Kong.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
0 Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
#3 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
450 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 11:35 AM
Dear Dr. Chew,
You may have missed my reply from yesterday. Here it is once more:
Please see my response to Mr. Teo regarding trace elements. It is not a question of whether these trace elements are recommended for patients with PD. They are considered to be among the “vital nutrients” – those which are required to support and maintain human life. Thus, a certain minimal amount is needed by all humans; so far as I am aware, this is regardless whether they have PD or not.
In rare cases, an individual may be born with a disease such as hemochromatosis or Wilson’s disease, in which he/she is genetically unable to metabolize a nutrient normally. In such cases, the supervising physician must diagnose the disease and provide the proper treatment. I am not aware that PD or medications used to treat PD are affected by these trace elements when ingested in normal amounts from a balanced diet or high-quality supplements providing the recommended daily amount. However, if you have information to the contrary, I hope you will share it with this forum, as it will be important for the health of many people with PD.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
0 Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
Sorry, I am not that clear about your opinion on the trace elements (selenium, manganese, copper). Are these trace elements recommended for PD patients? If so, what is the rationale for this?
Thanks for your advice.
Dr Chew Nee Kong.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
0 Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
#3 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
450 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Today, 11:35 AM
Dear Dr. Chew,
You may have missed my reply from yesterday. Here it is once more:
Please see my response to Mr. Teo regarding trace elements. It is not a question of whether these trace elements are recommended for patients with PD. They are considered to be among the “vital nutrients” – those which are required to support and maintain human life. Thus, a certain minimal amount is needed by all humans; so far as I am aware, this is regardless whether they have PD or not.
In rare cases, an individual may be born with a disease such as hemochromatosis or Wilson’s disease, in which he/she is genetically unable to metabolize a nutrient normally. In such cases, the supervising physician must diagnose the disease and provide the proper treatment. I am not aware that PD or medications used to treat PD are affected by these trace elements when ingested in normal amounts from a balanced diet or high-quality supplements providing the recommended daily amount. However, if you have information to the contrary, I hope you will share it with this forum, as it will be important for the health of many people with PD.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
0 Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
Sunday, August 8, 2010
Parkinson's, B6, B12, and Folate - What's the Connection?
Kathrynne Holden, MS, RD
Copyright 2000
Ms. Holden is a registered dietitian specializing in Parkinson's
disease. She has published research, books, articles, and manuals on
nutrition and PD, including "Eat well, stay well with Parkinson's
disease." She moderates the NPF forum Ask the Parkinson Dietitian at:
www.parkinson.org
In the past decade, there has been increasing interest among
researchers about the effects of three B vitamins - B6, B12, and folate.
We now know that deficiencies occur with greater frequency than ever
suspected previously, particularly in older adults. We also now know
that deficiencies, if not corrected, can result in irreversible damage
in some people. Some health professionals are beginning to suspect that
these three vitamins may be significant factors in Parkinson's disease.
What are B6, B12, and folate, and what do they do?
These are essential nutrients, meaning that they are vital to life.
These three vitamins work both independently and together in many of the body's systems.
Vitamin B6 assists in making hormones, new proteins, and
neurotransmitters ("messengers" between nerve cells) for the body's use.
It also helps release stored sugar when we need it for fuel. It works
together with B12 and folate to remove homocysteine from the blood.
Homocysteine is a substance increasingly associated with a number of
diseases; more about this later.
Vitamin B12 plays a role in the synthesis of DNA, needed for formation
of new red blood cells. It takes part in the manufacture of the myelin
sheath - the protective coating that surrounds nerve cells. With B6 and
folate it removes homocysteine from the blood.
Folate, also called folacin or folic acid, is a partner with B12 in DNA
synthesis and in removal of homocysteine, and is required in many other
vital processes. Without folate, B12 would be unable to complete many of
its functions, and vice versa. Folate is the form found in foods, folic
acid is the form in dietary supplements.
How much do we need of these vitamins?
Nutrient needs are broken down by gender, age group, pregnancy, and
lactation. New guidelines have also established a Tolerable Upper Intake
Level. So, for example, while the RDA for vitamin B6 for males and
females age 19-30 years is 1.3 mg/day, the Tolerable Upper Intake Level
for both is 100 mg/day, making it easier to provide recommended amounts.
RDA* Tolerable Upper Intake Level ** +
Vitamin B6***+ 1.7 mg/day 100 mg/day (age 19 and older)
Vitamin B12+ 2.4 mcg/day Not Determined
Folate + 400 mcg/day 1000 mcg/day
Recommended Dietary Allowance
** The Tolerable Upper Intake Level is the maximum level of daily
nutrient intake that is likely to pose no risk of adverse effects, and
represents the total intake from food, water, and supplements.
*** Adults age 51 and older
+ not applicable if pregnant or lactating
Why do deficiencies occur, and what are signs of deficiencies?
Vitamin B6. Mild deficiencies of B6 are fairly common in the U.S.,
mostly because of dietary deficiencies, but sometimes due to use of
certain medications which interfere with B6, including hydralazine,
isoniazid, MAO inhibitors, penicillamine, and theophylline. (Conversely,
large amounts of B6 can interfere with the absorption of levodopa, an
important medication for Parkinson's disease. Current use of the
combinations of carbidopa-levodopa or benserazide-levodopa offset this
interaction for the most part; but use of supplements containing more
than 15 mg of B6 can overwhelm the protective effects of the carbidopa
and benserazide.)
Good food sources of B6 include chicken, fish, eggs, nuts and seeds,
dried beans and peas, soybeans, wheat germ, bananas, avocados, and
brewer's yeast. Also, some foods, including a number of breakfast
cereals, are fortified with B6.
Signs of B6 deficiency include irritability, depression, and confusion;
sore tongue, sores or ulcers of the mouth, and ulcers of the skin at the
corners of the mouth.
Vitamin B12. The human body stores this vitamin so well that it can
take a long time to deplete, sometimes several years. Nevertheless,
there are several reasons why people sometimes do experience deficiency. Animal foods are the only source of B12, therefore people who eat few or no animal products (meat, fish, poultry, eggs, milk) are at risk unless they use vitamin supplements.
Another problem is that B12 in foods cannot be absorbed by the body
until it is freed from the proteins in the food; the stomach produces an
acid that removes this protein. However, with age, we produce less and
less of this stomach acid. Many older adults don't produce enough acid
to allow them to absorb B12. Further, people who have acid reflux often
use medications that reduce stomach acid, which unfortunately also
decreases absorption of B12. Vitamin B12 is one of the few nutrients
that is better absorbed in pill form than from dietary sources.
Signs of B12 deficiency include numbness or a tingling "pins and
needles" sensation, or a burning feeling; a red, sore, or burning
tongue; loss of appetite; gait abnormalities, personality changes, an
Alzheimer-like dementia, psychosis, depression, and agitation,
particularly in older adults. Other signs are megaloblastic anemia, and
elevated serum homocysteine, in people of all ages. Researchers believe
that as many as 42% of people aged 65 and older may have some degree of B12 deficiency. Many people with PD are age 65 or older, and should be considered at risk and tested for B12 deficiency.
Folate. Folate is available in many foods: lima beans, brewer's yeast,
orange juice, dried beans, green peas, asparagus, beets, Brussels
sprouts, broccoli, corn, spinach and other dark green leafy vegetables,
soybeans, nuts and seeds. Further, the U.S. government requires that
food manufacturers fortify processed grain products with folic acid.
Yet, deficiencies of folate are not uncommon. This could be in part
because folate is another of the few nutrients in which the synthetic
form is absorbed much better (about 40 percent better) than the natural
form.
Because of the possibility of deficiency, women, including women with
PD, who are pregnant or wish to become pregnant are advised to take
supplements of folic acid; deficiencies can result in neural tube
defects in the unborn child.
Deficiencies of folate are also being increasingly studied for a
possible role in other diseases:
. A low intake of folic acid is associated with risk for colon cancer.
Chronic constipation, experienced by many people with PD, also increases
risk for colon cancer; it is prudent for those with PD to control
constipation and to be sure the diet is adequate in folate.
. A low level of folic acid in the blood is associated with higher
levels of serum homocysteine, a substance in the blood that may
contribute to heart disease, stroke, and dementias.
. Animal studies point to a link between low levels of folic acid and
Alzheimer's disease; and people with Alzheimer's are often found to have
low levels of folic acid. Some people with PD develop an Alzheimer-type
dementia. Again, prudence dictates consumption of adequate folate.
. Another study using mice found that folic acid deficiency led to
increased levels of homocysteine and symptoms of Parkinson's disease.
Researchers speculate that homocysteine may damage DNA in the substantia nigra, the area of the brain affected in Parkinson's disease.
. There are reports of improvement in restless leg syndrome (RLS) with
use of folate supplements; this has not as yet been studied thoroughly,
so it is too early to say whether there is a definite link. However,
people with PD often complain of RLS, and physicians should rule out the
possibility of folic acid deficiency.
Signs of folic acid deficiency include appetite loss, weight loss,
burning tongue, fatigue, weakness, shortness of breach, memory loss,
irritability, megaloblastic anemia, and increased levels of serum
homocysteine.
Should people with PD be concerned about these vitamins?
Although there are concerns, as mentioned above, that deserve further
study, it's too early to say definitely that these three vitamins are of
significance to people with PD. However, if you are over age 50 these
vitamins are of importance independently of PD. Furthermore, studies
have demonstrated that some people who use levodopa, considered the best medication for PD, develop elevated levels of serum homocysteine, due to the way in which the medication is metabolized. It is certainly a good idea to ask your doctor to test levels of serum homocysteine annually, and to check for signs of B vitamin deficiencies.
Should you take supplements?
There is growing agreement that older adults are at risk for nutrient
deficiency, whether PD is present or not, and that supplements can help.
. One study of older adults found that a multivitamin containing 100% of
the Daily Value improved low levels of several nutrients, including
vitamins B6, B12, and folate.
. A recent study in the United Kingdom suggests that folic acid intake
should be about three times that of the current recommendation for
elderly people.
. Other studies indicate that up to 10% of older adults with low-normal
levels of B12 are actually deficient and could benefit from supplements.
Because folate supplements can mask a B12 deficiency, it becomes extra
important to get enough B12 daily.
. The American Heart Association recommends a folate-rich diet to lower
homocysteine levels, and supplements of 2 mg B6, 400 mcg folic acid, and 6 mcg of B12 if dietary means are not sufficient to lower the
homocysteine.
For people with PD who use a medication that contains levodopa (such as
Sinemet, Madopar, Syndopa, Larodopa, etc.), you should be aware that
large amounts of vitamin B6 (more than 15 mg) can affect the absorption
of levodopa, by converting levodopa to dopamine in the stomach and
bloodstream. Dopamine cannot cross the blood-brain barrier, so it is
effectively blocked from its purpose.
Sinemet and Madopar contain either carbidopa or benserazide, which
"protect" the levodopa from B6; so ordinary supplements of B6 should not
be a problem for most people. However, very large amounts of B6, greater than 15 mg (and in sensitive persons, possibly as low as 10 mg), could overwhelm the protective effects of the carbidopa or benserazide. Such a supplement should be taken at bedtime with a light snack, or with meals at least two hours separately from levodopa.
In summary, older adults are acknowledged to be at increased risk for B
vitamin deficiencies. People with PD who are age 50 and over, therefore,
are at increased risk also. Whether younger people with PD should be
concerned about such deficiencies remains to be seen. A prudent and
rational approach for all those with PD is to:
. Discuss the possibility with their physicians, and to request tests
for B vitamin deficiencies
. Be aware of the signs of B vitamin deficiency
. Take a multivitamin/mineral supplement daily. Unless anemic, choose a
supplement that does not contain iron
. Take a B complex supplement if deficiencies occur; and take the
supplement separately from levodopa by at least two hours, preferably
with meals or a snack.
Knowledge is strength; awareness of dietary needs can prevent illness,
malnutrition, suffering, and hospitalization. If you have questions
about B vitamins or other nutrition or dietary needs, please visit the
National Parkinson Foundation website:
The above article may not be reproduced in any form except with
permission from the author.
References
Giovannucci, E. et al. Alcohol, low-methionine-low-folate diets, and
risk of colon cancer in men. Journal of the National Cancer Institute.
1995; volume 87: pages 265-273.
Kruman II, Kumaravel TS, Lohani A, Pedersen WA, Cutler RG, Kruman Y,
Haughey N, Lee J, Evans M, Mattson MP. Folic Acid deficiency and
homocysteine impair DNA repair in hippocampal neurons and sensitize them
to amyloid toxicity in experimental models of Alzheimer's disease. J
Neurosci 2002 Mar 1;22(5):1752-62.
Lobo A, Naso A, Arheart K, Kruger WD, Abou-Ghazala T, Alsous F, Nahlawi
M, Gupta A, Moustapha A, van Lente F, Jacobsen DW, Robinson K. Reduction
of homocysteine levels in coronary artery disease by low-dose folic acid
combined with vitamins B6 and B12. Am J Cardiol 1999 Mar 15;83(6):821-5.
Malinow, M.R. et al. Homocyst(e)ine, diet, and cardiovascular diseases:
a statement for healthcare professionals from the nutrition committee,
American Heart Association. Circulation. 1999; volume 99: pages 178-182.
Muller T, Werne B, Fowler B, Kuhn W. Nigral endothelial dysfunction,
homocysteine, and Parkinson's disease. Lancet. 1999 Jul
10;354(9173):126-7.
Muller T, Woitalla D, Hauptmann B, Fowler B, Kuhn W. Decrease of
methionine and S-adenosylmethionine and increase of homocysteine in
treated patients with Parkinson's disease.
Neurosci Lett. 2001 Jul 27;308(1):54-6.
Naurath HJ, Joosten E, Riezler R, Stabler SP, Allen RH, Lindenbaum J.
Effects of vitamin B12, folate, and vitamin B6 supplements in elderly
people with normal serum vitamin concentrations. Lancet 1995; 346:85-89.
O'Keeffe ST. Restless legs syndrome. A review. Arch Intern Med.
1996;156:243-248.
0 Report
Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
Kathrynne Holden, MS, RD
Copyright 2000
Ms. Holden is a registered dietitian specializing in Parkinson's
disease. She has published research, books, articles, and manuals on
nutrition and PD, including "Eat well, stay well with Parkinson's
disease." She moderates the NPF forum Ask the Parkinson Dietitian at:
www.parkinson.org
In the past decade, there has been increasing interest among
researchers about the effects of three B vitamins - B6, B12, and folate.
We now know that deficiencies occur with greater frequency than ever
suspected previously, particularly in older adults. We also now know
that deficiencies, if not corrected, can result in irreversible damage
in some people. Some health professionals are beginning to suspect that
these three vitamins may be significant factors in Parkinson's disease.
What are B6, B12, and folate, and what do they do?
These are essential nutrients, meaning that they are vital to life.
These three vitamins work both independently and together in many of the body's systems.
Vitamin B6 assists in making hormones, new proteins, and
neurotransmitters ("messengers" between nerve cells) for the body's use.
It also helps release stored sugar when we need it for fuel. It works
together with B12 and folate to remove homocysteine from the blood.
Homocysteine is a substance increasingly associated with a number of
diseases; more about this later.
Vitamin B12 plays a role in the synthesis of DNA, needed for formation
of new red blood cells. It takes part in the manufacture of the myelin
sheath - the protective coating that surrounds nerve cells. With B6 and
folate it removes homocysteine from the blood.
Folate, also called folacin or folic acid, is a partner with B12 in DNA
synthesis and in removal of homocysteine, and is required in many other
vital processes. Without folate, B12 would be unable to complete many of
its functions, and vice versa. Folate is the form found in foods, folic
acid is the form in dietary supplements.
How much do we need of these vitamins?
Nutrient needs are broken down by gender, age group, pregnancy, and
lactation. New guidelines have also established a Tolerable Upper Intake
Level. So, for example, while the RDA for vitamin B6 for males and
females age 19-30 years is 1.3 mg/day, the Tolerable Upper Intake Level
for both is 100 mg/day, making it easier to provide recommended amounts.
RDA* Tolerable Upper Intake Level ** +
Vitamin B6***+ 1.7 mg/day 100 mg/day (age 19 and older)
Vitamin B12+ 2.4 mcg/day Not Determined
Folate + 400 mcg/day 1000 mcg/day
Recommended Dietary Allowance
** The Tolerable Upper Intake Level is the maximum level of daily
nutrient intake that is likely to pose no risk of adverse effects, and
represents the total intake from food, water, and supplements.
*** Adults age 51 and older
+ not applicable if pregnant or lactating
Why do deficiencies occur, and what are signs of deficiencies?
Vitamin B6. Mild deficiencies of B6 are fairly common in the U.S.,
mostly because of dietary deficiencies, but sometimes due to use of
certain medications which interfere with B6, including hydralazine,
isoniazid, MAO inhibitors, penicillamine, and theophylline. (Conversely,
large amounts of B6 can interfere with the absorption of levodopa, an
important medication for Parkinson's disease. Current use of the
combinations of carbidopa-levodopa or benserazide-levodopa offset this
interaction for the most part; but use of supplements containing more
than 15 mg of B6 can overwhelm the protective effects of the carbidopa
and benserazide.)
Good food sources of B6 include chicken, fish, eggs, nuts and seeds,
dried beans and peas, soybeans, wheat germ, bananas, avocados, and
brewer's yeast. Also, some foods, including a number of breakfast
cereals, are fortified with B6.
Signs of B6 deficiency include irritability, depression, and confusion;
sore tongue, sores or ulcers of the mouth, and ulcers of the skin at the
corners of the mouth.
Vitamin B12. The human body stores this vitamin so well that it can
take a long time to deplete, sometimes several years. Nevertheless,
there are several reasons why people sometimes do experience deficiency. Animal foods are the only source of B12, therefore people who eat few or no animal products (meat, fish, poultry, eggs, milk) are at risk unless they use vitamin supplements.
Another problem is that B12 in foods cannot be absorbed by the body
until it is freed from the proteins in the food; the stomach produces an
acid that removes this protein. However, with age, we produce less and
less of this stomach acid. Many older adults don't produce enough acid
to allow them to absorb B12. Further, people who have acid reflux often
use medications that reduce stomach acid, which unfortunately also
decreases absorption of B12. Vitamin B12 is one of the few nutrients
that is better absorbed in pill form than from dietary sources.
Signs of B12 deficiency include numbness or a tingling "pins and
needles" sensation, or a burning feeling; a red, sore, or burning
tongue; loss of appetite; gait abnormalities, personality changes, an
Alzheimer-like dementia, psychosis, depression, and agitation,
particularly in older adults. Other signs are megaloblastic anemia, and
elevated serum homocysteine, in people of all ages. Researchers believe
that as many as 42% of people aged 65 and older may have some degree of B12 deficiency. Many people with PD are age 65 or older, and should be considered at risk and tested for B12 deficiency.
Folate. Folate is available in many foods: lima beans, brewer's yeast,
orange juice, dried beans, green peas, asparagus, beets, Brussels
sprouts, broccoli, corn, spinach and other dark green leafy vegetables,
soybeans, nuts and seeds. Further, the U.S. government requires that
food manufacturers fortify processed grain products with folic acid.
Yet, deficiencies of folate are not uncommon. This could be in part
because folate is another of the few nutrients in which the synthetic
form is absorbed much better (about 40 percent better) than the natural
form.
Because of the possibility of deficiency, women, including women with
PD, who are pregnant or wish to become pregnant are advised to take
supplements of folic acid; deficiencies can result in neural tube
defects in the unborn child.
Deficiencies of folate are also being increasingly studied for a
possible role in other diseases:
. A low intake of folic acid is associated with risk for colon cancer.
Chronic constipation, experienced by many people with PD, also increases
risk for colon cancer; it is prudent for those with PD to control
constipation and to be sure the diet is adequate in folate.
. A low level of folic acid in the blood is associated with higher
levels of serum homocysteine, a substance in the blood that may
contribute to heart disease, stroke, and dementias.
. Animal studies point to a link between low levels of folic acid and
Alzheimer's disease; and people with Alzheimer's are often found to have
low levels of folic acid. Some people with PD develop an Alzheimer-type
dementia. Again, prudence dictates consumption of adequate folate.
. Another study using mice found that folic acid deficiency led to
increased levels of homocysteine and symptoms of Parkinson's disease.
Researchers speculate that homocysteine may damage DNA in the substantia nigra, the area of the brain affected in Parkinson's disease.
. There are reports of improvement in restless leg syndrome (RLS) with
use of folate supplements; this has not as yet been studied thoroughly,
so it is too early to say whether there is a definite link. However,
people with PD often complain of RLS, and physicians should rule out the
possibility of folic acid deficiency.
Signs of folic acid deficiency include appetite loss, weight loss,
burning tongue, fatigue, weakness, shortness of breach, memory loss,
irritability, megaloblastic anemia, and increased levels of serum
homocysteine.
Should people with PD be concerned about these vitamins?
Although there are concerns, as mentioned above, that deserve further
study, it's too early to say definitely that these three vitamins are of
significance to people with PD. However, if you are over age 50 these
vitamins are of importance independently of PD. Furthermore, studies
have demonstrated that some people who use levodopa, considered the best medication for PD, develop elevated levels of serum homocysteine, due to the way in which the medication is metabolized. It is certainly a good idea to ask your doctor to test levels of serum homocysteine annually, and to check for signs of B vitamin deficiencies.
Should you take supplements?
There is growing agreement that older adults are at risk for nutrient
deficiency, whether PD is present or not, and that supplements can help.
. One study of older adults found that a multivitamin containing 100% of
the Daily Value improved low levels of several nutrients, including
vitamins B6, B12, and folate.
. A recent study in the United Kingdom suggests that folic acid intake
should be about three times that of the current recommendation for
elderly people.
. Other studies indicate that up to 10% of older adults with low-normal
levels of B12 are actually deficient and could benefit from supplements.
Because folate supplements can mask a B12 deficiency, it becomes extra
important to get enough B12 daily.
. The American Heart Association recommends a folate-rich diet to lower
homocysteine levels, and supplements of 2 mg B6, 400 mcg folic acid, and 6 mcg of B12 if dietary means are not sufficient to lower the
homocysteine.
For people with PD who use a medication that contains levodopa (such as
Sinemet, Madopar, Syndopa, Larodopa, etc.), you should be aware that
large amounts of vitamin B6 (more than 15 mg) can affect the absorption
of levodopa, by converting levodopa to dopamine in the stomach and
bloodstream. Dopamine cannot cross the blood-brain barrier, so it is
effectively blocked from its purpose.
Sinemet and Madopar contain either carbidopa or benserazide, which
"protect" the levodopa from B6; so ordinary supplements of B6 should not
be a problem for most people. However, very large amounts of B6, greater than 15 mg (and in sensitive persons, possibly as low as 10 mg), could overwhelm the protective effects of the carbidopa or benserazide. Such a supplement should be taken at bedtime with a light snack, or with meals at least two hours separately from levodopa.
In summary, older adults are acknowledged to be at increased risk for B
vitamin deficiencies. People with PD who are age 50 and over, therefore,
are at increased risk also. Whether younger people with PD should be
concerned about such deficiencies remains to be seen. A prudent and
rational approach for all those with PD is to:
. Discuss the possibility with their physicians, and to request tests
for B vitamin deficiencies
. Be aware of the signs of B vitamin deficiency
. Take a multivitamin/mineral supplement daily. Unless anemic, choose a
supplement that does not contain iron
. Take a B complex supplement if deficiencies occur; and take the
supplement separately from levodopa by at least two hours, preferably
with meals or a snack.
Knowledge is strength; awareness of dietary needs can prevent illness,
malnutrition, suffering, and hospitalization. If you have questions
about B vitamins or other nutrition or dietary needs, please visit the
National Parkinson Foundation website:
The above article may not be reproduced in any form except with
permission from the author.
References
Giovannucci, E. et al. Alcohol, low-methionine-low-folate diets, and
risk of colon cancer in men. Journal of the National Cancer Institute.
1995; volume 87: pages 265-273.
Kruman II, Kumaravel TS, Lohani A, Pedersen WA, Cutler RG, Kruman Y,
Haughey N, Lee J, Evans M, Mattson MP. Folic Acid deficiency and
homocysteine impair DNA repair in hippocampal neurons and sensitize them
to amyloid toxicity in experimental models of Alzheimer's disease. J
Neurosci 2002 Mar 1;22(5):1752-62.
Lobo A, Naso A, Arheart K, Kruger WD, Abou-Ghazala T, Alsous F, Nahlawi
M, Gupta A, Moustapha A, van Lente F, Jacobsen DW, Robinson K. Reduction
of homocysteine levels in coronary artery disease by low-dose folic acid
combined with vitamins B6 and B12. Am J Cardiol 1999 Mar 15;83(6):821-5.
Malinow, M.R. et al. Homocyst(e)ine, diet, and cardiovascular diseases:
a statement for healthcare professionals from the nutrition committee,
American Heart Association. Circulation. 1999; volume 99: pages 178-182.
Muller T, Werne B, Fowler B, Kuhn W. Nigral endothelial dysfunction,
homocysteine, and Parkinson's disease. Lancet. 1999 Jul
10;354(9173):126-7.
Muller T, Woitalla D, Hauptmann B, Fowler B, Kuhn W. Decrease of
methionine and S-adenosylmethionine and increase of homocysteine in
treated patients with Parkinson's disease.
Neurosci Lett. 2001 Jul 27;308(1):54-6.
Naurath HJ, Joosten E, Riezler R, Stabler SP, Allen RH, Lindenbaum J.
Effects of vitamin B12, folate, and vitamin B6 supplements in elderly
people with normal serum vitamin concentrations. Lancet 1995; 346:85-89.
O'Keeffe ST. Restless legs syndrome. A review. Arch Intern Med.
1996;156:243-248.
0 Report
Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
PD,B6,B12 and folate
HomeParkinson’s DiseaseImproving CareCommunityHow to HelpAbout UsDonate Now: Article: PD, B6, B12, and Folate - What's the Connection? - Jump to content
0 unread notifications
Signed in as teokimhoe
My ProfileMy SettingsMy ContentManage FriendsManage Ignored Users
Sign OutHelpSearch This topicSearch section: This topic This forumForumsMembersHelpCalendar Advanced ForumsMembers> Medical Questions> Ask about NutritionView New ContentPage 1 of 1
Start a new topic Add Reply Stop watching topic
Article: PD, B6, B12, and Folate - What's the Connection? Poll: Was this article helpful? (7 member(s) have cast votes)
Was this article helpful?
Yes (7 votes [100.00%])
Percentage of vote: 100.00%
No (0 votes [0.00%])
Percentage of vote: 0.00%
VoteDelete My Vote
#1 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
446 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted 03 March 2007 - 10:07 AM
Parkinson's, B6, B12, and Folate - What's the Connection?
Kathrynne Holden, MS, RD
Copyright 2000
Ms. Holden is a registered dietitian specializing in Parkinson's
disease. She has published research, books, articles, and manuals on
nutrition and PD, including "Eat well, stay well with Parkinson's
disease." She moderates the NPF forum Ask the Parkinson Dietitian at:
www.parkinson.org
In the past decade, there has been increasing interest among
researchers about the effects of three B vitamins - B6, B12, and folate.
We now know that deficiencies occur with greater frequency than ever
suspected previously, particularly in older adults. We also now know
that deficiencies, if not corrected, can result in irreversible damage
in some people. Some health professionals are beginning to suspect that
these three vitamins may be significant factors in Parkinson's disease.
What are B6, B12, and folate, and what do they do?
These are essential nutrients, meaning that they are vital to life.
These three vitamins work both independently and together in many of the body's systems.
Vitamin B6 assists in making hormones, new proteins, and
neurotransmitters ("messengers" between nerve cells) for the body's use.
It also helps release stored sugar when we need it for fuel. It works
together with B12 and folate to remove homocysteine from the blood.
Homocysteine is a substance increasingly associated with a number of
diseases; more about this later.
Vitamin B12 plays a role in the synthesis of DNA, needed for formation
of new red blood cells. It takes part in the manufacture of the myelin
sheath - the protective coating that surrounds nerve cells. With B6 and
folate it removes homocysteine from the blood.
Folate, also called folacin or folic acid, is a partner with B12 in DNA
synthesis and in removal of homocysteine, and is required in many other
vital processes. Without folate, B12 would be unable to complete many of
its functions, and vice versa. Folate is the form found in foods, folic
acid is the form in dietary supplements.
How much do we need of these vitamins?
Nutrient needs are broken down by gender, age group, pregnancy, and
lactation. New guidelines have also established a Tolerable Upper Intake
Level. So, for example, while the RDA for vitamin B6 for males and
females age 19-30 years is 1.3 mg/day, the Tolerable Upper Intake Level
for both is 100 mg/day, making it easier to provide recommended amounts.
RDA* Tolerable Upper Intake Level ** +
Vitamin B6***+ 1.7 mg/day 100 mg/day (age 19 and older)
Vitamin B12+ 2.4 mcg/day Not Determined
Folate + 400 mcg/day 1000 mcg/day
* Recommended Dietary Allowance
** The Tolerable Upper Intake Level is the maximum level of daily
nutrient intake that is likely to pose no risk of adverse effects, and
represents the total intake from food, water, and supplements.
*** Adults age 51 and older
+ not applicable if pregnant or lactating
Why do deficiencies occur, and what are signs of deficiencies?
Vitamin B6. Mild deficiencies of B6 are fairly common in the U.S.,
mostly because of dietary deficiencies, but sometimes due to use of
certain medications which interfere with B6, including hydralazine,
isoniazid, MAO inhibitors, penicillamine, and theophylline. (Conversely,
large amounts of B6 can interfere with the absorption of levodopa, an
important medication for Parkinson's disease. Current use of the
combinations of carbidopa-levodopa or benserazide-levodopa offset this
interaction for the most part; but use of supplements containing more
than 15 mg of B6 can overwhelm the protective effects of the carbidopa
and benserazide.)
Good food sources of B6 include chicken, fish, eggs, nuts and seeds,
dried beans and peas, soybeans, wheat germ, bananas, avocados, and
brewer's yeast. Also, some foods, including a number of breakfast
cereals, are fortified with B6.
Signs of B6 deficiency include irritability, depression, and confusion;
sore tongue, sores or ulcers of the mouth, and ulcers of the skin at the
corners of the mouth.
Vitamin B12. The human body stores this vitamin so well that it can
take a long time to deplete, sometimes several years. Nevertheless,
there are several reasons why people sometimes do experience deficiency. Animal foods are the only source of B12, therefore people who eat few or no animal products (meat, fish, poultry, eggs, milk) are at risk unless they use vitamin supplements.
Another problem is that B12 in foods cannot be absorbed by the body
until it is freed from the proteins in the food; the stomach produces an
acid that removes this protein. However, with age, we produce less and
less of this stomach acid. Many older adults don't produce enough acid
to allow them to absorb B12. Further, people who have acid reflux often
use medications that reduce stomach acid, which unfortunately also
decreases absorption of B12. Vitamin B12 is one of the few nutrients
that is better absorbed in pill form than from dietary sources.
Signs of B12 deficiency include numbness or a tingling "pins and
needles" sensation, or a burning feeling; a red, sore, or burning
tongue; loss of appetite; gait abnormalities, personality changes, an
Alzheimer-like dementia, psychosis, depression, and agitation,
particularly in older adults. Other signs are megaloblastic anemia, and
elevated serum homocysteine, in people of all ages. Researchers believe
that as many as 42% of people aged 65 and older may have some degree of B12 deficiency. Many people with PD are age 65 or older, and should be considered at risk and tested for B12 deficiency.
Folate. Folate is available in many foods: lima beans, brewer's yeast,
orange juice, dried beans, green peas, asparagus, beets, Brussels
sprouts, broccoli, corn, spinach and other dark green leafy vegetables,
soybeans, nuts and seeds. Further, the U.S. government requires that
food manufacturers fortify processed grain products with folic acid.
Yet, deficiencies of folate are not uncommon. This could be in part
because folate is another of the few nutrients in which the synthetic
form is absorbed much better (about 40 percent better) than the natural
form.
Because of the possibility of deficiency, women, including women with
PD, who are pregnant or wish to become pregnant are advised to take
supplements of folic acid; deficiencies can result in neural tube
defects in the unborn child.
Deficiencies of folate are also being increasingly studied for a
possible role in other diseases:
. A low intake of folic acid is associated with risk for colon cancer.
Chronic constipation, experienced by many people with PD, also increases
risk for colon cancer; it is prudent for those with PD to control
constipation and to be sure the diet is adequate in folate.
. A low level of folic acid in the blood is associated with higher
levels of serum homocysteine, a substance in the blood that may
contribute to heart disease, stroke, and dementias.
. Animal studies point to a link between low levels of folic acid and
Alzheimer's disease; and people with Alzheimer's are often found to have
low levels of folic acid. Some people with PD develop an Alzheimer-type
dementia. Again, prudence dictates consumption of adequate folate.
. Another study using mice found that folic acid deficiency led to
increased levels of homocysteine and symptoms of Parkinson's disease.
Researchers speculate that homocysteine may damage DNA in the substantia nigra, the area of the brain affected in Parkinson's disease.
. There are reports of improvement in restless leg syndrome (RLS) with
use of folate supplements; this has not as yet been studied thoroughly,
so it is too early to say whether there is a definite link. However,
people with PD often complain of RLS, and physicians should rule out the
possibility of folic acid deficiency.
Signs of folic acid deficiency include appetite loss, weight loss,
burning tongue, fatigue, weakness, shortness of breach, memory loss,
irritability, megaloblastic anemia, and increased levels of serum
homocysteine.
Should people with PD be concerned about these vitamins?
Although there are concerns, as mentioned above, that deserve further
study, it's too early to say definitely that these three vitamins are of
significance to people with PD. However, if you are over age 50 these
vitamins are of importance independently of PD. Furthermore, studies
have demonstrated that some people who use levodopa, considered the best medication for PD, develop elevated levels of serum homocysteine, due to the way in which the medication is metabolized. It is certainly a good idea to ask your doctor to test levels of serum homocysteine annually, and to check for signs of B vitamin deficiencies.
Should you take supplements?
There is growing agreement that older adults are at risk for nutrient
deficiency, whether PD is present or not, and that supplements can help.
. One study of older adults found that a multivitamin containing 100% of
the Daily Value improved low levels of several nutrients, including
vitamins B6, B12, and folate.
. A recent study in the United Kingdom suggests that folic acid intake
should be about three times that of the current recommendation for
elderly people.
. Other studies indicate that up to 10% of older adults with low-normal
levels of B12 are actually deficient and could benefit from supplements.
Because folate supplements can mask a B12 deficiency, it becomes extra
important to get enough B12 daily.
. The American Heart Association recommends a folate-rich diet to lower
homocysteine levels, and supplements of 2 mg B6, 400 mcg folic acid, and 6 mcg of B12 if dietary means are not sufficient to lower the
homocysteine.
For people with PD who use a medication that contains levodopa (such as
Sinemet, Madopar, Syndopa, Larodopa, etc.), you should be aware that
large amounts of vitamin B6 (more than 15 mg) can affect the absorption
of levodopa, by converting levodopa to dopamine in the stomach and
bloodstream. Dopamine cannot cross the blood-brain barrier, so it is
effectively blocked from its purpose.
Sinemet and Madopar contain either carbidopa or benserazide, which
"protect" the levodopa from B6; so ordinary supplements of B6 should not
be a problem for most people. However, very large amounts of B6, greater than 15 mg (and in sensitive persons, possibly as low as 10 mg), could overwhelm the protective effects of the carbidopa or benserazide. Such a supplement should be taken at bedtime with a light snack, or with meals at least two hours separately from levodopa.
In summary, older adults are acknowledged to be at increased risk for B
vitamin deficiencies. People with PD who are age 50 and over, therefore,
are at increased risk also. Whether younger people with PD should be
concerned about such deficiencies remains to be seen. A prudent and
rational approach for all those with PD is to:
. Discuss the possibility with their physicians, and to request tests
for B vitamin deficiencies
. Be aware of the signs of B vitamin deficiency
. Take a multivitamin/mineral supplement daily. Unless anemic, choose a
supplement that does not contain iron
. Take a B complex supplement if deficiencies occur; and take the
supplement separately from levodopa by at least two hours, preferably
with meals or a snack.
Knowledge is strength; awareness of dietary needs can prevent illness,
malnutrition, suffering, and hospitalization. If you have questions
about B vitamins or other nutrition or dietary needs, please visit the
National Parkinson Foundation website:
The above article may not be reproduced in any form except with
permission from the author.
References
Giovannucci, E. et al. Alcohol, low-methionine-low-folate diets, and
risk of colon cancer in men. Journal of the National Cancer Institute.
1995; volume 87: pages 265-273.
Kruman II, Kumaravel TS, Lohani A, Pedersen WA, Cutler RG, Kruman Y,
Haughey N, Lee J, Evans M, Mattson MP. Folic Acid deficiency and
homocysteine impair DNA repair in hippocampal neurons and sensitize them
to amyloid toxicity in experimental models of Alzheimer's disease. J
Neurosci 2002 Mar 1;22(5):1752-62.
Lobo A, Naso A, Arheart K, Kruger WD, Abou-Ghazala T, Alsous F, Nahlawi
M, Gupta A, Moustapha A, van Lente F, Jacobsen DW, Robinson K. Reduction
of homocysteine levels in coronary artery disease by low-dose folic acid
combined with vitamins B6 and B12. Am J Cardiol 1999 Mar 15;83(6):821-5.
Malinow, M.R. et al. Homocyst(e)ine, diet, and cardiovascular diseases:
a statement for healthcare professionals from the nutrition committee,
American Heart Association. Circulation. 1999; volume 99: pages 178-182.
Muller T, Werne B, Fowler B, Kuhn W. Nigral endothelial dysfunction,
homocysteine, and Parkinson's disease. Lancet. 1999 Jul
10;354(9173):126-7.
Muller T, Woitalla D, Hauptmann B, Fowler B, Kuhn W. Decrease of
methionine and S-adenosylmethionine and increase of homocysteine in
treated patients with Parkinson's disease.
Neurosci Lett. 2001 Jul 27;308(1):54-6.
Naurath HJ, Joosten E, Riezler R, Stabler SP, Allen RH, Lindenbaum J.
Effects of vitamin B12, folate, and vitamin B6 supplements in elderly
people with normal serum vitamin concentrations. Lancet 1995; 346:85-89.
O'Keeffe ST. Restless legs syndrome. A review. Arch Intern Med.
1996;156:243-248.
0 Report
Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
#2 teokimhoe
Advanced Member
Group:
Members Posts:
210 Joined:
03-March 07 LocationMalaysia Posted 02 August 2010 - 02:37 AM
Kathrynne Holden, MS, on 03 March 2007 - 10:07 AM, said:
Parkinson's, B6, B12, and Folate - What's the Connection?
Kathrynne Holden, MS, RD
Copyright 2000
Ms. Holden is a registered dietitian specializing in Parkinson's
disease. She has published research, books, articles, and manuals on
nutrition and PD, including "Eat well, stay well with Parkinson's
disease." She moderates the NPF forum Ask the Parkinson Dietitian at:
www.parkinson.org
In the past decade, there has been increasing interest among
researchers about the effects of three B vitamins - B6, B12, and folate.
We now know that deficiencies occur with greater frequency than ever
suspected previously, particularly in older adults. We also now know
that deficiencies, if not corrected, can result in irreversible damage
in some people. Some health professionals are beginning to suspect that
these three vitamins may be significant factors in Parkinson's disease.
What are B6, B12, and folate, and what do they do?
These are essential nutrients, meaning that they are vital to life.
These three vitamins work both independently and together in many of the body's systems.
Vitamin B6 assists in making hormones, new proteins, and
neurotransmitters ("messengers" between nerve cells) for the body's use.
It also helps release stored sugar when we need it for fuel. It works
together with B12 and folate to remove homocysteine from the blood.
Homocysteine is a substance increasingly associated with a number of
diseases; more about this later.
Vitamin B12 plays a role in the synthesis of DNA, needed for formation
of new red blood cells. It takes part in the manufacture of the myelin
sheath - the protective coating that surrounds nerve cells. With B6 and
folate it removes homocysteine from the blood.
Folate, also called folacin or folic acid, is a partner with B12 in DNA
synthesis and in removal of homocysteine, and is required in many other
vital processes. Without folate, B12 would be unable to complete many of
its functions, and vice versa. Folate is the form found in foods, folic
acid is the form in dietary supplements.
How much do we need of these vitamins?
Nutrient needs are broken down by gender, age group, pregnancy, and
lactation. New guidelines have also established a Tolerable Upper Intake
Level. So, for example, while the RDA for vitamin B6 for males and
females age 19-30 years is 1.3 mg/day, the Tolerable Upper Intake Level
for both is 100 mg/day, making it easier to provide recommended amounts.
RDA* Tolerable Upper Intake Level ** +
Vitamin B6***+ 1.7 mg/day 100 mg/day (age 19 and older)
Vitamin B12+ 2.4 mcg/day Not Determined
Folate + 400 mcg/day 1000 mcg/day
* Recommended Dietary Allowance
** The Tolerable Upper Intake Level is the maximum level of daily
nutrient intake that is likely to pose no risk of adverse effects, and
represents the total intake from food, water, and supplements.
*** Adults age 51 and older
+ not applicable if pregnant or lactating
Why do deficiencies occur, and what are signs of deficiencies?
Vitamin B6. Mild deficiencies of B6 are fairly common in the U.S.,
mostly because of dietary deficiencies, but sometimes due to use of
certain medications which interfere with B6, including hydralazine,
isoniazid, MAO inhibitors, penicillamine, and theophylline. (Conversely,
large amounts of B6 can interfere with the absorption of levodopa, an
important medication for Parkinson's disease. Current use of the
combinations of carbidopa-levodopa or benserazide-levodopa offset this
interaction for the most part; but use of supplements containing more
than 15 mg of B6 can overwhelm the protective effects of the carbidopa
and benserazide.)
Good food sources of B6 include chicken, fish, eggs, nuts and seeds,
dried beans and peas, soybeans, wheat germ, bananas, avocados, and
brewer's yeast. Also, some foods, including a number of breakfast
cereals, are fortified with B6.
Signs of B6 deficiency include irritability, depression, and confusion;
sore tongue, sores or ulcers of the mouth, and ulcers of the skin at the
corners of the mouth.
Vitamin B12. The human body stores this vitamin so well that it can
take a long time to deplete, sometimes several years. Nevertheless,
there are several reasons why people sometimes do experience deficiency. Animal foods are the only source of B12, therefore people who eat few or no animal products (meat, fish, poultry, eggs, milk) are at risk unless they use vitamin supplements.
Another problem is that B12 in foods cannot be absorbed by the body
until it is freed from the proteins in the food; the stomach produces an
acid that removes this protein. However, with age, we produce less and
less of this stomach acid. Many older adults don't produce enough acid
to allow them to absorb B12. Further, people who have acid reflux often
use medications that reduce stomach acid, which unfortunately also
decreases absorption of B12. Vitamin B12 is one of the few nutrients
that is better absorbed in pill form than from dietary sources.
Signs of B12 deficiency include numbness or a tingling "pins and
needles" sensation, or a burning feeling; a red, sore, or burning
tongue; loss of appetite; gait abnormalities, personality changes, an
Alzheimer-like dementia, psychosis, depression, and agitation,
particularly in older adults. Other signs are megaloblastic anemia, and
elevated serum homocysteine, in people of all ages. Researchers believe
that as many as 42% of people aged 65 and older may have some degree of B12 deficiency. Many people with PD are age 65 or older, and should be considered at risk and tested for B12 deficiency.
Folate. Folate is available in many foods: lima beans, brewer's yeast,
orange juice, dried beans, green peas, asparagus, beets, Brussels
sprouts, broccoli, corn, spinach and other dark green leafy vegetables,
soybeans, nuts and seeds. Further, the U.S. government requires that
food manufacturers fortify processed grain products with folic acid.
Yet, deficiencies of folate are not uncommon. This could be in part
because folate is another of the few nutrients in which the synthetic
form is absorbed much better (about 40 percent better) than the natural
form.
Because of the possibility of deficiency, women, including women with
PD, who are pregnant or wish to become pregnant are advised to take
supplements of folic acid; deficiencies can result in neural tube
defects in the unborn child.
Deficiencies of folate are also being increasingly studied for a
possible role in other diseases:
. A low intake of folic acid is associated with risk for colon cancer.
Chronic constipation, experienced by many people with PD, also increases
risk for colon cancer; it is prudent for those with PD to control
constipation and to be sure the diet is adequate in folate.
. A low level of folic acid in the blood is associated with higher
levels of serum homocysteine, a substance in the blood that may
contribute to heart disease, stroke, and dementias.
. Animal studies point to a link between low levels of folic acid and
Alzheimer's disease; and people with Alzheimer's are often found to have
low levels of folic acid. Some people with PD develop an Alzheimer-type
dementia. Again, prudence dictates consumption of adequate folate.
. Another study using mice found that folic acid deficiency led to
increased levels of homocysteine and symptoms of Parkinson's disease.
Researchers speculate that homocysteine may damage DNA in the substantia nigra, the area of the brain affected in Parkinson's disease.
. There are reports of improvement in restless leg syndrome (RLS) with
use of folate supplements; this has not as yet been studied thoroughly,
so it is too early to say whether there is a definite link. However,
people with PD often complain of RLS, and physicians should rule out the
possibility of folic acid deficiency.
Signs of folic acid deficiency include appetite loss, weight loss,
burning tongue, fatigue, weakness, shortness of breach, memory loss,
irritability, megaloblastic anemia, and increased levels of serum
homocysteine.
Should people with PD be concerned about these vitamins?
Although there are concerns, as mentioned above, that deserve further
study, it's too early to say definitely that these three vitamins are of
significance to people with PD. However, if you are over age 50 these
vitamins are of importance independently of PD. Furthermore, studies
have demonstrated that some people who use levodopa, considered the best medication for PD, develop elevated levels of serum homocysteine, due to the way in which the medication is metabolized. It is certainly a good idea to ask your doctor to test levels of serum homocysteine annually, and to check for signs of B vitamin deficiencies.
Should you take supplements?
There is growing agreement that older adults are at risk for nutrient
deficiency, whether PD is present or not, and that supplements can help.
. One study of older adults found that a multivitamin containing 100% of
the Daily Value improved low levels of several nutrients, including
vitamins B6, B12, and folate.
. A recent study in the United Kingdom suggests that folic acid intake
should be about three times that of the current recommendation for
elderly people.
. Other studies indicate that up to 10% of older adults with low-normal
levels of B12 are actually deficient and could benefit from supplements.
Because folate supplements can mask a B12 deficiency, it becomes extra
important to get enough B12 daily.
. The American Heart Association recommends a folate-rich diet to lower
homocysteine levels, and supplements of 2 mg B6, 400 mcg folic acid, and 6 mcg of B12 if dietary means are not sufficient to lower the
homocysteine.
For people with PD who use a medication that contains levodopa (such as
Sinemet, Madopar, Syndopa, Larodopa, etc.), you should be aware that
large amounts of vitamin B6 (more than 15 mg) can affect the absorption
of levodopa, by converting levodopa to dopamine in the stomach and
bloodstream. Dopamine cannot cross the blood-brain barrier, so it is
effectively blocked from its purpose.
Sinemet and Madopar contain either carbidopa or benserazide, which
"protect" the levodopa from B6; so ordinary supplements of B6 should not
be a problem for most people. However, very large amounts of B6, greater than 15 mg (and in sensitive persons, possibly as low as 10 mg), could overwhelm the protective effects of the carbidopa or benserazide. Such a supplement should be taken at bedtime with a light snack, or with meals at least two hours separately from levodopa.
In summary, older adults are acknowledged to be at increased risk for B
vitamin deficiencies. People with PD who are age 50 and over, therefore,
are at increased risk also. Whether younger people with PD should be
concerned about such deficiencies remains to be seen. A prudent and
rational approach for all those with PD is to:
. Discuss the possibility with their physicians, and to request tests
for B vitamin deficiencies
. Be aware of the signs of B vitamin deficiency
. Take a multivitamin/mineral supplement daily. Unless anemic, choose a
supplement that does not contain iron
. Take a B complex supplement if deficiencies occur; and take the
supplement separately from levodopa by at least two hours, preferably
with meals or a snack.
Knowledge is strength; awareness of dietary needs can prevent illness,
malnutrition, suffering, and hospitalization. If you have questions
about B vitamins or other nutrition or dietary needs, please visit the
National Parkinson Foundation website:
The above article may not be reproduced in any form except with
permission from the author.
References
Giovannucci, E. et al. Alcohol, low-methionine-low-folate diets, and
risk of colon cancer in men. Journal of the National Cancer Institute.
1995; volume 87: pages 265-273.
Kruman II, Kumaravel TS, Lohani A, Pedersen WA, Cutler RG, Kruman Y,
Haughey N, Lee J, Evans M, Mattson MP. Folic Acid deficiency and
homocysteine impair DNA repair in hippocampal neurons and sensitize them
to amyloid toxicity in experimental models of Alzheimer's disease. J
Neurosci 2002 Mar 1;22(5):1752-62.
Lobo A, Naso A, Arheart K, Kruger WD, Abou-Ghazala T, Alsous F, Nahlawi
M, Gupta A, Moustapha A, van Lente F, Jacobsen DW, Robinson K. Reduction
of homocysteine levels in coronary artery disease by low-dose folic acid
combined with vitamins B6 and B12. Am J Cardiol 1999 Mar 15;83(6):821-5.
Malinow, M.R. et al. Homocyst(e)ine, diet, and cardiovascular diseases:
a statement for healthcare professionals from the nutrition committee,
American Heart Association. Circulation. 1999; volume 99: pages 178-182.
Muller T, Werne B, Fowler B, Kuhn W. Nigral endothelial dysfunction,
homocysteine, and Parkinson's disease. Lancet. 1999 Jul
10;354(9173):126-7.
Muller T, Woitalla D, Hauptmann B, Fowler B, Kuhn W. Decrease of
methionine and S-adenosylmethionine and increase of homocysteine in
treated patients with Parkinson's disease.
Neurosci Lett. 2001 Jul 27;308(1):54-6.
Naurath HJ, Joosten E, Riezler R, Stabler SP, Allen RH, Lindenbaum J.
Effects of vitamin B12, folate, and vitamin B6 supplements in elderly
people with normal serum vitamin concentrations. Lancet 1995; 346:85-89.
O'Keeffe ST. Restless legs syndrome. A review. Arch Intern Med.
1996;156:243-248.
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit Delete
--------------------------------------------------------------------------------
#3 teokimhoe
Advanced Member
Group:
Members Posts:
210 Joined:
03-March 07 LocationMalaysia Posted 02 August 2010 - 02:54 AM
Thank you for your interesting artiles.
There are some Parkinson's patiemts do not have trouble with B6, B12 and Folate interaction and side effects with Parkinson's medication.
I only have side efffect dizziness,nausea,irregular blood pressure with B6, B12 and folate with PD medication after I have T.I.A (minor stroke)as I am taking for years
As parkinson's diseaes is a boutique disease there are different symptoms from one after by ohter.
Some patients have interaction and side effects with PD medication on medications for other disease.
Kindly clarify
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit Delete
--------------------------------------------------------------------------------
#4 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
446 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Yesterday, 11:46 AM
Dear Mr. Teo,
You make a very good point – PD is often referred to as a “designer disease” because it affects each person differently.
Long-time users of levodopa have sometimes been found to have elevated levels of homocysteine, a substance in the blood that is associated with stroke. As you mention, these three B vitamins, B6, B12, and folate, together will normally remove homocysteine from the blood, and this may be why your doctor advised you to take them following your stroke.
You are the first person I have heard of who has experienced side effects of dizziness, nausea, or irregular blood pressure with use of these B vitamins. To the best of my knowledge, they would not ordinarily affect either PD itself or interact with PD medications. In your case, therefore, your personal physician is the proper health professional to address this matter. S/he has your medical records, medical history, family history, lab findings, and other data needed to determine your treatment.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
0 Report
Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
Currently viewing all posts. Change threshold?
Hide posts below View all posts 20 points 10 points 0 points -10 points -20 points
Forum Home Forum Information |-- Discussion Corner Announcements |-- NPF Forum Member Service Center |---- Helpful User Information Medical Questions |-- Ask The Doctor |---- Archive - 2009 Posts of the Week |---- Archive - 2010 Posts of the Week |-- Ask The Surgical Team |-- Ask about Nutrition |-- Ask the Pharmacist |-- Pregúntele al Médico |-- Talk To A Speech Clinician Unmoderated Discussion |-- Open Forum |-- Caregivers Forum |-- Young Onset Forum NPF Affiliate Discussion |-- NPF Center Discussion |-- NPF Chapter Discussion |-- Community Partners for Parkinson Care Discussion
← Previous TopicAsk about NutritionNext Topic →Share this topic:
Page 1 of 1
Start a new topic Add Reply
--------------------------------------------------------------------------------
1 User(s) are reading this topic
1 members, 0 guests, 0 anonymous users
teokimhoe.Delete PostRemove From View The post may still be visible to moderators in this topic
Reason:
Delete From Topic The post will be removed from this topic completely
Skin and Language
Theme: IP.Board Mobile NPF Language: English (USA) Execution Stats
Time Now: Aug 08 2010 07:47 AM
Last Visit: Today, 06:14 AM
.Back to topForum HomeDelete My CookiesMark Board As ReadCommunity Forum Software by IP.Board 3.1.0
--------------------------------------------------------------------------------
NPF ForumsRSS FeedsYouTubeFacebookTwitterContact UsPress & Media KitDisclaimerSite Map
800.327.4545
© 2010 National Parkinson Foundation | Privacy & Terms of Use
.
0 unread notifications
Signed in as teokimhoe
My ProfileMy SettingsMy ContentManage FriendsManage Ignored Users
Sign OutHelpSearch This topicSearch section: This topic This forumForumsMembersHelpCalendar Advanced ForumsMembers> Medical Questions> Ask about NutritionView New ContentPage 1 of 1
Start a new topic Add Reply Stop watching topic
Article: PD, B6, B12, and Folate - What's the Connection? Poll: Was this article helpful? (7 member(s) have cast votes)
Was this article helpful?
Yes (7 votes [100.00%])
Percentage of vote: 100.00%
No (0 votes [0.00%])
Percentage of vote: 0.00%
VoteDelete My Vote
#1 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
446 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted 03 March 2007 - 10:07 AM
Parkinson's, B6, B12, and Folate - What's the Connection?
Kathrynne Holden, MS, RD
Copyright 2000
Ms. Holden is a registered dietitian specializing in Parkinson's
disease. She has published research, books, articles, and manuals on
nutrition and PD, including "Eat well, stay well with Parkinson's
disease." She moderates the NPF forum Ask the Parkinson Dietitian at:
www.parkinson.org
In the past decade, there has been increasing interest among
researchers about the effects of three B vitamins - B6, B12, and folate.
We now know that deficiencies occur with greater frequency than ever
suspected previously, particularly in older adults. We also now know
that deficiencies, if not corrected, can result in irreversible damage
in some people. Some health professionals are beginning to suspect that
these three vitamins may be significant factors in Parkinson's disease.
What are B6, B12, and folate, and what do they do?
These are essential nutrients, meaning that they are vital to life.
These three vitamins work both independently and together in many of the body's systems.
Vitamin B6 assists in making hormones, new proteins, and
neurotransmitters ("messengers" between nerve cells) for the body's use.
It also helps release stored sugar when we need it for fuel. It works
together with B12 and folate to remove homocysteine from the blood.
Homocysteine is a substance increasingly associated with a number of
diseases; more about this later.
Vitamin B12 plays a role in the synthesis of DNA, needed for formation
of new red blood cells. It takes part in the manufacture of the myelin
sheath - the protective coating that surrounds nerve cells. With B6 and
folate it removes homocysteine from the blood.
Folate, also called folacin or folic acid, is a partner with B12 in DNA
synthesis and in removal of homocysteine, and is required in many other
vital processes. Without folate, B12 would be unable to complete many of
its functions, and vice versa. Folate is the form found in foods, folic
acid is the form in dietary supplements.
How much do we need of these vitamins?
Nutrient needs are broken down by gender, age group, pregnancy, and
lactation. New guidelines have also established a Tolerable Upper Intake
Level. So, for example, while the RDA for vitamin B6 for males and
females age 19-30 years is 1.3 mg/day, the Tolerable Upper Intake Level
for both is 100 mg/day, making it easier to provide recommended amounts.
RDA* Tolerable Upper Intake Level ** +
Vitamin B6***+ 1.7 mg/day 100 mg/day (age 19 and older)
Vitamin B12+ 2.4 mcg/day Not Determined
Folate + 400 mcg/day 1000 mcg/day
* Recommended Dietary Allowance
** The Tolerable Upper Intake Level is the maximum level of daily
nutrient intake that is likely to pose no risk of adverse effects, and
represents the total intake from food, water, and supplements.
*** Adults age 51 and older
+ not applicable if pregnant or lactating
Why do deficiencies occur, and what are signs of deficiencies?
Vitamin B6. Mild deficiencies of B6 are fairly common in the U.S.,
mostly because of dietary deficiencies, but sometimes due to use of
certain medications which interfere with B6, including hydralazine,
isoniazid, MAO inhibitors, penicillamine, and theophylline. (Conversely,
large amounts of B6 can interfere with the absorption of levodopa, an
important medication for Parkinson's disease. Current use of the
combinations of carbidopa-levodopa or benserazide-levodopa offset this
interaction for the most part; but use of supplements containing more
than 15 mg of B6 can overwhelm the protective effects of the carbidopa
and benserazide.)
Good food sources of B6 include chicken, fish, eggs, nuts and seeds,
dried beans and peas, soybeans, wheat germ, bananas, avocados, and
brewer's yeast. Also, some foods, including a number of breakfast
cereals, are fortified with B6.
Signs of B6 deficiency include irritability, depression, and confusion;
sore tongue, sores or ulcers of the mouth, and ulcers of the skin at the
corners of the mouth.
Vitamin B12. The human body stores this vitamin so well that it can
take a long time to deplete, sometimes several years. Nevertheless,
there are several reasons why people sometimes do experience deficiency. Animal foods are the only source of B12, therefore people who eat few or no animal products (meat, fish, poultry, eggs, milk) are at risk unless they use vitamin supplements.
Another problem is that B12 in foods cannot be absorbed by the body
until it is freed from the proteins in the food; the stomach produces an
acid that removes this protein. However, with age, we produce less and
less of this stomach acid. Many older adults don't produce enough acid
to allow them to absorb B12. Further, people who have acid reflux often
use medications that reduce stomach acid, which unfortunately also
decreases absorption of B12. Vitamin B12 is one of the few nutrients
that is better absorbed in pill form than from dietary sources.
Signs of B12 deficiency include numbness or a tingling "pins and
needles" sensation, or a burning feeling; a red, sore, or burning
tongue; loss of appetite; gait abnormalities, personality changes, an
Alzheimer-like dementia, psychosis, depression, and agitation,
particularly in older adults. Other signs are megaloblastic anemia, and
elevated serum homocysteine, in people of all ages. Researchers believe
that as many as 42% of people aged 65 and older may have some degree of B12 deficiency. Many people with PD are age 65 or older, and should be considered at risk and tested for B12 deficiency.
Folate. Folate is available in many foods: lima beans, brewer's yeast,
orange juice, dried beans, green peas, asparagus, beets, Brussels
sprouts, broccoli, corn, spinach and other dark green leafy vegetables,
soybeans, nuts and seeds. Further, the U.S. government requires that
food manufacturers fortify processed grain products with folic acid.
Yet, deficiencies of folate are not uncommon. This could be in part
because folate is another of the few nutrients in which the synthetic
form is absorbed much better (about 40 percent better) than the natural
form.
Because of the possibility of deficiency, women, including women with
PD, who are pregnant or wish to become pregnant are advised to take
supplements of folic acid; deficiencies can result in neural tube
defects in the unborn child.
Deficiencies of folate are also being increasingly studied for a
possible role in other diseases:
. A low intake of folic acid is associated with risk for colon cancer.
Chronic constipation, experienced by many people with PD, also increases
risk for colon cancer; it is prudent for those with PD to control
constipation and to be sure the diet is adequate in folate.
. A low level of folic acid in the blood is associated with higher
levels of serum homocysteine, a substance in the blood that may
contribute to heart disease, stroke, and dementias.
. Animal studies point to a link between low levels of folic acid and
Alzheimer's disease; and people with Alzheimer's are often found to have
low levels of folic acid. Some people with PD develop an Alzheimer-type
dementia. Again, prudence dictates consumption of adequate folate.
. Another study using mice found that folic acid deficiency led to
increased levels of homocysteine and symptoms of Parkinson's disease.
Researchers speculate that homocysteine may damage DNA in the substantia nigra, the area of the brain affected in Parkinson's disease.
. There are reports of improvement in restless leg syndrome (RLS) with
use of folate supplements; this has not as yet been studied thoroughly,
so it is too early to say whether there is a definite link. However,
people with PD often complain of RLS, and physicians should rule out the
possibility of folic acid deficiency.
Signs of folic acid deficiency include appetite loss, weight loss,
burning tongue, fatigue, weakness, shortness of breach, memory loss,
irritability, megaloblastic anemia, and increased levels of serum
homocysteine.
Should people with PD be concerned about these vitamins?
Although there are concerns, as mentioned above, that deserve further
study, it's too early to say definitely that these three vitamins are of
significance to people with PD. However, if you are over age 50 these
vitamins are of importance independently of PD. Furthermore, studies
have demonstrated that some people who use levodopa, considered the best medication for PD, develop elevated levels of serum homocysteine, due to the way in which the medication is metabolized. It is certainly a good idea to ask your doctor to test levels of serum homocysteine annually, and to check for signs of B vitamin deficiencies.
Should you take supplements?
There is growing agreement that older adults are at risk for nutrient
deficiency, whether PD is present or not, and that supplements can help.
. One study of older adults found that a multivitamin containing 100% of
the Daily Value improved low levels of several nutrients, including
vitamins B6, B12, and folate.
. A recent study in the United Kingdom suggests that folic acid intake
should be about three times that of the current recommendation for
elderly people.
. Other studies indicate that up to 10% of older adults with low-normal
levels of B12 are actually deficient and could benefit from supplements.
Because folate supplements can mask a B12 deficiency, it becomes extra
important to get enough B12 daily.
. The American Heart Association recommends a folate-rich diet to lower
homocysteine levels, and supplements of 2 mg B6, 400 mcg folic acid, and 6 mcg of B12 if dietary means are not sufficient to lower the
homocysteine.
For people with PD who use a medication that contains levodopa (such as
Sinemet, Madopar, Syndopa, Larodopa, etc.), you should be aware that
large amounts of vitamin B6 (more than 15 mg) can affect the absorption
of levodopa, by converting levodopa to dopamine in the stomach and
bloodstream. Dopamine cannot cross the blood-brain barrier, so it is
effectively blocked from its purpose.
Sinemet and Madopar contain either carbidopa or benserazide, which
"protect" the levodopa from B6; so ordinary supplements of B6 should not
be a problem for most people. However, very large amounts of B6, greater than 15 mg (and in sensitive persons, possibly as low as 10 mg), could overwhelm the protective effects of the carbidopa or benserazide. Such a supplement should be taken at bedtime with a light snack, or with meals at least two hours separately from levodopa.
In summary, older adults are acknowledged to be at increased risk for B
vitamin deficiencies. People with PD who are age 50 and over, therefore,
are at increased risk also. Whether younger people with PD should be
concerned about such deficiencies remains to be seen. A prudent and
rational approach for all those with PD is to:
. Discuss the possibility with their physicians, and to request tests
for B vitamin deficiencies
. Be aware of the signs of B vitamin deficiency
. Take a multivitamin/mineral supplement daily. Unless anemic, choose a
supplement that does not contain iron
. Take a B complex supplement if deficiencies occur; and take the
supplement separately from levodopa by at least two hours, preferably
with meals or a snack.
Knowledge is strength; awareness of dietary needs can prevent illness,
malnutrition, suffering, and hospitalization. If you have questions
about B vitamins or other nutrition or dietary needs, please visit the
National Parkinson Foundation website:
The above article may not be reproduced in any form except with
permission from the author.
References
Giovannucci, E. et al. Alcohol, low-methionine-low-folate diets, and
risk of colon cancer in men. Journal of the National Cancer Institute.
1995; volume 87: pages 265-273.
Kruman II, Kumaravel TS, Lohani A, Pedersen WA, Cutler RG, Kruman Y,
Haughey N, Lee J, Evans M, Mattson MP. Folic Acid deficiency and
homocysteine impair DNA repair in hippocampal neurons and sensitize them
to amyloid toxicity in experimental models of Alzheimer's disease. J
Neurosci 2002 Mar 1;22(5):1752-62.
Lobo A, Naso A, Arheart K, Kruger WD, Abou-Ghazala T, Alsous F, Nahlawi
M, Gupta A, Moustapha A, van Lente F, Jacobsen DW, Robinson K. Reduction
of homocysteine levels in coronary artery disease by low-dose folic acid
combined with vitamins B6 and B12. Am J Cardiol 1999 Mar 15;83(6):821-5.
Malinow, M.R. et al. Homocyst(e)ine, diet, and cardiovascular diseases:
a statement for healthcare professionals from the nutrition committee,
American Heart Association. Circulation. 1999; volume 99: pages 178-182.
Muller T, Werne B, Fowler B, Kuhn W. Nigral endothelial dysfunction,
homocysteine, and Parkinson's disease. Lancet. 1999 Jul
10;354(9173):126-7.
Muller T, Woitalla D, Hauptmann B, Fowler B, Kuhn W. Decrease of
methionine and S-adenosylmethionine and increase of homocysteine in
treated patients with Parkinson's disease.
Neurosci Lett. 2001 Jul 27;308(1):54-6.
Naurath HJ, Joosten E, Riezler R, Stabler SP, Allen RH, Lindenbaum J.
Effects of vitamin B12, folate, and vitamin B6 supplements in elderly
people with normal serum vitamin concentrations. Lancet 1995; 346:85-89.
O'Keeffe ST. Restless legs syndrome. A review. Arch Intern Med.
1996;156:243-248.
0 Report
Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
#2 teokimhoe
Advanced Member
Group:
Members Posts:
210 Joined:
03-March 07 LocationMalaysia Posted 02 August 2010 - 02:37 AM
Kathrynne Holden, MS, on 03 March 2007 - 10:07 AM, said:
Parkinson's, B6, B12, and Folate - What's the Connection?
Kathrynne Holden, MS, RD
Copyright 2000
Ms. Holden is a registered dietitian specializing in Parkinson's
disease. She has published research, books, articles, and manuals on
nutrition and PD, including "Eat well, stay well with Parkinson's
disease." She moderates the NPF forum Ask the Parkinson Dietitian at:
www.parkinson.org
In the past decade, there has been increasing interest among
researchers about the effects of three B vitamins - B6, B12, and folate.
We now know that deficiencies occur with greater frequency than ever
suspected previously, particularly in older adults. We also now know
that deficiencies, if not corrected, can result in irreversible damage
in some people. Some health professionals are beginning to suspect that
these three vitamins may be significant factors in Parkinson's disease.
What are B6, B12, and folate, and what do they do?
These are essential nutrients, meaning that they are vital to life.
These three vitamins work both independently and together in many of the body's systems.
Vitamin B6 assists in making hormones, new proteins, and
neurotransmitters ("messengers" between nerve cells) for the body's use.
It also helps release stored sugar when we need it for fuel. It works
together with B12 and folate to remove homocysteine from the blood.
Homocysteine is a substance increasingly associated with a number of
diseases; more about this later.
Vitamin B12 plays a role in the synthesis of DNA, needed for formation
of new red blood cells. It takes part in the manufacture of the myelin
sheath - the protective coating that surrounds nerve cells. With B6 and
folate it removes homocysteine from the blood.
Folate, also called folacin or folic acid, is a partner with B12 in DNA
synthesis and in removal of homocysteine, and is required in many other
vital processes. Without folate, B12 would be unable to complete many of
its functions, and vice versa. Folate is the form found in foods, folic
acid is the form in dietary supplements.
How much do we need of these vitamins?
Nutrient needs are broken down by gender, age group, pregnancy, and
lactation. New guidelines have also established a Tolerable Upper Intake
Level. So, for example, while the RDA for vitamin B6 for males and
females age 19-30 years is 1.3 mg/day, the Tolerable Upper Intake Level
for both is 100 mg/day, making it easier to provide recommended amounts.
RDA* Tolerable Upper Intake Level ** +
Vitamin B6***+ 1.7 mg/day 100 mg/day (age 19 and older)
Vitamin B12+ 2.4 mcg/day Not Determined
Folate + 400 mcg/day 1000 mcg/day
* Recommended Dietary Allowance
** The Tolerable Upper Intake Level is the maximum level of daily
nutrient intake that is likely to pose no risk of adverse effects, and
represents the total intake from food, water, and supplements.
*** Adults age 51 and older
+ not applicable if pregnant or lactating
Why do deficiencies occur, and what are signs of deficiencies?
Vitamin B6. Mild deficiencies of B6 are fairly common in the U.S.,
mostly because of dietary deficiencies, but sometimes due to use of
certain medications which interfere with B6, including hydralazine,
isoniazid, MAO inhibitors, penicillamine, and theophylline. (Conversely,
large amounts of B6 can interfere with the absorption of levodopa, an
important medication for Parkinson's disease. Current use of the
combinations of carbidopa-levodopa or benserazide-levodopa offset this
interaction for the most part; but use of supplements containing more
than 15 mg of B6 can overwhelm the protective effects of the carbidopa
and benserazide.)
Good food sources of B6 include chicken, fish, eggs, nuts and seeds,
dried beans and peas, soybeans, wheat germ, bananas, avocados, and
brewer's yeast. Also, some foods, including a number of breakfast
cereals, are fortified with B6.
Signs of B6 deficiency include irritability, depression, and confusion;
sore tongue, sores or ulcers of the mouth, and ulcers of the skin at the
corners of the mouth.
Vitamin B12. The human body stores this vitamin so well that it can
take a long time to deplete, sometimes several years. Nevertheless,
there are several reasons why people sometimes do experience deficiency. Animal foods are the only source of B12, therefore people who eat few or no animal products (meat, fish, poultry, eggs, milk) are at risk unless they use vitamin supplements.
Another problem is that B12 in foods cannot be absorbed by the body
until it is freed from the proteins in the food; the stomach produces an
acid that removes this protein. However, with age, we produce less and
less of this stomach acid. Many older adults don't produce enough acid
to allow them to absorb B12. Further, people who have acid reflux often
use medications that reduce stomach acid, which unfortunately also
decreases absorption of B12. Vitamin B12 is one of the few nutrients
that is better absorbed in pill form than from dietary sources.
Signs of B12 deficiency include numbness or a tingling "pins and
needles" sensation, or a burning feeling; a red, sore, or burning
tongue; loss of appetite; gait abnormalities, personality changes, an
Alzheimer-like dementia, psychosis, depression, and agitation,
particularly in older adults. Other signs are megaloblastic anemia, and
elevated serum homocysteine, in people of all ages. Researchers believe
that as many as 42% of people aged 65 and older may have some degree of B12 deficiency. Many people with PD are age 65 or older, and should be considered at risk and tested for B12 deficiency.
Folate. Folate is available in many foods: lima beans, brewer's yeast,
orange juice, dried beans, green peas, asparagus, beets, Brussels
sprouts, broccoli, corn, spinach and other dark green leafy vegetables,
soybeans, nuts and seeds. Further, the U.S. government requires that
food manufacturers fortify processed grain products with folic acid.
Yet, deficiencies of folate are not uncommon. This could be in part
because folate is another of the few nutrients in which the synthetic
form is absorbed much better (about 40 percent better) than the natural
form.
Because of the possibility of deficiency, women, including women with
PD, who are pregnant or wish to become pregnant are advised to take
supplements of folic acid; deficiencies can result in neural tube
defects in the unborn child.
Deficiencies of folate are also being increasingly studied for a
possible role in other diseases:
. A low intake of folic acid is associated with risk for colon cancer.
Chronic constipation, experienced by many people with PD, also increases
risk for colon cancer; it is prudent for those with PD to control
constipation and to be sure the diet is adequate in folate.
. A low level of folic acid in the blood is associated with higher
levels of serum homocysteine, a substance in the blood that may
contribute to heart disease, stroke, and dementias.
. Animal studies point to a link between low levels of folic acid and
Alzheimer's disease; and people with Alzheimer's are often found to have
low levels of folic acid. Some people with PD develop an Alzheimer-type
dementia. Again, prudence dictates consumption of adequate folate.
. Another study using mice found that folic acid deficiency led to
increased levels of homocysteine and symptoms of Parkinson's disease.
Researchers speculate that homocysteine may damage DNA in the substantia nigra, the area of the brain affected in Parkinson's disease.
. There are reports of improvement in restless leg syndrome (RLS) with
use of folate supplements; this has not as yet been studied thoroughly,
so it is too early to say whether there is a definite link. However,
people with PD often complain of RLS, and physicians should rule out the
possibility of folic acid deficiency.
Signs of folic acid deficiency include appetite loss, weight loss,
burning tongue, fatigue, weakness, shortness of breach, memory loss,
irritability, megaloblastic anemia, and increased levels of serum
homocysteine.
Should people with PD be concerned about these vitamins?
Although there are concerns, as mentioned above, that deserve further
study, it's too early to say definitely that these three vitamins are of
significance to people with PD. However, if you are over age 50 these
vitamins are of importance independently of PD. Furthermore, studies
have demonstrated that some people who use levodopa, considered the best medication for PD, develop elevated levels of serum homocysteine, due to the way in which the medication is metabolized. It is certainly a good idea to ask your doctor to test levels of serum homocysteine annually, and to check for signs of B vitamin deficiencies.
Should you take supplements?
There is growing agreement that older adults are at risk for nutrient
deficiency, whether PD is present or not, and that supplements can help.
. One study of older adults found that a multivitamin containing 100% of
the Daily Value improved low levels of several nutrients, including
vitamins B6, B12, and folate.
. A recent study in the United Kingdom suggests that folic acid intake
should be about three times that of the current recommendation for
elderly people.
. Other studies indicate that up to 10% of older adults with low-normal
levels of B12 are actually deficient and could benefit from supplements.
Because folate supplements can mask a B12 deficiency, it becomes extra
important to get enough B12 daily.
. The American Heart Association recommends a folate-rich diet to lower
homocysteine levels, and supplements of 2 mg B6, 400 mcg folic acid, and 6 mcg of B12 if dietary means are not sufficient to lower the
homocysteine.
For people with PD who use a medication that contains levodopa (such as
Sinemet, Madopar, Syndopa, Larodopa, etc.), you should be aware that
large amounts of vitamin B6 (more than 15 mg) can affect the absorption
of levodopa, by converting levodopa to dopamine in the stomach and
bloodstream. Dopamine cannot cross the blood-brain barrier, so it is
effectively blocked from its purpose.
Sinemet and Madopar contain either carbidopa or benserazide, which
"protect" the levodopa from B6; so ordinary supplements of B6 should not
be a problem for most people. However, very large amounts of B6, greater than 15 mg (and in sensitive persons, possibly as low as 10 mg), could overwhelm the protective effects of the carbidopa or benserazide. Such a supplement should be taken at bedtime with a light snack, or with meals at least two hours separately from levodopa.
In summary, older adults are acknowledged to be at increased risk for B
vitamin deficiencies. People with PD who are age 50 and over, therefore,
are at increased risk also. Whether younger people with PD should be
concerned about such deficiencies remains to be seen. A prudent and
rational approach for all those with PD is to:
. Discuss the possibility with their physicians, and to request tests
for B vitamin deficiencies
. Be aware of the signs of B vitamin deficiency
. Take a multivitamin/mineral supplement daily. Unless anemic, choose a
supplement that does not contain iron
. Take a B complex supplement if deficiencies occur; and take the
supplement separately from levodopa by at least two hours, preferably
with meals or a snack.
Knowledge is strength; awareness of dietary needs can prevent illness,
malnutrition, suffering, and hospitalization. If you have questions
about B vitamins or other nutrition or dietary needs, please visit the
National Parkinson Foundation website:
The above article may not be reproduced in any form except with
permission from the author.
References
Giovannucci, E. et al. Alcohol, low-methionine-low-folate diets, and
risk of colon cancer in men. Journal of the National Cancer Institute.
1995; volume 87: pages 265-273.
Kruman II, Kumaravel TS, Lohani A, Pedersen WA, Cutler RG, Kruman Y,
Haughey N, Lee J, Evans M, Mattson MP. Folic Acid deficiency and
homocysteine impair DNA repair in hippocampal neurons and sensitize them
to amyloid toxicity in experimental models of Alzheimer's disease. J
Neurosci 2002 Mar 1;22(5):1752-62.
Lobo A, Naso A, Arheart K, Kruger WD, Abou-Ghazala T, Alsous F, Nahlawi
M, Gupta A, Moustapha A, van Lente F, Jacobsen DW, Robinson K. Reduction
of homocysteine levels in coronary artery disease by low-dose folic acid
combined with vitamins B6 and B12. Am J Cardiol 1999 Mar 15;83(6):821-5.
Malinow, M.R. et al. Homocyst(e)ine, diet, and cardiovascular diseases:
a statement for healthcare professionals from the nutrition committee,
American Heart Association. Circulation. 1999; volume 99: pages 178-182.
Muller T, Werne B, Fowler B, Kuhn W. Nigral endothelial dysfunction,
homocysteine, and Parkinson's disease. Lancet. 1999 Jul
10;354(9173):126-7.
Muller T, Woitalla D, Hauptmann B, Fowler B, Kuhn W. Decrease of
methionine and S-adenosylmethionine and increase of homocysteine in
treated patients with Parkinson's disease.
Neurosci Lett. 2001 Jul 27;308(1):54-6.
Naurath HJ, Joosten E, Riezler R, Stabler SP, Allen RH, Lindenbaum J.
Effects of vitamin B12, folate, and vitamin B6 supplements in elderly
people with normal serum vitamin concentrations. Lancet 1995; 346:85-89.
O'Keeffe ST. Restless legs syndrome. A review. Arch Intern Med.
1996;156:243-248.
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit Delete
--------------------------------------------------------------------------------
#3 teokimhoe
Advanced Member
Group:
Members Posts:
210 Joined:
03-March 07 LocationMalaysia Posted 02 August 2010 - 02:54 AM
Thank you for your interesting artiles.
There are some Parkinson's patiemts do not have trouble with B6, B12 and Folate interaction and side effects with Parkinson's medication.
I only have side efffect dizziness,nausea,irregular blood pressure with B6, B12 and folate with PD medication after I have T.I.A (minor stroke)as I am taking for years
As parkinson's diseaes is a boutique disease there are different symptoms from one after by ohter.
Some patients have interaction and side effects with PD medication on medications for other disease.
Kindly clarify
Regards
TEOKIMHOE
to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0 Report
Back to top of the page up there ^
MultiQuote
Reply Edit Delete
--------------------------------------------------------------------------------
#4 Kathrynne Holden, MS
Advanced Member
Group:
Ask the Dietician Moderators Posts:
446 Joined:
22-January 07 Locationwww.nutritionucanlivewith.com Posted Yesterday, 11:46 AM
Dear Mr. Teo,
You make a very good point – PD is often referred to as a “designer disease” because it affects each person differently.
Long-time users of levodopa have sometimes been found to have elevated levels of homocysteine, a substance in the blood that is associated with stroke. As you mention, these three B vitamins, B6, B12, and folate, together will normally remove homocysteine from the blood, and this may be why your doctor advised you to take them following your stroke.
You are the first person I have heard of who has experienced side effects of dizziness, nausea, or irregular blood pressure with use of these B vitamins. To the best of my knowledge, they would not ordinarily affect either PD itself or interact with PD medications. In your case, therefore, your personal physician is the proper health professional to address this matter. S/he has your medical records, medical history, family history, lab findings, and other data needed to determine your treatment.
Best regards,
Kathrynne Holden, MS
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
0 Report
Back to top of the page up there ^
MultiQuote
Reply
--------------------------------------------------------------------------------
Currently viewing all posts. Change threshold?
Hide posts below View all posts 20 points 10 points 0 points -10 points -20 points
Forum Home Forum Information |-- Discussion Corner Announcements |-- NPF Forum Member Service Center |---- Helpful User Information Medical Questions |-- Ask The Doctor |---- Archive - 2009 Posts of the Week |---- Archive - 2010 Posts of the Week |-- Ask The Surgical Team |-- Ask about Nutrition |-- Ask the Pharmacist |-- Pregúntele al Médico |-- Talk To A Speech Clinician Unmoderated Discussion |-- Open Forum |-- Caregivers Forum |-- Young Onset Forum NPF Affiliate Discussion |-- NPF Center Discussion |-- NPF Chapter Discussion |-- Community Partners for Parkinson Care Discussion
← Previous TopicAsk about NutritionNext Topic →Share this topic:
Page 1 of 1
Start a new topic Add Reply
--------------------------------------------------------------------------------
1 User(s) are reading this topic
1 members, 0 guests, 0 anonymous users
teokimhoe.Delete PostRemove From View The post may still be visible to moderators in this topic
Reason:
Delete From Topic The post will be removed from this topic completely
Skin and Language
Theme: IP.Board Mobile NPF Language: English (USA) Execution Stats
Time Now: Aug 08 2010 07:47 AM
Last Visit: Today, 06:14 AM
.Back to topForum HomeDelete My CookiesMark Board As ReadCommunity Forum Software by IP.Board 3.1.0
--------------------------------------------------------------------------------
NPF ForumsRSS FeedsYouTubeFacebookTwitterContact UsPress & Media KitDisclaimerSite Map
800.327.4545
© 2010 National Parkinson Foundation | Privacy & Terms of Use
.
Subscribe to:
Posts (Atom)