ADD/ADHD, Attention Deficit and Hyperactivity Disorders: Understanding, Reversing, and Preventing with Complementary Medicine

Paul Reller, L.Ac.

The incidence of Attention Deficit and Hyperactivity Disorders has risen dramatically in the United States in the last two decades. Many of the patients that seek medical help with this problem are adults, although most of the attention in the press concerns the problem with children. Many adult patients are still affected at work and at home with problems of cognitive focus and related problems despite having taken medications when they were young. Extensive research in this field has produced much clinically relevant information concerning nutrient and herbal therapy, dietary changes, clearing of environmental toxins and heavy metals, as well as proof that acupuncture is itself an effective potential neurostimulant. Studies utilizing functional MRI have proven that the correct acupuncture stimulation does increase activity in specific centers of the brain. Many patients are now investigating and utilizing these advances in Complementary Medicine to insure a greater chance of success in treatment of ADHD and neurodegeneration.

The CDC, or Center for Disease Control, in 2003, stated that prevalence of ADHD in school-aged children ranges from 2-18% in various community samples, and it notes that substantial health risks might be associated with medication. These health risks include psychosis with long-term use, as well as increased risk of future drug addiction, and short-term side effects include high incidence of nervousness and insomnia. The medication typically prescribed is an amphetamine, Methylphenidate, commonly known by the trade names Ritalin, Attenta, Methylin, Equasim, Rubifen, or Concerta, and it works by increasing the neuroinhibitor dopamine in the brain. The original name for ADHD disorder in the 1960s was Minimal Brain Dysfunction, which reflects recent findings that ADHD is indeed a neurodegenerative disorder. While Methylpenidate may relieve some of the hyperactivity and attention deficit symptoms, it does not actually reverse the neurodegeneration that we see in this disorder. There are few quality clinical trials to evaluate the long-term effects of these stimulants, and studies on animals suggest that long-term use could adversely affect the dopaminergic system in the brain and produce eventual adverse effects on brain development in many patients. Complementary Medicine offers a more thorough approach to this neurodegenerative health problem that could help the ADHD patient to reverse neurodegeneration and reduce dependancy on symptom-relieving medication and its risks and side effects.

“To date, no study has found any long-term benefit of attention-deficit medication on academic performance, peer relationships or behavior problems, the very things we would most want to improve. Until recently, most studies of these drugs had not been properly randomized and some of them had other methodological flaws. But in 2009, findings were published from a well-controlled study that had been going on for more than a decade, and the results were very clear...At first this study suggested that medication, or medication plus therapy (cognitive-behavioral), produced the best results. However, after three years, these effects had faded, and by eight years there was no evidence that medication produced any academic or behavioral benefits.” L. Alan Stroufe, professor emeritus of psychology at the University of Minnesota’s Institute of Child Development, quoted in a January 29, 2012 article in the New York Times entitled Ritalin Gone Wrong.

Rates of ADHD incidence in the United States vary significantly between regions, but are generally noted as 5-10 times greater than in other countries. This is because many aspects of our nation's environment have gone unregulated regarding serious known causes of neurodegeneration. Lead and mercury toxin in the form of carbon compounds carried in gaseous states from dirty coal-fired power plants and smelters are now recognized as a significant cause of neurodegeneration in the entire population. You might read the section on Lead and Mercury toxicity on this website to access EPA reports etc. Commercial food production has also gone unregulated and allowed to foist harmful ingredients onto the population, such as processed sugars and transfats that are implicated in severe problems with advanced glycation endproducts (AGEs) and imbalances related to essential fatty acid deficiencies.

There are many causative links to the various problems that may result in significant neurodegeneration. Since this health problem is multifactorial, there is no way to connect specific problems and environmental threats linearly in data analysis. Because of the complexity of the disorder, a specific cause of neurodegeneration will affect one part of the population more than another, depending upon the whole array of health problems with these individuals. This is why we see some individuals exposed to unhealth dietary habits without symptoms. This problem of a simple direct data link does not negate the health threats, and scientists are now working on a more complex and holistic system of analysis. The individual patient needs to maintain an objective view and work to decrease all of these threats to neurological health, in oneself, and in the whole population. Ignoring health threats does not make them go away.

The entire population is affected by the causes of neurodegeneration, although most of us do not have symptoms significant enough to warrant concern. We need to understand that symptoms are often like the tip of an iceberg. The real threat to navigation in life is the body of the iceberg below the surface. By the time you see the tip protruding from the water, it may be too late. The time to understand, treat, and prevent neurodegenerative threats to your health is now. Waiting until old age and the onset of Alzheimer's or Parkinsonism is not a wise choice. You can now take advantage of all of the research performed to understand ADHD and neurodegenerative conditions by utilizing a knowledgeable Complementary Medicine physician, such as a Licensed Acupuncturist that is also skilled and educated in herbal and nutrient medicine. Neurological health is no different than the health of your cardiovascular or digestive system, and should carry no stigma prompting avoidance of proper health maintenance.

For a more complete understanding of ADHD and neurodegenerative conditions, go to the article on this website entitled Parkinson's, Alzheimer's, ADD and other Neurodegenerative Conditions. Understanding your health problem is the key to an effective proactive approach to cure and management. You may not be able to understand all of the science and physiology of your health problems, but whatever level of understanding you achieve, this will be the most important aspect of your health care. The patient is always the primary person involved in effective health care treatment and health maintenance. Your other physicians are here to help you with your goals, and hopefully can integrate their care and advice in the most efficient manner.

There is an underlying link to many of the common health problems now affecting up to a fifth of the population, and this concerns gradual focal degeneration of the central nervous system. Whether your child is affected by attention deficit and hyperactivity disorder, you are bothered by problems with attention span, or your parents are diagnosed with Alzheimer's or a Parkinson's disorder, the health concern is a complex and multifaceted problem that concerns the health maintenance of the tissues and function of our brain.

It is now confirmed with scientific study and measurement that ADD and ADHD involves neurodegeneration. Modern imaging techniques allow scientists to measure both volume and function of sections of the brain involved with our cognitive control of attention span and hyperactivity of the brain. These studies confirm that patients with a chronic history of ADHD and ADD, no matter what the age, consistently reveal a decrease in size of these brain centers, as well as decrease in function. The knowledge that we now have of the physiology of neurotransmitter production, neurohormonal connection, cell receptors, and regulatory proteins has revealed that the problems in ADHD concern a complex health problem associated with oxidant stress, metabolic disorder, circulatory problems, and hormonal imbalance. The key to correcting this problem is to take a holistic approach to correct and improve all of these systems in the body. An individualized approach is also necessary, as the overall problem is very complex, and a one-size-fits-all assembly line medical approach will not work on a majority of patients. Seeking expert advice and management of your health treatment, maintenance or prevention is the smart choice.

An array of environmental causes may contribute to ADD and ADHD

What are the causes or contributors to attention deficit and hyperactivity at an early age? ADHD has also proven to be a neurodegenerative condition, even at an early age. We all know by now of the growing problem of hyperactivity in children and the treatment with the dopamine reuptake inhibitor Ritalin, an amphetamine, that is also used to treat adult ADHD. Clinical blinded placebo trials have shown that such chemicals as artificial food coloring and sulfite and benzoate preservatives have increased hyperactivity in children diagnosed with the disorder. Studies at Washington University in St. Louis, and at the University of Southamtpon in England gave proof that these common food additives worsened hyperactive behavior in children, and that removal of these chemicals from the diet improved the ADHD (The Lancet 370(9598):1560-7; McCann D et al). Subsequent investigation by the NIH resulted in an announcement of unclear conclusions regarding this subject, but acknowledgement of risks with chemical food additives in almost all commercial food products is not expected. How do benzoate preservatives and artificial food dyes contribute to neurodegenerative pathology? Once again, the answer is complicated, but a few key points elucidate the basic process. Read on.

Benzoic acid, a common food preservative, has been demonstrated to cause oxidative stress. These preservative acids also have a negative consequence on cellular membranes, that both act to insure effective metabolism at dopamine receptors, and to protect the cell from environmental cytotoxins that enter the bloodstream. Cell membranes protect the mitochondria in our brain cells, the small oxygen factories that supply energy to our cells, and which are the subject of much study of the root of neurodegeneration. While organic food preservative acids, such as benzoic and sorbic acid, are stable, or cytostatic, under conditions used for food preservation, they may cause a disruption of the cellular plasma membrane and cause a cytocidal effect when they reach our brain, especially under acidic conditions in the body. Acidity in the body is increased when there is too much intake of simple carbohydrates like sugar, refined grain, beer, granola, etc. Periods of high body acidity may also occur with poor stomach function, or poor hormonal regulation of key antacids, such as calcium. High body acidity may make benzoic acid food presersetives toxic and damaging to our brain cells.

High intake of benzoic acid preservative, coupled with a lack of healthy fats, or lipids, that make up the phospholipid membranes, and with a deficiency of oxidative potential to clear the damage, results in neurodegenerative cell death and functional cell membrane disruption that may occur at an early age. As mentioned, advanced glycation endproducts (AGEs) are also a dietary and metabolic problem that affects healthy cell membranes. When children eat too much processed food with these ingredients, it is easy to understand how the health of their brain cells are damaged. The problem in children is probably easily reversed by sticking to a healthy diet that avoids preservatives and food dyes, transfats, and simple carbohydrates, and includes sufficient antioxidant foods and omega-3 fatty acids. Even parents that believe that they are keeping their children's diet healthy are sometimes mistaken, as large intake of fructose, in the form of fruit juices and supposedly healthy carbonate beverages, can create an excess of AGEs. Over time, without ingredients for cellular repair, such as antioxidants, essential fatty acids, attention deficit and hyperacitivity disorder may become chronic. All scientific studies of neurodegeneration now demonstrate a measurable decrease in tissue quantity in key areas of the brain that are the result of this type of cellular damage, utilizing newer functional MRI imaging. This objective data is irrefutable.

The study of artifical food coloring in food causing or contributing to ADHD has produced no definitive chemical cause, but studies and clinical reports of observed effects on children with hyperactivity disorders are now numerous, and in 2011, the FDA is again asking a panel of experts to review the scientific literature and advise on a possible increased warning or even ban of many of these chemicals. Most or the artificial dyes and colorings in food were approved by the federal government in the 1930s, prior to the creation of the modern federal food and drug administration, and a number of common food dyes have been found toxic and banned in the U.S. in the past. So far, little evidence has been found to directly link specific chemicals to specific harmful effects, and experts believe that the future research will reveal how these chemicals work in tandem with other environmental chemicals or physiological problems in the brain. The concern surrounding these artifical food dyes has prompted some major food chains, such as Whole Foods and Trader Joes, to refuse to sell foods with artifical coloring. Since these bright food colors are very appealing to children, the industry is fighting regulation with much money. The Center for Science in the Public Interest is pushing heavily for a stronger FDA response, citing recent research linking a worsening of ADHD in children with these food chemicals. FDA researchers state that this research is very difficult to interpret, and standard methods of scientific evaluation have not delivered a clear and specific link between artificial food colorings and the pathology of ADHD in the broad population.

The study of various chemical food additives on neurotoxicity is now extensive, and experts in the field, when reviewing many large studies, find that the potential for neurotoxicity of a wide variety of synthetic food chemicals is indeed confirmed. Large studies have shown repeatedly that decrease or elimination of certain of these food additives has both shown a decrease in symptoms of ADHD patients, and has apparently improved cognitive function in the broad population. In 1986, a dietary policy of lowered sucrose, synthetic food colors and flavors, and two preservatives (BHA and BHT) over 4 years in 803 public schools in New York was followed with a 15.7% increase in mean academic percentile ranking above the rest of the nation's schools who used the same standardized tests. Prior to this dietary policy, these schools had not shown any deviation from the national standards (Int J Biosocial Res; 1986; 8(2): 185-195). Other studies since this time have duplicated such findings. A variety of studies have found specific physiological defects that would explain the pathophysiology, such as differences in protein enzymes that degrade histamine in the brain, and other aspects of oxidative stress that are affected by various of these chemicals. fMRI studies of brain activity associated with these provoking foods also demonstrated a physicological explanation, or association. Studies at prestigious medical schools have shown a significant improvement in severe ADHD symptoms with a modified ketogenic diet, as well. The ketogenic diet has long been proven to effectively treat epilepsy, even in children that do not respond to standard medications (see the article on this website entitled Nutritional Healing in Standard Medicine). While extreme diets are difficult to adhere to, these studies do show that modification of the diet, and eating fresh whole foods, while avoiding processed foods, may be an important part of the overall treatment strategy.

All of the above causes of neurodegeneration leave our bodies more susceptible to inflammatory degeneration. Most studies of neurodegenerative disorders now focus on excess inflammatory processes and lack of oxidative clearance as the prime problem in neurodegeneration. Studies show that increased exposure to viral illnesses, and the penetration of some strains of these viruses deep into the organ tissues, generates excessive lipopolysaccharides that are released from antigen cell walls, and increase pro-inflammatory cytokines such as interleukin-1 (IL-1). The chronic increases expression of IL-1 has been shown to have both direct and indirect mechanisms that exacerbate neurodegeneration of dopaminergic neurons. IL-1 directly triggers 6-OHDA-triggered dopaminergic toxicity, and increases oxidative stress. Lipopolysaccharides were found to directly accelerate and increase motor signs in study animals, showing a positive link to direct hyperactivity cause. We can't completely eliminate the viral illness from our world, but we can work to create a healthier response to viral illnesses in our bodies.

In summary, the known history of causes of increased incidence of neurodegenerative disorders in the United States population include unhealthy ingredients in commercial processed foods that go unregulated, increasing amounts of lead, mercury and other heavy metal organic compounds, primarily from dirty coal fired power plants that go unregulated, and the increased oxidative stress and decreased immune health generated by our modern lifestyle, diet, and environment. As individuals, and as a population, we can change these harmful aspects of our world now, and clean up both our own bodies, and the environment. By utilizing Complementary Medicine, understanding and improving our habits, and urging our politicians to act now, future generations as well as our own will benefit immensely.

Complementary Medicine utilizes a number of treatment strategies to affect these disease mechanisms in neurodegenerative disorders. Antioxidant herbs and supplements are utilized, 5HTP from the griffonia seed may be prescribed, and acupuncture may reduce stress levels and benefit adrenal function. Hormonal balance can be analyzed inexpensively in labs that test saliva or bloodstick samples, and topical creams that adjust hormonal levels with very safe low dosage herbal extracts can be utilized. Evidence-based herbal medicine allows the acupuncturist/herbalist to utilize dopaminergic herbs in treatment. Nutritional knowledge helps the Licensed Acupuncturist to effectively guide changes in dietary habits that specifically work for the individual. A number of herbal chemicals have been proven effective as a part of the therapy for various neurodegenerative disorders, such as Huperzine, and these may be incorporated into the overall treatment protocol. Since the disease mechanism is complicated, logic dictates that the treatment protocol will also be complicated. The Licensed Acupuncturist, utilizing Complementary Medicine, can integrate effectively with the M.D. specialists and help make the right choices to narrow this complicated treatment strategy and find the most efficient treatment for each individual. Quality of herbal and nutrient products is also important, and FDA regulation is almost nonexistent. The Licensed Acupuncturist has access to professional products that insure quality and reliable effectiveness.

ADD and ADHD, Attention Deficit and Attention Deficit Hyperactivity Disorder, may also be neurodegenerative conditions with a similar pathological concern to the more well known neurodegenerative diseases, Parkinsons and Alzheimers, although different in manifestation of symptoms

Attention deficit and hyperactivity disorder has been linked to dysfunction with the D3 dopamine receptors, but the pathology is still poorly understood. Neural degeneration, or metabolic dysfunction related to dopamine enzymes, both could be causative of ADHD disorder, and this is demonstrated by the neuroimaging studies demonstrating atrophy or size decrease in key areas of the brain in ADHD patient populations, as well as the metabolic studies, such as those that demonstrate that excess benzoic acid (food preservative) may induce protein kinase A (PKA) pathways that are autophagic (self-destructive) in a nitrogen starved cellular metabolism. Certain areas of the brain associated with ADHD have been found to consistently smaller than normal in patients both young and old that have been afflicted with ADHD. Hyperactivity in these areas of the brain, which leads to short attention span, is a result of overstimulation of dopamine D3 receptors due to a decrease in the number of these D3 receptors overall.

The reasons for loss of the dopamine D3 receptors and neurodegenerative atrophy of these areas of the brain associated with functions of attention span, memory, control of muscle spasticity etc. are the subject of current study, and may reveal more and more novel ways to utilize Complementary Medicine in a long-term treatment protocol. G-proteins are immunoglobulin (Ig)-binding proteins produced in chronic low grade infections and allergic immune responses. G-protein coupled receptors are stimulated by a variety of chemicals in the brain, including neurotransmitters such as dopamine, hormones, light-sensitive compounds, odors and pheromones. Neurohormonal imbalance as well as hypersensitivity disorder may stimulate G-protein receptors that are overexpressed due to chronic deep subclinical infections. Since parts of these G-protein receptors can be glycosylated, excess accumulation of advanced glycosylation endproducts (AGEs) are also a known cause of dysfunction (see my article on AGEs under For Practitioners - Treatment Protocols). Overexpression of G-protein coupled receptors then produces excess accumulation of G-proteins and may cause deficiency of dopamine. Activation of dopamine D3 receptors by excess G-proteins inhibits the enzyme adenylyl cyclase, a second messenger, causing dysfunction and desensitization of a percentage of dopamine D3 receptors. In ADHD, as in Parkinson's, loss of a percentage of these neurons or receptors could have led to overactive stimulation of the surviving healthy neurons, causing hyperactivity of the mind as well as attention deficit. The goals of therapy must not be to just block specific functions in the brain with drugs, but to actually work in a comprehensive manner to stop the disease mechanisms and restore healthy cells and function to the parts of the brain that have suffered neurodegeneration.

Ritalin, or methylphenidate, is a norepinephrine and dopamine reuptake inhibitor, which means that it works by increasing the level of dopamine stimulation. Ritalin only works in the ADHD patient when levels of an important neurotransmitter, Phenylethylamine (PEA), is increased. It has been established that Ritalin acts by stimulation of parts of the brain that have become underactive, possibly due to neural degeneration. Phenylethylamine is a trace neurotransmitter that is biosynthesized in the neural cells from the amino acid phenylalanine by enzymatic decarboxylation. Dietary sources of phenylethylamine do not reach the brain because they are quickly broken down by the enzyme MAO-B. Increase in cell production of PEA is probably best aided by healthier protein metabolism, or liver function. Stories about how chocolate contains PEA and is beneficial are thus misleading. Chemicals that are similar to phenylethylamines and are substituted may cause dysfunction in cellular metabolism of the real phenylethylamine in the brain. These chemicals include the drug ecstasy (MDMA), mescaline, ephedrine, amphetamines, Phen-fen, various anti-depressants, and some bronchodilators. We see that the potential for environmental and drug causes of ADHD are widespread and common. Even the taking of Ritalin, or the other drugs that treat ADHD, requires that healthy neural function, and increase in PEA, is achieved. This gives new meaning to the term 'PEA-brain'. Complementary Medicine can even help the patient taking these pharmaceuticals achieve better results.

Deficient decarboxylation via protein enzymes may be an important part of the pathophysiology of these various neurodegenerative disorders. Decarboxylation refers to the removal of carbon dioxide waste from the cell. Deficiency of enzymatic decarboxylation will not only result in low levels of the essential neurotransmitter phenylethylamine, but results in deficient metabolism of a number of key transformations of amino acids to amines in the brain. Tryptophan to tryptamine, tyrosine to tyramine, glutamic acid to GABA, 5-HTP to serotonin, and L-DOPA to dopamine are are regulated by decarboxylation. Deficiency of copper may decrease the rate of decarboxylation, as copper, and various ketones, are natural catalysts of decarboxylation. Chronic kidney deficiency could play a role in reduced ketone catalysts as well. Relative states of acidity could also play a key role in decarboxylase enzyme rates. A number of factors could influence this key metabolic function, and only a holistic approach can bring the whole organism back to proper function, or homeostasis.

Oxidative decarboxylation is a vital part of the metabolism of the citric acid cycle within the mitochondria of neurons that are subject to oxidative damage and neurodegeneration. Both antioxidant metabolism and supply of sufficient oxygen via adequate microcirculation are important to mitochondrial function in brain cells. One molecule produced by decarboxylation is histamine. Histamine dilates capillaries and increases capillary permeability to supply sufficient oxygen to brain cells. Histamine has different effects on different receptors in the body. In the stomach, histamine stimulates gastric secretions, while in the sinuses it stimulates swelling and congestion in allergic response. Chronic use of antihistamine medications, with allergy meds, asthma meds, or medications to control stomach acids, are well known causes of side effects in the central nervous system. Overuse of antihistamines may contribute heavily to the pathology of neurodegenerative disease.

Another subject of research concerning neurodegeneration and ADHD, Parkinson's and Alzheimer's diseases is the subject of cannabinoids. Cannibinoids are not only found in marijuana, but are endogenously produced in everyone's brain to control mood swings, pain perception, etc. One large long-term study at six universities across the world showed that a patient population that had a history of marijuana smoking exhibited a 15% decrease in risk of developing Parkinson's disease. Not everyone smokes pot, but everyone does produce cannibinoids in their brain. Endocannabinoids are important molecules produced in the brain that moderate symptoms of Parkinson's, and are also activated by decarboxylation. By enhancing decarboxylation metabolism in the ways mentioned above, and by other natural means, we may be able to prevent or reverse neurodegenerative disease in many patients. Although this is only one of the metabolic factors being researched at present, it may hold the key to reversal of neurodegenerative changes.

Can herbal medicine affect these metabolic pathways, such as rates of decarboxylation? Although study is still underfunded in the West, and studies of herbal chemistry are still underpublished here, much research in China shows the potential for such herbal chemical benefits. Astragalus was studied in 2002 and shown to promote cell differentiation by means of inducing ornithine decarboxylase in animal studies. http://www.ncbi.nlm.nih.gov/pubmed/12585191. Myrrh is used in Chinese herbalism to speed tissue healing, and British research has revealed that it is able to increase dopamine-beta-decarboxylation. As research continues to reveal specific herbal remedies to these complex disease pathways of ADD and ADHD, these herbal chemicals need to be part of a more thorough and holistic individualized treatment protocol. Experts in the field are beginning to realize the potential for integration of this strategy. This statement from the University of Johannesburg, South Africa, in 2011, shows that University medical faculties are expanding their views to integrate effective Complementary Medicine: click to see this link: http://www.ncbi.nlm.nih.gov/pubmed/22214252 . In the United States, as well, parents have initiated a serious change in the treatment strategies and prompted improved research into Complementary Medicine. This statement in 2008 from Wayne State University School of Medicine, in Detroit, Michigan, demonstrates the rise in acceptance of Complementary Medicine by health care providers, prompted by a demand from parents: http://www.ncbi.nlm.nih.gov/pubmed/18822835 . Although skepticism is still the norm, more and more herbal protocols are being recognized as effective in the treatment of ADD and ADHD. Two very safe, gentle and effective herbal tinctures, Bacopa moniera (brahmi) and Piper methysticum (kava) have been recognized by University medical researchers, as well as lignans from pine bark (Pycnogenol), krill oil (omega-3 EPA and DHA rich), zinc monomethionine, natural iron supplements, acetyl-L-carnitine, Hypericum perforatum (St. Johns Wort), and Gingko biloba, as well as a Chinese herbal formula called Ningdong. To see this meta-review from 2011 by the University of Melbourne Department of Psychiatry, click on this link: http://www.ncbi.nlm.nih.gov/pubmed/21827936 . Study of this typical Chinese herbal formula to treat neurodegenerative conditions and hyperactivity, such as Tourette’s Syndrome, Ningdong Granula, revealed that this herbal formula could increase the HVA content in the brain sera, downregulate the expression of dopamine type 2 receptors, and inhibit hyperactivity behaviors in animal studies. Contstituent chemicals, such as homovanillic acid, are shown to be potent antioxidants. This formula is composed of 8 common Chinese herbs, and variations of the formula are widely used in professional prescription in TCM. Controlled human trials have found the formula to be as effective as Ritalin in treatment of ADHD (Psychopharmacology (Berl) 2011 Mar 18; Li JJ Li ZW).

Lack of protection from oxidative stress seems a key to most of theories concerned with the gradual worsening of these parts of the brain. Oxidative stress may increase due to accumulations of toxic heavy metals in the tissues, misshapen proteins, or sticky plaque, accumulation, or excess stimulation of G-protein second messengers by adrenal hormones or other hormonal imbalances. These are just some of the metabolic stresses that result in excess metabolic oxidant free radicals and require increased antioxidant metabolism to clear. Transient ischemic attacks, or TIAs, often go unnoticed in the population, and studies reveal that the amount of neural cell death that results may occur over a number of days, and is related to the lack of antioxidant protection in different areas of the brain. Lead and mercury toxicity has been proven to cause neurodegeneration, and is an ubiquitous environnmental toxin due to the tones of organic small particle lead and mercury pollutants that enter the air from coal fired power plants. Levels of glutathione and SOD are key to neuroprotection in these cases. Restoration of antioxidant metabolism is the first step in a long course of therapy necessary to finally achieve a potential reversal of neuron cell death and return of function. In utilizing Complementary Medicine for these neurodegenerative problems, much patience is required. Some symptom relief can potentially be achieved quickly, but most improvement will be noted over a long period of time.

Standard treatment of ADD/ADHD

Adderall, a potent mix of amphetamines given at low dosage, is the current drug of choice to treat ADHD in adults. Two types of Adderall are presecribed, extended release (XR) and instant release (IR). Amphetamines are thought to act to curb ADHD symptoms by increasing the amount of dopamine and norepinephrine (noradrenalin) in the brain, acting as both reuptake inhibitors and reverse transporters of the monoamines, dopamine, norepinephrine (noradrenaline), adrenalin, serotonin, melatonin, phenylethylamine, tryptamine, tyramine, and thyronamines. The mix of amphetamine chemicals in Adderall will create these effects to increase dopamine and adrenalin without the obvious adverse effects of stronger amphetamine stimulation. Concerns about long-term side effects have been voiced by the medical community, though, and prompted a ban in Canada on the sale of Adderall due to adverse cardiovascular effects and reports of sudden death syndrome in children. Adderall, like all amphetamines, may produce a rise in blood pressure, motor restlessness, and aggressive behavior, changes in vision, and decreased appetite. Other drugs that affect monoamines are contraindicated, including SSRI and SNRI anti-depressants and anti-anxiety drugs, tricyclic anti-depressants, MAO inhibitors, Buproprion (Wellbutrin), and other atypical anti-psychotic medications, which are often prescribed off-label. Newer drugs prescribed for chronic pain may also indirectly affect dopamine availability and transport, and may be found to be problematic. The Canadian ban for Adderall was withdrawn after a year of study, but a U.S. FDA black box warning was instituted, mainly warning of the potential of high cardiovascular and psychiatric risks with concurrent use of recreational amphetamines and cocaine.

Obviously, use of a low dosage amphetamine is popular as a means to increase mental excitation and stamina, and is now well known to be used as a stimulant. Adderall is especially popular among college students, and is referred to as a “study drug”, useful for cramming and and staying up at night to study for tests. A study by William Frankenberger, a professor at the University of Wisconsin in Eau Claire, in 2004, reported that at least 14% of the college students on this campus used one of the amphetamine ADD drugs, including Adderall, much of it bought without prescription, although obtaining a prescription for Adderall is not very difficult, as the determination of a diagnosis of ADHD is subjective, and not based on objective tests. The use of Adderall as an athletic performance enhancing drug is also increasingly of concern, and there has been restrictions of the use of Adderall by athletes in college even by prescription now.

While the use of Adderall is symptom relieving and stimulating of cognitive function, this drug does not address the underlying causes and imbalances of the pathology. Patients with ADD/ADHD may wish to improve the health and treat the underlying conditions, improve brain function and health, and potentially solve the health problems so that long-term use of medications is unnecessary. One problem in this regard is the common warning by the prescribing medical doctor that all herbs and nutrient medicines should be avoided due to the potential of adverse interactions. Of course, there are very few herbs and nutrients that could potentially adversely interact with a low dosage amphetamine. Only a few herbs are known to possess significant monoamine oxidase inhibitory effects (MAOI) which may increase dopamine, serotonin, and norepinephrine bioavailability somewhat. These include Saint Johns Wort and Passionflower. Since a number of chemicals are combined in these herbs, though, they exert modulatory effects, reacting to levels of monamines. Ephedrine, an herbal chemical, may also exert adverse effects, and is a stimulant as well. A relatively large amount of study of this potential herb-drug interaction has been performed, and only a handful of herbs and foods have been found to exert a potential negative interaction, including nutmeg and licorice. Pausinystalia yohimbe has also been found to have a weak MAOI effect. Actual clinical adverse effects, though, have not been found, despite the fact that amphetamines are a very popular recreational drug, for at least four decades, and Saint Johns Wort is also a popular herb, as well as passionflower.

For patients wishing to achieve increased dopamine bioavailability, there are a few dopaminergic herbs that exert mild effects, and increasing the modulation of various neurotransmitters may also exert positive effects on the dopamine metabolism may also be achieved with various herbal and nutrient medicine strategies. Many patients are trying these more conservative methods of reducing symptoms in ADD and ADHD before resorting to amphetamines. A comprehensive strategy in Complementary Medicine would utilize a variety of treatment protocols to correct the underlying health problems and improve brain function and health as well, though. This treatment strategy could also be valuable as a preventive medicine to avoid future problems with neurodegeneration, and serve to correct or prevent problems with motor restlessness and sleep disorders, such as restless leg syndrome and nocturnal bruxism. The benefits from a comprehensive strategy with acupuncture, herbal and nutrient medicine are many, and may also resolve the problems of ADD/ADHD without permanent dependence on drug therapy, or any therapy for that matter.

Lifestyle, Diet and therapeutic regimens may be a key to successful prevention and therapy

A University of Toronto study of carbohydrates and cognitive function found a 37% increase in memory and cognitive function occurred in a group of subjects that ate a porridge of barley each morning. Simpler carbohydrates resulted in short lived memory and cognitive benefit. Complex carbohydrates may thus be very important to supplying your brain with the necessary chemicals for neuronal health. While barley may be difficult for many to incorporate into their breakfast diet, steel cut oats, amaranth and various whole grains can be made into delicious warm cereal porridge. Barley sprout powder can be used as a morning supplement, slowly pouring a tablespoon of the powder into warm liquid in a blender. Research concerning the effects of Ritalin on increased memory, cognition and control of hyperactivity in the brain showed that this drug increased glucose metabolism in the brain by 50%. It is suggested that an increased level of glucose bioavailability from a complex carbohydrate diet could achieve similar results.

Omega 3 fatty acids are also important to incorporate into the diet. Studies of Parkinson's patients found a consistent imbalance between Omega-6 and Omega-3 fatty acids in key areas of the brain. Deficiency of the Omega-3 DHA and EPA were common, and linked to various theories of metabolic dysfunction concerning inflammatory regulation and lipid peroxidation. DHA and EPA mutually support each other in the function of vascular renewal, and deficiency could result in a poor vascularization that contributes to neural cell death or poor neural receptor function. DHA is essential to brain development and growth, and deficiencies have been linked to poor fetal development of brain function. These essential fatty acids are obtained from both foods and supplements. Various fatty ocean fish, as well as some fresh water fish are high in these EFAs, and this preformed DHA increases level more quickly than the foods and herbs rich in alpha-linolenic acid, but this latter class of foods is more commonly eaten and dietary changes incorporating these foods is recommended. The DHA levels rise more slowly from foods and herbs containging the Omega-3 alpha-linolenic acid, but the eventual change may be more dramatic. Scientists long invested in treatment of populations with malnutrition of Omega-3 and Omega-6 fatty acids highly recommend using a combination of fatty fish with spirulina, blue-green algae and chlorella, which are rich and balanced with these nutrients. Salmon, mackeral and sardine are the fish highest in Omega-3 fatty acids. Trout, herring, anchovy, butterfish and tuna are also high in content. Various cooking, baking and salad oils are high in content, including pumpkin seed oil, and toasted walnut oil. Tempeh and dark, leafy green vegetables, such as collard greens, spinach, kale, chard, some endives, etc. are also rich in alpha-linolenic acid, the precursor to the DHA and EPA. Herbs such as digupi, and xuanshen that clear deficiency heat, and chaihu and cheqianzi, which benefit the liver and kidney, as well as duhuo, sangshen, gouqizi and nuzhenzi are all commonly used in TCM formulas and are rich in linolenic and linoleic acids.

Key herbal and nutrient medicines in the treatment of neurodegenerative disorders

Unlike synthetic pharmaceutical medicines, herbs usually contain a long list of synergistic chemicals that help your condition in a variety of ways. In this section, key herbs will be explained, but many of the beneficial actions of the numerous chemicals in the herbs will not be explained due to the need for brevity. Of course, in this complicated subject, brevity is a relative term. If you want, you may do further research on the herbs and chemicals contained within the herbs yourself. Often, a small group of herbs and nutrients will be listed in the description of the herb or nutrient, so that you may see how to increase the potential of treatment with a small formula of substances. Of course, therapy guided by a knowledgable professional will achieve the best results, tailoring the treatment to the individual, and proceeding step-by-step in a logical manner to achieve medical goals. Despite the large number of products needed in neurodegenerative therapy, which is a drawback that discourages most patients, those patients that proceed with herbal and nutrient therapy patiently and persistently are thrilled with the results over time.

While the list of herbal and nutrient medicines found effective in aiding the complex pathology of neurodegeneration is long, the patient and physician can evaluate and choose from this long list to achieve the best individualized results based on the specific patient needs. If the desired effects are achieved more simply, this is great. If the desired effects are not achieved at first, more nutrient and herbal medicines may be prescribed to achieve the goals. Persistence and thorough knowledge and assessment of individualized problems and health profile are what is important in restoring a healthy central neurological function.

Is there evidence that herbal medicine really works in the treatment of Parkinson's and neurodegenerative diseases? A growing body of evidence is proving that herbal medicine can work in a variety of ways to reverse neurodegenertion. There are currently 158 scientific citations on the NIH website PubMed concerning herbal medicine and Alzheimer's disease. See some of this great body of evidence by clicking here: http://www.ncbi.nlm.nih.gov/pubmed/18719316 and here: http://www.ncbi.nlm.nih.gov/pubmed/18324353

• Essential nutrients for cognitive function and nervous system health: patients with neurodegenerative disorders should start with a period of replenishment of key nutrients that may be deficient and thus necessary to reverse the disease. You do not need to take these nutrients constantly or forever, but replenishing the body's store and metabolism may be essential to the success of therapy. Vitamin B6 (the active metabolite is called P5P) has been found to be deficient in 50% of the U.S. population, and is essential for dopamine production. Choline is necessary for proper transmission of nerve impulses and is a key component of the cholinergic system, as well as fatty acid metabolism in the neural mitochondria. To utilize choline as as supplement, inositol (phosphatidylinositol), Vitamin B12 (sublingual high dose), folic acid (5MTHF), and Vitamin B complex are essential. Choline as a food source is available in egg yolks, legumes, milk, soy and whole grains, and the taking of choline and inositol supplement with these foods is recommended. The supplement formula Phophatidylserine Plus (Vitamin Research) contains phosphatidylcholine and phosphatidylinositol, two more usable forms of choline and inositol. DMAE, or dimethylaminoethanol, is another supplement that stimulates production of choline by the brain cells, and also may be very useful. Lecithin, a B Vitamin, is also helpful to increase choline bioavailability, and to aid nerve transmission. The natural lipid component of lecithin is called phosphatydilcholine, and is now widely used to enhance cognitive functions. The Glutamic acid metabolism is a necessary part of the central nervous system function and GABA regulation, and is best enhanced by taking a combination of L-Glutamate, niacinamide and Vitamin B6 (P5P) with Choline and inositol. A complete essential nutrient formula may include Choline, inositol, Vitamin B6 (P5P), L-Glutamine, Vitamin B12 (sublingual or intramuscular injection), folic acid (5MTHF), DMAE and lecithin (phosphatidylcholine). Foods that are dopaminergic include steel cut oats, fermented soy (tempeh), lentils, barley, rice, alfalfa, avocado and fenugreek. A quality dried barley sprout supplement is highly recommended for its array of beneficial chemicals, which include three types of anti-inflammatory biologics, chlorophyll, PD41 and mucopolysaccharides, as well as being a rich source of healthy proteins, enzymes and Vitamin A. Barleygrass sprouts also contain SOD, super-oxide dismutase, to help clear heavy metal toxicities and their oxidant free radicals.
• Omega-3 Fatty acids, EPA and DHA: a 2007 study listed below confirms that these essential fatty acids are often deficient in the Parkinson's, Alzheimer's and ADD patients studied. An excess of the Omega-6 essential fatty acids in our diet contributes to a dysfunction of the cells and inflammatory regulation in key areas of our brains. These Omega-6 fatty acids should be balanced with Omega-3 for optimal health of the metabolism in neurodegenerative disorders. A relative deficiency of Omega-3 fatty acids may impede membrane fluidity at the dopamine receptor sites by allowing stiff membranes to form. The best source of Omega-3 fatty acids, DHA and EPA, is krill oil, concentrated and possessing a natural preservative, unlike fish oils and flaxseed oil. EPAQ by Health Concerns is recommended. This oil is so concentrated in the right type of essential fatty acids that just one or two small capsules per day is needed, instead of the tablespoons of fish oil.
• Rhodiola rosea or Hong jin tian: improves dopamine optimization and serotonin bioavailability. Dopaminergic herbs include Muira puama, Murcuna pruriens, Salvia miltiorrhiziae (Dan shen), Alismatis orientalis (Ze xie), and Uncaria tomentosa (Gou teng or Cat's claw). Dopamine receptor sites will be enhanced through the nutrient Sam-E. Dopamine is a neurotransmitter that accounts for 90% of the catecholamines in the nervous system and is a precursor to norepinephrine and epinephrine, key adrenal neurohormones. Adrenal insufficiency could result in increased demand for dopamine as a precursor. Adrenal health can be enhanced by the use of a small formula called Adrenosen, from Health Concerns, that contains PKA, barley sprouts, wild mountain yam, schizandra berries and the hyacinth bean. In women, copper is in greater demand, and is sometimes deficient. The catecholamine oxidative metabolism of dopamine in the citric acid cycle of mitochondrial health, as well as oxidative conversion to norepinephrine, is dependant on a copper-containing enzyme, dopamine beta-monooxygenase. Copper in the diet is derived from organ meats, some seafood, dried beans, quality nuts and whole grains. Copper supplementation must include cofactors of zinc methionine (Opti-zinc) and folic acid to assimilate, but the 2.5 mg copper supplement (in the form copper amino acid chelate) should be taken about 2 hours after the zinc supplement to avoid competition in absorption. Rhodiola, muira puama, Cat's claw, SamE, OptiZinc, Adrenosen,
• Uncaria Tomentosa or Cat's Claw: uncarine alkaloids have been studied and found to exert a beneficial effect on memory impairment induced by cholinergic dysfunction. Cat's claw is also dopaminergic and stimulating of the glutamate metabolism. Maca has been studied as a synergetic herb used in combination with Cat's claw to achieve enhanced effect. Alpha-glyceryl-phosphoryl-choline, or Alpha-GPC, also aids the cholinergic system, acting as a precursor to acetylcholine, or ACh, and has been proven in studies to enhance memory and cognitive function. Inositol and Choline are often useful to enhance the treatment of cholinergic dysfunction, allowing for greater bioavailability of choline. To enhance assimilation of Choline, inositol, Vitamin B12 (sublingual large dose), folic acid, Vitamin C, and Vitamin B complex are helpful cofactors. Alpha-GPC is available in the Health Concerns product called Cogni-Spark.
• Resveratrol, an active chemical found in the Chinese herb Polygonum cuspidatum, or Bushy knotweed, Hu zhang: this antioxidant is now well known and utilized, even by M.D.s, to protect dopamine neurons from degeneration. This active chemical from a Chinese herb is so potent that pharmaceutical companies are now introducing a synthetic version (patentable and expensive) to the market. Patients report significant benefit soon after starting the herbal supplement. Perhaps due to this success there is now a plethora of misinformation about this chemical. Many doctors tell their patients that the chemical is extracted from red wine or grapes, when all studies show that the amount of this chemical in red wine is very small, and the companies marketing this herbal supplement obtain the chemical from the Chinese herb Polygonum cuspidatum. Newer studies cite the poor absorption of reservatrol from red wine and grapes to counter it's success. The truth is that a concentrated supplement from the herb prepared properly, or an extract in an alcohol tincture is effectively absorbed and utilized by the human body. http://www.herbalextractok.com/Herbal-Extract/Resveratrol-extract.html
• Huperzine and Vinpurazine, from Clubmoss and Vinca Periwinkle: studies in Shanghai confirm that huperzine works better than tacrine or E2020, chemical anticholinesterases, to enhance memory and reverse neurodegeneration. The first group of drugs approved by the FDA to treat mild to moderate Alzheimer's are the acetylcholinesterase inhibitors, and huperzine is one of six herbal chemicals in Chinese herbs found to have significant anticholinesterase effects in scientific studies. http://www.find-health-articles.com/rec_pub_18573242-anti-acetylcholinesterase-activities-traditional-chinese-medicine.htm The Health Concerns product Vinpurazine combines these two herbal chemicals with rosemary extract to form a potent combination, which also clears excesses of chronic inflammation in the CNS cells.
• Trypterygium wilfordii or Lei gong teng, and Scutellaria baicalensis, or Huang qin: studies have confirmed that these herbs will protect dopaminergic neurons from inflammatory processes and inflammation mediated damage by inhibiting microglial activation of inflammatory mediators. Many citations of research published by the NIH on the PubMed research database show significant benefit from Trypterygium wilfordii. PMID 12504865 shows that the herb is found to benefit dopaminergic degenerative neurons. PMID 16989518 shows that there is some mild toxicity to the herb and should be used only with professional guidance, but that it contains alkaloids useful in chronic inflammatory states. PMID 16989518 shows that safety and efficacy has been confirmed in human clinical trials in the United States and abroad. PMID 17240858 shows that the herb inhibits key inflammatory cytokines that are linked to chronic inflammatory states.
• Alpha Lipoic Acid plus L-Carnitine: R-lipoic acid is the active form of ALA, and acetyl L-carnitine is the most studied nutrient chemical fo the treatment of cognitive function; this combination will aid mitochondrial efficiency and clear buildup of sticky proteins that have been linked to Parkinson's and Alzheimer's pathologies. Sticky proteins are misshapen beta-amyloid extracellular plaque deposits, sometimes called tangles. Causes of the misshapen lipoproteins may be linked to toxic heavy metal accumulation, such as alumninum from cookware, along with accumulations of oxidant free radicals as the body tries to clear this accumulation. ALA helps to neutralize the effects of free radicals by enhancing the antioxidant benefits of Vitamins C, E, and glutathione. Carnitine is a B vitamin with a chemical structure similar to amino acids, whose main function is to help transport long-chain fatty acids, and also enhances the antioxidant effects of Vitamines C and E. Carnitine is produced in the body if sufficient amounts of B1, B6, lysine and methionine are available, and Vitamin B6 deficiency is common in the population. Vegetarians are more susceptible to deficiency, and a chief symptom of deficiency is confusion. The combination of these two nutrients helps antioxidant maintenance of neuron mitochondria as well as prevention of unwanted lipid proteins called sticky proteins, which are the subject of much research into the pathophysiology of Alzheimer's.
• SAMe, or S-adenosylmethionine, converts to methionine at D4 dopamine receptors sites, which becomes part of the healthy beta-amyloid protein structure at dopamine receptors. Dopamine receptor sites also need 5MeTHF, a folate and methyl donor for homocysteine, to methylate phospholipid membranes, and allow for healthier fluidity, or transport of molecules, across the membranes of dopamine receptors. 5MeTHF is deficient in the livers of patients with riboflavin, or Vitamin B2 deficiency, which is another common deficiency in the population, especially for patients who have used oral contraceptives, consumed excess alcohol, taken prolonged courses of antibiotics, or engaged in strenuous exercise. One of the signs of B2 deficiency is slowed mental response. 5MeTHF may also be deficient if the body has a folate deficiency, and dietary folic acid does not satisfy the demand for folate metabolism. A combination of SAMe, Vitamin B2 and folic acid (5MTHF) is recommended to reduce sticky proteins and stiff membranes at dopamine receptor sites to insure healthier metabolism. To reduce beta-amyloid (Abeta) accumulation, or sticky protein plaques, the chemical S-allyl-L-cysteine from water extract aged garlic has also been proven effective. Astra Garlic is a formula from Health Concerns that is a synergistic blend of herbs for this effect. The Chinese herbs Yu jin and E zhu (curcuma zedoaria), which contain curcuma, have also been proven to break up and prevent beta-amyloid plaque accumulation. Regeneration is a formula from Health Concerns is a formula that contains curcuma and has a blend of herbs that could greatly benefit the Alzheimer's patient. Since the effects of curcuma are dose dependant, the herbalist sometimes prescribes a decoction of curcuma for a period of time, and this decoction has the added benefit of aiding digestion by increasing stomach and pancreatic secretions and bile flow, as well as being a proven anti-cancer agent.
• Bioflavonoids, such as are found in Gingko biloba and many Chinese herbs: there are many bioflavonoid chemicals in the body, including quercetin, rutin, hesperidin, and eriodictyol, and bioflavonoids cannot be produced by the body, and are thus called essential nutrients. Depletion of our soil chemistry by modern farming methods has resulted in widespread deficiencies of bioflavonoids, which are linked to neurodegenerative disorders. These nutrient chemicals are important in microcurculation, antioxidant clearing, and cellular metabolism. A number of herbs are rich in bioflavanoids, which account for much of their success in therapy, the most well known being Gingko biloba. It is recommended that you ingest a variety of bioflavonoids to insure success. I recommend the herbal formula Flavonex, from Health Concerns, along with a tincture of fresh Gingko biloba leaf, and a diet that includes organic oranges, lemons, grapes, dried apricots, dried cherries, black currants, bell peppers, and dried buckwheat sprout powder. Vitamin C is an excellent cofactor to bioflavonoids, and the supplement formula Astra C, from Health Concerns, is highly recommended a part of the flavonoid regimen.
• Antioxidants, especially CoQ10: Coenzyme Q10 is a vitaminlike substance that is also called ubiquinone, because it is needed by most cells in the body, hence ubiquitous. This chemical is essential to mitochondrial function and oxidative processes, and has long been an important part of standard medical therapy in Asia for treatment of Parkinson's, Alzheimer's and other neurodegenerative diseases. CoQ10 also aids circulation and microcirculation, stimulation of the immune system, prevention of cell aging or cell death, and tissue oxygenation. Deficiencies of CoQ10 are common, and are linked to such diseases as muscular dystrophy. Deficiencies may be caused by a number of common pharmaceutical medicines, including the cholesterol lowering statins, beta-adrenergic inhibitors prescribed for hypertension, tricyclic antidepressants, and anti-diabetic sulfonylurea drugs. More than 12 million patients are prescribed CoQ10 in Japan by their medical doctors. CoQ10 supplements vary considerably in quality and bioavailability, and enhanced forms, as well as sublingual powders are available. CoQ10 is oil soluble and best taken with fatty or oily foods, especially sardines, mackerel and salmon, which contain the highest amounts of CoQ10 in foods. Peanuts, beef and spinach also contain CoQ10. Taking CoQ10 supplement with Krill oil, a potent source of essential fatty acids, especially EPA and DHA, or omega 3 and 6, is recommended. CoQ10-H2 is a more active metabolite of Coenzyme Q10, with much better bioavailability, and is recommended for many disorders.
• Other antioxidants proven to protect dopamine neurons: epigallocatechin gallate in tea (camellia sinensis), especially quality green tea, is effective. Super oxide dismutase, or SOD, is a potent antioxidant the clear superoxides, which are a more harmful type. A short course of copper/zinc SOD may be helpful. Gingko biloba standardized extract EGb761 was shown to be significantly neuroprotecive of dopamine depletion. Go to my article on antioxidants to learn more.
• Glutathione metabolism and the nutrients needed to insure health: a deficiency of glutathione is linked to many types of oxidative stress, and oxidative stress in the mitochondria of key nerve cells is a major part of the neurodegenerative process. To insure a strong glutathione metabolism it is recommended that liver function is optimal, and that a number of nutrients that are precursors to cellular glutathione metabolism are available in the body. These include, L-glutamate, N-acetyl-L-cysteine, and L-glycine. Milk thistle and Schizandra berry are also beneficial to the glutathione metabolism of the liver. Studies of stroke patients revealed that those with deficient glutathione metabolism had a marked increase in oxidative damage in the hippocampus and corpus striatum.
• L-Tyrosine: this amino acid is a precursor to dopamine and norepinephrine, which regulate mood and muscle firing, and are the key neurotransmitters deficient in function in Parkinson's and other neureodegenerative disorders. Tyrosine is used extensively by the thyroid gland and attaches to iodine to form thryroid hormones. Hypothyroid states, as well as deficient iodine states, could be related to deficient tyrosine, and this supplement could be a key part of therapy in both neurodegenerative disorders and hypothyroid dysfunction. Food sources include almonds, avocadoes, bananas, dairy, lima beans, pumpkin seed, and sesame seed. L-Tyrosine supplements should be taken with high carbohydrate meals, such as breakfast porridge, or with a small snack at bedtime so that the intake does not compete with other amino acids in the diet. Studies have demonstrated that increased tyrosine bioavailability can enhance dopamine synthesis in and release from nigrostriatal neurons if the firing rates of these neurons are accelerated, as in more advanced cases of Parkinson's degeneration, where the surviving cells are found to fire at increased rates to compensate. (Proc Natl Acad Sci USA 1980 Jul;77(7):4305-9 6254020 (PSGEB) E Melamed, F Hefti, R J Wurtman).
• R-Lipoic Acid: R-Lipoic Acid is rightly called the ‘mitochondrial antioxidant’, and many scientific studies (cited below) demonstrate its role in preventing or decreasing depletion of glutathione antioxidant compound (GSH). Lipoic acid is one of the most thoroughly investigated dietary supplements and most healthcare practitioners agree it is a preventive supplement of choice. R-Lipoic Acid is a more potent form – the more biologically active form – of alpha lipoic acid. As such, it offers more benefit with a lower dose. Lipoic acid serves to regenerate vitamins C and E, and helps maintain glutathione levels, a vital cellular antioxidant and liver protectant. It is a vascular and neuroprotective agent.
• 5HTP: there is some link between the serotonergic fibers in the striatal tissues of the basal ganglia and dopamine conversion and production in these 5HT (5-hydroxytryptophan) fibers in scientific study. Taking the 5HTP supplement (from Griffonia seed) may aid the dopamine metabolism. Study on animals found that the drug L-Dopa may be converted to dopamine within the 5HT fibers, and 5HTP possibly has some effect that may enhance the effectiveness for patients taking L-Dopa. 5HTP is also a precursor to melatonin, which is proven to be a potent neuroprotector for dopamine neurons.
• St. John's Wort, Hypericum perforatum: this much maligned but effective herb has been both proven safe for use and effective in the treatment of Alzheimer's and neurodegenerative disease. Prior reports that chemicals in St. John's Wort could alter levels of other pharmaceutical medications through competition in liver catabolism of the P450 enzyme pathway were shown to be overblown. Studies revealed that the effects of chemicals in St. John's Wort were modulatory of liver function, and that effects on the P450 enzyme pathway were modulated and normalized within two weeks of use to achieve a homeostatic effect despite catabolic competition from harsh pharmaceuticals. This was accomplished because a variety of chemicals in hypericum act to improve liver function. Of course, this also implies that the whole herb extract, and not pharmaceutical products with just the active ingredient enhanced, should be used. To see the current research on St. John's Wort, click here: http://www.ncbi.nlm.nih.gov/pubmed/16880827
• Topical progesterone and pregnenelone creams: studies show that progesterone modulates dopamine release in the corpus striatum and the pregnenelone could modulate the dopamine transmission in the corpus striatum by causing changes in the activity of tyrosine hydroxylase and/or in the pre- and post-synaptic dopaminergic terminals. This neurosteroid mechanism could be a new kind of neurotransmitter systems modulation affecting dopamine metabolism significantly. (Neurol Res 2007 Jan 16; 17535560 (PGSEB)). Use of these simple bioidentical hormone therapies could have significant effect, especially if there is a progesterone deficiency. Testing and administration should be overseen by a professional.
• Vitamin D3 cholecalciferol: recent studies fo Parkinson's patients found a significantly increased incidence of Vitamin D3 hormone deficiency over the general population, which also shows a 36-41% rate of defciency in this important hormonal chemical. While these results are not highly significant at this stage of investigation, supplementation with cholecalciferol might help the neurodegenerative patient. Remember that D3 converts to the active hormonal form in circulation only when the patient's skin is exposed to sunlight. Take the pills in the morning with breakfast and go for a walk in the midday sunlight with the face and arms exposed each day.
• Herbal formula to enhance brain circulation: circulatory aids are helpful both for brain circulation, as well as peripheral circulation in Parkinson's. Circulatory aid is beneficial to improve cognitive function, repair of the nervous tissues, increased benefits from the other herbal and nutrient medicines, and peripheral circulation. I recommend Cir-Q from Health Concerns.
• Red Mold Rice extract: a number of polylipids from specific fermented grains have been proven to affect lipid metabolism in a healthy way and now show promise in the treatment of Alzheimer's, and potentially ADD and ADHD. A combination of effects, including reduction of amyloid beta-peptide plaque, called neurofibrillary tangles, as well as various antioxidant and antiinflammatory mechanisms were found in this herbal supplement. I prescribe the Health Concerns supplement Polylipid, or utilize Red Yeast Rice (Vitamin Research) to achieve these effects. Red Yeast Rice extract is now famous due to studies that demonstrate the cholesterol lowering effects of this nutrient medicine as well, which are equivalent to statin drugs. To review the research, click here: http://www.ncbi.nlm.nih.gov/pubmed/18438657
• Endocannabinoids: research around the world has confirmed that cannabinoids are not just chemicals found in marijuana, but actually are important chemicals used by the brain to regulate excessive activity of dopamine neurons in the corpus striatum. Studies at numerous universities found that patients that had used marijuana for some time in their life had a 30% decrease risk of acquiring Parkinson's. Stimulation of endocannabinoid cellular production, as well as the bioavailability of endocannabinoids from hemp seed in the diet, are being explored by scientists today. It could be that a topical cannabinoid cream that is oil based is the answer to immediate effect. Such a cream has been developed in England and is used to decrease neuralgia. Unfortunately, U.S. pharmaceutical lobbying has prompted the FDA to delay approval on the U.S. market of this benign topical medicine. There is no connection between the drug effects of THC in marijuana and this valuable herbal medicine.
• Anticholinergic herbs: sometimes cholinergic dysfunction in Parkinson's can be calmed with anticholinergic chemicals, which have been used successfully at times by modern medicine. This treatment protocol runs counter to the anticholinesterase protocol, but in some cases has reduced acute symptoms related to cholinergic nerve stimulation. Some herbs have both anticholinergic chemicals and anti-cholinesterase chemicals, implying a modulatory effect on the cholinergic system. These effects will be milder than those produced by synthetic anticholinergic chemicals, but will have no side effect. The herbs that contain anticholinergic chemicals include the mulberry parts, leaf, bark, stem, and fruit, called Sang ye, Sang bai pi, and Sang shen, as well as Corydalis, or Yan hu suo, and Artemesia abrotanum, or Southernwood. Horse chestnut bark also contains an anticholinergic, and is beneficial for the health of the veins and veinous circulation. This herb is found in the Health Concerns formula, Formula V, along with butcher's broome and stoneroot. Some antichonlinergic herbs contain scopolamines, and are a little toxic, thus are rarely used, and monitored professionally. These include Jimsonweed and Anisodus tanguticus, or Zang qie. This type of therapy may be indicated for more advanced cases to control symptoms.

Information Resources

1. A 2005 FDA advisory warning for the popularly prescribed amphetamine drug Adderall is seen on this You Tube video. This warning was provided after Canadian authorities banned Adderall prescription due to long term cardiovascular and psychiatric risks: http://www.youtube.com/watch?v=yA79qMuEbAE
2. An excellent report on CoQ10 deficiencies is found on the LifeExtension magazine website: http://www.lef.org/magazine/mag2000/july2000_review.html
3. Research publication on progesterone and pregnenelone therapy in relation to dopamine metabolism in the corpus striatum in Parkinson's: http://lib.bioinfo.pl/pmid:17535560
4. A study by Thomas Jefferson University Medical College in Pennsylvania concerning the efficacy of herbal chemicals as neuroprotective antioxidants, especially reservatrol in Hu Zhang: http://www.ncbi.nlm.nih.gov/pubmed/11897104/
5. Research in 2007 concludes that deficiency in DHA and EPA, or Omega-3 essential fatty acid, is linked to Parkinson's, and that a balance between Omega-6 and Omega-3 fatty acids is essential to Neuronal health.: http://www.medicalnewstoday.com/articles/89928.php
6. A double-blind placebo study of Alzheimer's patients and patients with diagnosis of mild cognitive impairment in 2008 showed that the Omega-3 fatty acid EPA, used alone, produced significant improvement in cognitive function in the patients with mild cognitive impairment and overall improvement in the severe Alzheimer's patients as noted by the clinical physician. EPA and DHA, in krill oil, is thus an effective part of the holistic protocol in treatment of Alzheimer's and neurodegenerative disease: http://www.ncbi.nlm.nih.gov/pubmed/18573585
7. Research in 2001 showed that standardized extract of Gingko biloba, or AGb761 was significantly effective in partial prevention of dopamine depletion of corpus striatum cells subjected to neurotoxicity.: http://www.springerlink.com/content/l18dtptbnlvb6g4e/
8. Research in 2002 at the University of California at Berkeley, The Children's Hospital in Oakland, and the Buck Institute of Aging in Novato, California revealed that R-Lipoic Acid is a potent preventative supplement for neurodegnerative conditions: http://www.sciencedirect.com/science
9. Research in 2000 showed that neurodegeneration spread from the corpus striatum to the cortex and thalamus over time with the progression of the disease.: http://www.neurology.org/cgi/content/abstract/54/7/1482
10. Research in 2009 at the University of Columbia in Vancouver found that chronic adrenal stress could desensitize serotonergic 5HT receptors in the hypothalamus and cause endocrine suppression. Such findings may implicate adrenal stress in the suppression of dopamine receptors as well.: http://www.sciencedirect.com/science
11. Research review in Parkinson's treatment approaches in 2007 is outlined in this article and shows that adrenal stress is now a primary focus in study of the pathology, and the the neuroprotective and adaptive approaches of herbal medicine are now being explored by modern pharmacology: http://vml.med.uoc.gr/molmedgp-guide-2007/molmedgp_guide_2007_page_076-080.pdf
12. In vitro studies in 2007 proved that S-allyl-L-cysteine, found in water extract of aged garlic, inhibited beta-amyloid (Abeta) accumulation, or sticky protein plaques, that are linked to Alzheimer's: http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=18023978
13. In vivo studies in 2005 found that curcumin, from the Chinese herbs Yu jin and E zhu (curcuma zedoaria), both broke up and inhibited beta-amyloid (Abeta) accumulation, or sticky protein plaques, that are linked to Alzheimer's: http://www.ncbi.nlm.nih.gov/pubmed/15590663
14. For a complete research review of Attention Deficit and Hyperactivity Disorder and the complex science of potential causes: http://www.acnp.org/asset.axd?id=26c3b427-a7b2-4e3b-9c5f-8245305786bb
15. A type of shitake mushroom, the Yamabushitake (Hericium erinaceus) was proven in a double-blind placebo study in Japan to significantly increase cognitive function in 50-80 year old patients diagnosed with neurodegenerative cognitive impairment, such as in Alzheimer's: http://www.ncbi.nlm.nih.gov/pubmed/18844328
16. Food preservatives, such as benzoic acid, produce oxidative stress and disruption of cellular membranes, and the science is available to utilize healthier alternatives in the food industry to decrease incidence of neurodegeneration: http://aem.asm.org/cgi/reprint/70/8/4449.pdf
17. Scientific study in 2007 uncovered the role of chronic inflammatory cytokines and the link to viral lipopolysaccharides as both a direct stimulation of symptoms of hyperacitivity and a major cause of dopaminergic neurotoxicity. Of course, the recommendation was to increase use of corticsteroids that have harsh side effects, but Complementary Medicine offers safe effective alternative to this approach: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2442423

The information on this website is not intended to be used as a specific medical advice or cure. Please consult with the practitioner or an appropriate physician, such as a licensed acupuncturist, naturopath, or medical doctor, to discuss the proper application of the information contained on this website.