It's been in the news recently...let's talk about Parkinson's Disease.

Yes, Parkinson's Disease has been in the news recently. Let's review factors to avoid that are associated with the development of this devastating neurodegenerative condition. For this discussion, all forms of Parkinsonism will be lumped together and referred to as either Parkinson's Disease (PD) or Parkinsonism.

Let's clarify a couple of things for this discussion. When we discuss the cause of medical conditions, we are going to use the word cause to encompass antecedents, triggers, mediators of disease, and associated factors. Antecedents, which set us up for the condition, and an example is a family history of the condition. Triggers are as they sound and directly result in the condition starting soon thereafter. For PD, a trigger may be severe, repetitive head trauma. Mediators tend to continue to stoke the fire of disease, and an example may be a sedentary lifestyle. Associated factors/associations include anything that appears to increase the risk of a particular disease without having proof positive. As an example, cigarette smoking is a direct cause of cancer, but other toxins that in this day and age of political medicine do not have double-blinded placebo-controlled studies in humans may only be considered associated with cause and not proven.

For lowering exposure to associated factors of Parkinson's Disease, an ounce of prevention is worth a pound of cure.

Mitochondria. We cannot talk about PD without talking about mitochondria, as it appears that the cause of neuron death is related to the death of the mitochondria, and this is the case whether PD is genetic or sporadic.1 The first evidence of this was recognized in 1983 when drug users used a synthetic heroin that caused parkinsonism acutely after use. Let's review the numbers of mitochondria in various cells in the body:

• 300-400 in each neuron (neuro/brain cells)

• 800 in each hepatocyte (liver cells)

• 5,000 in cardiac cells (heart muscle)

• 200-2,000 in other cells of the body

Looking at the number of mitochondria per cell, it becomes clear that neurons are more fragile than many other cells of the body. Damaged or lost mitochondria result in cell death. With fewer mitochondria per cell, neurons are most susceptible to toxins and lack of oxygen.

Gut-Brain pathway. Olfactory nerve. As we learn more about the vagus nerve (a very large nerve going from your brain to your gut) and the ability of toxins to climb up to the brain, we now know that the health of the gut and what is ingested can affect the brain. There is evidence that beta-amyloid (dementia, Alzheimer's disease) can crawl up the vagus nerve and cause neurodegenerative conditions. Is it possible that eosinophilic alpha-synuclein (aSYN) positive inclusion bodies (termed Lewy pathology and the deposits of PD) can do the same? There is evidence that these particles can propagate from cell to cell. The olfactory nerve in your nose goes directly to your brain. Some toxins have been proven to use this nerve to get to the CNS and this has been proven by loss of sense of smell coupled with neurological symptoms.

As you read on, keep the gut-brain connection, olfactory nerve, and mitochondria in mind.

Pesticides/herbicides. Many pesticides cause neuronal cell death. When you read on the side of a label that a product can cause neurologic symptoms or damage, think of Parkinson's Disease and all other neurodegenerative conditions. Paraquat, maneb, rotenone, permethrin, dieldrin, pyrethroids, organochlorides, 2,4-dichlorphenoxyacetic acid, organophosphates, glyphosate, and many others induce oxidative stress and mitochondrial dysfunction. These chemicals have been found to be associated with the development of PD. Unfortunately, the brain has limited antioxidant and repair/regeneration capacity. Persons living in rural areas also have a higher rate of PD, which is thought to be due to exposure to farming.

Local perspective: Chatham County mosquito control program sprays Trumpet EC, which contains naled (its degradation product is dichlorvos), an organophosphate. Naled has a T1/2 of 5 hours in sunlight and 5-6 days without sunlight. We are told that there is no increased risk of Parkinson's with these chemicals. The problem is that in rats that were chronically exposed, neuron cell death did occur as a result of reactive oxygen species and mitochondrial dysfunction.2

Other toxins. Around 2010, Dr. Philip Landrigan noted that we have been careless in assuming chemicals are safe until proven otherwise. Since WWII, over 85,000 synthetic chemicals have been registered with the EPA. Polychlorinated biphenyls (banned in the 1970s) and BMAA from cyanobacteria (certain algae, sago palm) are associated with PD and other neurologic degenerative conditions. BMAA is interesting because it may cause damage from ingestion or inhalation. You may have heard of BMAA if you have heard of Guam Disease in humans or Vacuolar Myeloinopathay (basically Guam Disease) in bald eagles that have been occurring in the south. BMAA occurs in waterways where an invasive hydrilla flourishes, resulting in increased cyanobacteria in the water.

Solvents. I have always liked fine fabrics, but I no longer buy clothes that are "Dry Clean Only," and that is because of the solvents. All solvents, whether used for dry cleaning, hobbies, cleaners, fumes, paint thinners, or home renovation/restoration, are toxins that "can lead to neurologic damage," which means PD. Long-term exposure has been found to greatly increase the risk of developing PD.

Heavy Metals. Cadmium, mercury, manganese, copper, lead, and even iron have links to PD. Some of the listed metals are necessary, but too much is toxic. High exposure to manganese, usually by inhalation (not to be confused with magnesium), has been shown to cause a form of PD and is most associated with welders. Manganese may be transported to the brain through several mechanisms, including the olfactory nerve. Yes, you need some manganese for nerve cell function, but too much is toxic. Over the years, I have heard of several cases of mercury poisoning from over-ingestion of high-mercury fish and dental amalgams, with the result being PD in a younger person.

That said, there are a few things you may want to do to lower your exposure to the associated factors of PD and other neurodegenerative conditions.

• Only eat low mercury fish and only once a week

• Have silver dental amalgams removed under precautions

• Do organic gardening and lawn care, accept the weeds and pests

• Eat organic produce and foods

• Avoid dry cleaning fabrics and keep dry cleaning down to a minimum

• Wear a solvent respirator mask by 3M for any painting, stripping, or use of solvents/chemicals

• Avoid personal care solvents (such as nail polish and remover)

• Use the EWG Skin Deep database to check toxins in personal care products (ewg.org/skindeep)

• When supplementing minerals/metals, only use high-quality supplements under the direction of a physician

• Use natural cleaning products like vinegar, soap & water, and baking soda

• Stay in when mosquito spraying occurs, and consider not gardening/mowing the lawn for 1 or more days after

• Avoid living in areas where there is high pesticide use, such as agricultural areas, golf courses, and factories

• Avoid areas with algae blooms (the adverse health effects are not completely known)

• Avoid contact sports to avoid head injury

• Exercise regularly
  

1 Henrich, M.T., Oertel, W.H., Surmeier, D.J. et al. Mitochondrial dysfunction in Parkinson’s disease – a key disease hallmark with therapeutic potential. Mol Neurodegeneration 18, 83 (2023). https://doi.org/10.1186/s13024-023-00676-7

2 Wani WY, Gudup S, Sunkaria A, Bal A, Singh PP, Kandimalla RJ, Sharma DR, Gill KD. Protective efficacy of mitochondrial targeted antioxidant MitoQ against dichlorvos induced oxidative stress and cell death in rat brain. Neuropharmacology. 2011 Dec;61(8):1193-201. doi: 10.1016/j.neuropharm.2011.07.008. Epub 2011 Jul 26. PMID: 21784090.