The little known warning signs of Parkinson's Disease

 In the last year, three people I know have been diagnosed with Parkinson's Disease. Each time, I've sat across from someone whose life has just shifted—a diagnosis that marks the beginning of a long, uncertain road with limited conventional treatment options. Each time, I've thought: what if we had known ten years ago?

Because here's what most people don't realize: Parkinson's doesn't begin with a tremor. The neurodegenerative process that leads to Parkinson's Disease starts approximately a decade before the characteristic motor symptoms appear—the tremor, rigidity, and shuffling gait that we associate with the disease. By the time these motor symptoms emerge, roughly 60-80% of the dopamine-producing neurons in the substantia nigra (a critical area of the midbrain) have already been lost.

But the body sends signals long before that tremor begins. The question is: are we paying attention?

The Early Warning Signs

The prodromal phase of Parkinson's—the years before diagnosis—often presents with symptoms that seem unrelated to movement disorders:

• Loss of smell (hyposmia): One of the earliest and most common signs, occurring in up to 90% of people who will develop Parkinson's. This isn't just a diminished sense of smell from a cold—it's a persistent inability to detect odors that can begin 4-10 years before motor symptoms.

• Constipation: Chronic constipation and other gastrointestinal issues can precede motor symptoms by decades. The enteric nervous system—often called our "second brain"—shows signs of Parkinson's pathology years before the brain does.

• REM Sleep Behavior Disorder (RBD): People with RBD act out their dreams physically—punching, kicking, shouting during sleep. This disorder can appear 10-15 years before Parkinson's diagnosis and is one of the strongest predictors of future neurodegeneration.

• Restless Leg Syndrome: The uncomfortable sensations and irresistible urge to move the legs, especially at night, may signal early dopaminergic dysfunction.

• Depression and anxiety: Mood changes often precede motor symptoms by several years, reflecting the broader neurochemical changes occurring in the brain.

• Subtle motor changes: Decreased arm swing on one side, smaller handwriting (micrographia), softer voice, and masked facial expression can appear years before a formal diagnosis.

If you're experiencing several of these symptoms, especially if you have a family history of Parkinson's, it's time to take action. And here's where naturopathic medicine offers something that conventional medicine often doesn't: a comprehensive neuroprotective strategy that can be implemented long before disease sets in.

Who's at Risk?

While anyone can develop Parkinson's, certain factors increase susceptibility:

• Family history: Having a parent or sibling with Parkinson's increases your risk, though most cases are not directly inherited

• Environmental exposures: Pesticides, herbicides, heavy metals, and industrial chemicals

• Head trauma: Repeated head injuries increase risk

• Age: Risk increases with age, though early-onset Parkinson's can occur

• Gender: Men are 1.5 times more likely to develop Parkinson's than women

The Gut-Brain Connection: Where Parkinson's May Begin

One of the most exciting areas of Parkinson's research involves the gut-brain axis—the bidirectional communication highway between your digestive system and your brain. Emerging evidence suggests that Parkinson's may actually begin in the gut, not the brain.

The hallmark of Parkinson's is the accumulation of misfolded alpha-synuclein protein in the brain. But this same pathological protein has been found in the enteric nervous system—the vast network of neurons lining your gut—years before it appears in the brain. The theory: alpha-synuclein may originate in the gut and travel up the vagus nerve to the brain, like a slow-moving wildfire spreading through the nervous system. This would explain why constipation and other GI symptoms appear so early in the disease process.

The gut microbiome—the trillions of bacteria, fungi, and other microorganisms living in your digestive tract—plays a crucial role in this process. People with Parkinson's have distinctly different gut microbiomes than healthy individuals, with reduced beneficial bacteria and increased inflammatory species. These microbial imbalances can:

• Increase intestinal permeability ("leaky gut"), allowing inflammatory compounds to enter circulation and reach the brain

• Reduce production of short-chain fatty acids, which protect the gut lining and have anti-inflammatory effects

• Alter neurotransmitter production—90% of serotonin and 50% of dopamine are produced in the gut

• Trigger chronic low-grade inflammation that accelerates neurodegeneration

• Impair the metabolism of L-DOPA medication in those already diagnosed

This means that healing and supporting the gut is not peripheral to Parkinson's prevention—it's central.

Supporting the Gut-Brain Axis:

• Probiotics and fermented foods: Regular consumption of diverse, high-quality probiotics and traditionally fermented foods (sauerkraut, kimchi, kefir, miso) can help restore healthy gut flora. Specific strains like Lactobacillus and Bifidobacterium have shown promise in research.

• Prebiotics: Feed your beneficial bacteria with fiber-rich foods—asparagus, garlic, onions, Jerusalem artichokes, dandelion greens, chicory root.

• Heal intestinal permeability: Address leaky gut with L-glutamine, zinc carnosine, deglycyrrhizinated licorice (DGL), slippery elm, and marshmallow root.

• Reduce gut inflammation: Eliminate food sensitivities, reduce sugar and processed foods, and incorporate anti-inflammatory herbs like turmeric and ginger.

• Support vagal tone: The vagus nerve is the superhighway between gut and brain. Practices like deep breathing, humming, singing, cold water exposure, and gargling can stimulate vagal tone and support healthy gut-brain communication.

A Naturopathic Prevention Protocol: Neuroprotection Before Degeneration

The beauty of early intervention is that we can support the brain's resilience and slow or potentially prevent the cascade of neurodegeneration. Here's a comprehensive approach:

Diet: The Foundation

The brain is exquisitely sensitive to what we eat. An anti-inflammatory, antioxidant-rich diet is essential for neuroprotection.

• Mediterranean and MIND diets: Both have been associated with reduced Parkinson's risk. Emphasize colorful vegetables, berries, leafy greens, nuts, seeds, olive oil, and wild-caught fish

• Organic whenever possible: Reducing exposure to pesticides and herbicides is critical, as these chemicals are strongly linked to Parkinson's development

• Fava beans (broad beans): A natural source of L-DOPA, the precursor to dopamine. Fava beans have been used traditionally to support dopamine levels and can be incorporated regularly into the diet

• Green tea: Rich in polyphenols, particularly EGCG, which has demonstrated neuroprotective effects in multiple studies

• Adequate protein: But balanced—too much protein can interfere with L-DOPA absorption if you're already on medication

• Calorie restriction and intermittent fasting: Research suggests that mild calorie restriction and intermittent fasting stimulate autophagy (the body's cellular cleanup process), reduce oxidative stress, and support mitochondrial health—all crucial for preventing neurodegeneration

Targeted Supplementation

When it comes to Parkinson's prevention, certain nutrients have robust evidence for neuroprotection:

• Coenzyme Q10 (CoQ10): A powerful antioxidant that supports mitochondrial function. Dosing typically ranges from 300-1200mg daily. CoQ10 has shown promise in slowing Parkinson's progression in early stages.

• Glutathione: The brain's master antioxidant, often depleted in Parkinson's patients. Can be taken as liposomal glutathione, S-acetyl glutathione, or IV glutathione. Precursors like N-acetyl cysteine (NAC) also support glutathione production.

• Vitamin D: Low vitamin D levels are associated with increased Parkinson's risk. Optimal levels (50-80 ng/mL) support neuroprotection and reduce inflammation. Most people need 2000-5000 IU daily, but testing is essential.

• NADH (Nicotinamide Adenine Dinucleotide): Supports cellular energy production and may enhance dopamine synthesis. Typical dosing: 10-20mg daily.

• Melatonin: Beyond its role in sleep, melatonin is a potent antioxidant that crosses the blood-brain barrier. It may help with REM sleep behavior disorder and provides direct neuroprotection. Dosing ranges from 3-10mg before bed.

• Creatine: Supports mitochondrial energy production and has shown neuroprotective effects in early studies. Dosing: 5-10g daily.

• Mucuna pruriens: A natural source of L-DOPA that has been used in Ayurvedic medicine for centuries. It can support dopamine levels and, in some studies, has been as effective as synthetic L-DOPA with fewer side effects. This should be used under supervision, especially if someone is already on Parkinson's medications.

• Ginkgo biloba: Improves cerebral blood flow and has antioxidant properties. May support cognitive function and slow neurodegeneration. Typical dosing: 120-240mg daily of standardized extract.

• Omega-3 fatty acids (EPA/DHA): Essential for brain health, anti-inflammatory, and supportive of neuronal membrane integrity. Aim for 2-3g daily of combined EPA/DHA from high-quality fish oil or algae.

Acupuncture: Moving Qi, Protecting Neurons

In Chinese medicine, Parkinson's can be understood as a deficiency of Liver and Kidney Qi, Blood, and Yin, combined with internal Wind. Acupuncture can:

• Improve motor symptoms and reduce tremor

• Support dopamine regulation

• Reduce inflammation

• Improve sleep quality and address REM sleep disorders

• Enhance overall vitality and Qi flow

Regular acupuncture—weekly or biweekly during the prodromal phase—can be a powerful preventive tool, especially when combined with Chinese herbal medicine tailored to the individual's constitution.

Lifestyle Recommendations: The Daily Practice of Neuroprotection

• Exercise: Perhaps the single most important intervention. Regular aerobic exercise, strength training, and practices like tai chi or qigong support neuroplasticity, increase BDNF (brain-derived neurotrophic factor), improve balance, and may slow disease progression. Aim for at least 150 minutes of moderate exercise weekly.

• Sleep hygiene: Prioritize 7-9 hours of quality sleep. Address sleep disorders early, especially REM sleep behavior disorder.

• Stress management: Chronic stress accelerates neurodegeneration. Daily meditation, breathwork, time in nature, and practices that cultivate presence are essential.

• Reduce toxic exposures: Avoid pesticides, choose organic produce, filter your water, minimize exposure to heavy metals and industrial chemicals.

• Social connection and purpose: Isolation and lack of meaning contribute to neurodegeneration. Maintain strong social bonds and engage in activities that bring purpose and joy.

• Cognitive engagement: Keep your brain active with learning, creative pursuits, music, languages, puzzles—anything that challenges and engages your mind.

The Power of Early Action

What I want everyone reading this to know is this: Parkinson's is not an on/off switch. It's a process that unfolds over years, even decades. And in that window of time, we have tremendous power to intervene.

If you recognize early warning signs in yourself or a family member, don't wait. The decade before diagnosis is not a period of helpless watching—it's an opportunity. An opportunity to nourish your nervous system, reduce inflammation, support mitochondrial health, protect dopamine-producing neurons, and potentially change the trajectory of disease.

Naturopathic medicine offers a path forward when conventional medicine says "wait and see." We don't have to wait. We can act now, with the tools of prevention, the wisdom of traditional medicine, and the growing body of research that shows us: neuroprotection is possible.

The Importance of Individualized Care

While this article provides a comprehensive overview of neuroprotective strategies, it's crucial to understand that naturopathic and Chinese medicine work best when they are customized and tailored according to the individual person being seen. In my practice, I assess each patient through pulse diagnosis, tongue diagnosis, constitutional evaluation, and detailed intake to understand their unique presentation. What works powerfully for one person may not be the right approach for another.

The dosages, herbal formulas, acupuncture protocols, and dietary recommendations I use are determined by the specific pattern of imbalance I observe—whether someone presents with Kidney Yang deficiency, Liver Blood deficiency, Spleen Qi deficiency with Dampness, or any combination of these patterns. This individualized approach is what makes traditional medicine so effective and why a one-size-fits-all protocol will never match the results of personalized care.

Given the insidious nature of this devastating disease, I highly recommend dedicated care from a trusted naturopathic or Chinese medicine practitioner who can monitor your progress, adjust treatments as needed, and provide the nuanced, individualized support that prevention and early intervention require.

This is not a condition to navigate alone or to treat with generic protocols. Find a practitioner who will take the time to truly see you, listen to your body's signals, and craft a treatment plan as unique as you are.

The time to support your brain is not after the tremor begins. It's now.