In Chinese Medicine reading the pulse is one of the two key diagnostic methods, tongue diagnosis being the other. We use 3 fingers below each wrist where we can access different depths of the radial artery as it lies over the curved bone. The different positions under each finger have been correlated over the centuries with different organs. We listen to the movement of blood in the blood vessels and note the speed, shape and any rhythmical irregularities coming from the heart or other tissues. We feel the thickness or thinness of the blood vessels, how deeply they lie, how full of blood they are and note their resilience and vitality. And we note the tension of the tissue around the blood vessel. Radio signals communicated between the brain and heart gives information we may not be able to verbalize. It is a deep listening.
Too often we practitioners draw from a pool of similar patients and are not able to experience the vast information potentially read from pulses. Even more infrequent is the pulse experienced at the end of life when many are in hospitals hooked up to machines that may interfere with natural death.
I was fortunate to be able to listen to my father’s pulse as he passed away at home and I thought you might find it interesting.
Burton Vaughan 1927-2015
Ever the teacher he would not mind my sharing this with you.
My dad was an 89 year old man in otherwise good health who had leaky heart valves. He had chosen not to get them repaired as it usually involves some mental impairment and he was teaching graduate school classes until last year. So the ability of his heart to support his activities was substantially reduced as the valves were unable to push blood through the heart.
During his last day his pulse was very rapid as his heart was compensating for the low force. Qi could not command blood. The beat started strong then fizzled out as the weak valves could not push the blood. It was regularly irregular but the “fizzle” took a third to a half of the beat. He was so hot he required fanning, but his hands and feet were icy cold. This would be what we call false heat caused by the stagnation of blood due to low qi/ force. The force of the pulse was low but curiously his Kidney pulses were not inordinately weak compared to the others.
As he died his breathing was reduced and it was hard to find what had become a feeble pulse. The pulse got deeper and deeper until it was hidden. His forehead was still hot as was his vertex but the warm area moved up and the cold overtook him. The pulse diminished and he peacefully died.
Constipation refers to bowel movements that either occur less often than expected or with a stool that is hard, dry and difficult to pass. (Types 1-3 on the Bristol Stool Chart, below.) A healthy adult should pass one to two stools a day, although some otherwise healthy adults pass a stool every other day. There are a number of reasons one might not pass feces, including diet, fluid intake, medications, stress, anal pain from hemorrhoids or fissures, lack of probiotic gut bacteria, laxative abuse, specific diseases, such as stroke, diabetes, thyroid disease and Parkinson’s, change in circardian rhythm (due to irregular sleeping while traveling) and a poor posture while eliminating
In Chinese medicine proper digestion has been seen as a paramount hallmark of health and one school of medicine considered poor digestion to be the root of almost all diseases. Chinese medicine looks at whether the constipation is because of a dry hard stool (dryness, usually due to heat) or a normal stool without peristalsis (qi stagnation). Heat can be of external or internal origin and is the major cause of constipation, especially if stools are hard or dry. Qi stagnation involves anything that blocks peristalsis, from emotions (Liver qi stagnation) to physical blockages or lack of exercise.
Laxatives and Laxative Abuse
Western medicine recognizes two types of laxatives: hyperosmolar and stimulant. The hyperosmolar laxatives (MiraLax, GoLytely, and Philips Milk of Magnesium) are agents that draw water into the bowel, making the stool softer and promoting movement of the stool. Hyperosmolar laxatives are over the counter medications, often used in healthcare as they have few risks and tend not to cause abdominal cramping. Stimulant laxatives, on the other hand, stimulate the propelling action of the bowel.. These include the anthraquinone laxatives These medications are associated with cramping and potentially harmful side effects.
Kyle Thompson, self made. Stool images and text made into document in OpenOffice.org, exported to PDF and then captured in OS X as a roundabout, but best way of ensuring good layout! Intended for use in a new article Bristol Stool Chart (Photo credit: Wikipedia)
In Chinese medicine we use three classes of laxatives. Emergency cathartics are given only in serious circumstances such as constipation accompanied by ascites. Only experienced practitioners should use this category which causes serious cramping and diarrhea. Strong laxatives like Da Chen Qi Tang are often based on stimulants like rhubarb root and hyperosmolar magnesium, which are only taken until the first bowel movement. The second category is comparable to the anthraquinone laxatives (like senna, cascara sagrada, buckthorn, or aloe), Mirelax, phenolphthalein and bisacodyl. Gentle bulk laxatives make up most treatments for constipation. The gentle bulk laxatives include flax and psyllium seed (Metamucil), methylcellulose (Citrucel) and prunes. Stool softeners (emollient laxatives like docusate) are more benign western laxatives which are similarly gentle and allow fluids to penetrate the hard stool. Stool softeners are commonly used when there is a need to soften the stool temporarily and make defecation easier (for example, after surgery, childbirth, or heart attacks). They are also used for individuals with hemorrhoids or anal fissures.They have temporary uses, but over the long run water in the diet should do the trick for most people.
A unique forth class of nourishing laxatives comes from Ayurvedic medicine and is based on the rasayana (longevity tonic) Triphala which consists of three fruits: : Amala (Emblica officinalis) one of the highest natural sources of Vitamin C, Bibhitaki (Terminalia bellirica), and Haritaki (Terminalia chebula). This is the only nourishing laxative I know of and can be used to recover peristalsis after damage from overuse of anthraquinone laxatives. It may be combined with other herbs like guggulu,
Laxative abuse can be a major cause of constipation since people with constipation will often inappropriately choose stimulant laxatives, use them too frequently or use them for purging in a misguided attempt to control weight. This can take over the body’s natural peristalsis and the person will no longer be able to have a normal bowel movement. The anthraquinonne laxatives will cause laxative dependence within two weeks of constant use. Herbalist David Hoffman tells how the British Navy in its wisdom wanted its sailors to be regular, so issued a daily dose of senna, dooming the sailors to lifetime laxative dependence. (Perhaps if they had listened to the Indians they were colonizing, they might have learned to overcome the dependence with triphala!)
Medications and Constipation
There are a number of medications that can cause constipation, notably pain killers and other medicines based on opiods. I once treated a woman on methadone maintenance who had retained so much stool that she appeared 9 months pregnant. She spent a large part of each day trying enemas and other actions to move a little stool. The opiate killed her peristalsis. Codeine based pain killers are known for causing constipation that can be worse than the pain being treated. Examples include Tylenol #3, oxycodone (Percocet), and hydromorphone (Dilaudid.) Ibuprofen (Motrin) often works as well after the first few doses of codeine.
Diuretics like Lasix and calcium channel blocking drugs such as diltiazem (Cardizem) and nifedipine (Procardia) can dry the stool out. Antidepressants such as amitriptyline (Elavil, Endep) and imipramine (Tofranil and anticonvulsants such as phenytoin (Dilantin) and carbamazepine (Tegretol) are constipating although Prozac is not. Parkinson’s disease medications including anticholinergic medications, Artane and Cogentin can constipate, but then so can the disease. Even iron supplements and aluminum-containing antacids such as Amphojel, Maalox, Mylanta, Gelusil and Rollaids can cause constipation. Speak to your doctor about non-constipating alternatives and consider natural alternatives to iron and antacid supplements. For instance dock (Rumex crispus) tincture helps iron assimilation in drop doses. And bitters before meals can reduce the need for antacids (which are usually the wrong remedy for people over 30.)
Diet and Constipation
Diet is perhaps the main cause of constipation and can be the easiest to remedy once laxative dependence is addressed. Dietary influences come from a variety of sources. For example magnesium has decreased by over a third in most foods tested by the USDA since the mid 1970s and magnesium helps attract fluid into the stool. But we also have less fiber and fewer bitter vegetables, both of which would help reduce constipation..
Honey Rum Fruit Salad (Photo credit: SliceOfChic)
Fluids: If you don’t get enough fluids from food or drink, your constipation won’t go away. You need 6-8 servings of fluid a day, approximately 2 liters. It does not have to be from pure water although water is good. Fluid can come from drinks, fruit like watermelon, vegetables like cucumber, coffee and tea (although a small amount of caffeinated beverages will pass through without hydrating you.) If you sip- half a cup or less at a time- you will hydrate better. If you gulp, you will trigger your urinary reflex. That is a good thing because it flushes out the tissues but you need hydration to stop constipation.
Lots of fluid-rich fruits and vegetables like watermelon, honeydew melon, cucumber and celery.
Allergens or food sensitivities, especially milk can cause chronic constipation by creating inflammation that causes changes in the lining of the gut, specifically the eosinophilia of the rectal mucosa. (see references below.) Sometimes this causes diarrhea or mixed constipation and diarrhiea, but constipation alone can be triggered.
Insufficient fats. Fats lubricate the intestines and allow for smooth passage of the feces. In Chinese medicine we use oily seeds like apricot pits, flaxseed, cannabis seed and olive seed. Coconut or olive oil also work.
Fiber: You need about 25 to 30 grams of fiber every day to soften the stool and encourage proper bowel function. Most American diets contain less than half that amount. Fiber from powdered supplements can impact if you don’t take them with enough fluid. Fruits and vegetables provide fiber in a hydrating package. Bananas, apples, celery, fennel root and cucumber all help.
Mucilage is a specific kind of water-soluble fiber that provides lubrication. Sea vegetables, mucilage from slippery elm bark, hibiscus flowers, marshmallow root, okra, chia seeds or flax seeds will also lubricate the intestines.
Lack of bitters. The bitter taste stimulates the liver to make bile and to stimulate both digestive juices in the stomach and peristalsis. We have significantly reduced this important digestive signal by hybridizing bitter fruits and greens to have a sweeter taste. Bite into a lime peel, then squeeze the sour juice into water and drink it before your meal. Or eat grapefruit, radicchio salad, Karela (bitter melon), drink black coffee or have a little Angostura bitters in water before your main course. Urban Moonshine makes purse-sized bitter sprays that make it easy to get the bitter trigger in the go (tiny amounts work.)
Coffee. This is one of the most common agents to stimulate the bowel and a cup in the morning is often followed by a bowel movement. Coffee is a bitter, is rich in magnesium, chlorogenic acids, cafestol, kahweol, caffeine, theophylline and theobromine.
Fermented foods: are a source of probiotics wrapped up in fluid, frequently fat and often fiber. Aside from buttermilk, yogurt, kefir, sour cream, fermented butter, live blue cheese, gorgonzola, kombucha and live vinegar, which don’t appreciably contain fiber with their organisms, pickles, kim chee, sauerkraut, fermented veggies, olives, miso and fermented fish all help repopulate the gut and move things along. The fermented vegetables are easy to make if not found nearby, and they contain prebiotic foods for the probiotic organisms. Te good bacteria form a living wallpaper in your gut and help the health of the intestinal villi.
Probiotic supplements can be useful to repopulate the gut after antibiotics but very few probiotics have much more than 4-5 Lactobacillus or Bifidobacteria species and we have hundreds to thousands of naturally-occurring gut species. So while there is value in populating the most common probiotic species there is a need to take in probiotic foods. The two probiotics I recommend are Pharmax Sinbiotics Human Lactobacillus Complex which come with very potent sachets and Florastor which uses the less common probiotic yeast Saccharomyces boulardii. In Europe one can find probiotic strains of benign e-coli (the kind thin people have naturally) like Escherichia coli Nissle, but the FDA does not permit their sale in the USA.
Vitamin C is also laxative in large doses. 1000 mg of the vitamin in the morning can help stimulate a bowel movement.
Physical Aspects of Constipation
The Puborectalis Muscle kinks the rectum closed while sitting but relaxes while squatting.
First, movement is necessary to provide qi to the bowels so peristalsis can occur. A person who never moves is likely to have trouble moving their bowels. Engaging in walking after meals is good for someone who is beginning to move.
Acupuncture can also help move the bowels. Your acupuncturist might us points near your belly button, with additional points on your lower leg to moisten the stool and points below your knee for peristalsis. The acupuncture acts as a reset button for your body to take over normal elimination.
But another, less-appreciated issue in western society is that we eliminate in the wrong position. For most of human history and in most places people have defecated in a squatting position. With the knees above the hips and the pelvic floor engaged, elimination is easier and more complete. I did not appreciate this until going to Beijing and getting intestinal problems. We stayed in a fine hotel that provided both western thrones and eastern squat toilets and surprisingly it was easier to manage with the eastern toilets because you could clear out more easily.
More significant to constipation is the understanding of the role of the puborectalis muscle. The large intestine unloads at the rectum. However the rectum is supported by a loop of muscle, the puborectalis muscle which in a sitting or standing position chokes off the rectum to maintain continence. When one squats, the anorectal angle is increased, the rectum straightens and the stool can be easily evacuated. We pay a high price for retaining the Victorian “throne”. Because the anorectal angle is in a kinked position while sitting one is forced to strain in order to move the bowels, which is the main cause of hemorrhoids. While squatting the angle straightens out allowing the fecal matter to eliminate quickly and easily without straining.
Since most of us will be unable to install a squat toilet in a western home or business, the Squatty Potty was designed as a corrective to the toilet. It consists of an elevated step stool that has a cutout to hug the toilet and allows elimination with a 35 degree anorectal angle. It is better than using a narrow foot stool and certainly better than standing on an unstable toilet seat.
Sitting with elevated feet is not quite as efficient as eliminating in a true squatting position. Weight rests on the buttocks instead of the feet, although one probably could work up to a true squat on the wood versions, as seen in the second video below. Nonetheless it is better than sitting at either a 90 degree angle or balancing on an unstable toilet seat.
Nutrition for Parkinson’s Disease has four components: What to Eat, What Not to Eat, Useful supplements and How to Eat, given symptoms of the disease. This will be a four piece series. Some of it is basic: the foods and superfoods that enrich the diet. Some is specific to the typical complaints from either the disease, the medications and the often restrictive lifestyles that PD patients often adopt. And the how-to acknowledges that the disease creates some physical problems that adaptive devices might help.
Mucuna in flower, source of L.Dopa (Photo credit: Wikipedia)
Nutrition for Parkinson’s Disease Part 1: What to Eat
People with Parkinson’s have some extra requirements in their diet. Because shaking can burn calories, it is easy to become underweight, although that is not universal. Yin deficiency, a kind of dehydration or wasting, is generally seen in symptoms like shaking, muscle spasms, constipation, poorly nourished muscles and skin, as well as dehydration. Blood deficiency can be seen with pale skin, lips and tongue as well as with muscle wasting. While we have limited knowledge of what causes the substantia nigra to stop making dopamine, it is likely that missing nutrients will be implicated in both the production of dopamine and the preservation of brain cells. People with Parkinson’s often suffer from constipation and muscle spasms. So what should you eat?
Berries and other fruits- While people with Parkinson’s who are not overweight can eat fruit rather freely, it is best to deal with nutrient-dense berries. Blueberries, huckleberries, goji berries, blackberries, raspberries, organic strawberries, pomegranates, and cherries all pack a deeper nutritional punch than apples, pears and bananas. All are useful, but especially the berries which are rich sources of flavonoids. Blueberries and organic strawberries can reduce depression, improve memory and slow neuro-degeneration. Goji berries are especially high in antioxidants and can build blood. Cranberries may protect the urinary tract. Tart cherries can help insomnia with their melatonin. Berries can pack in the nutrition especially as swallowing becomes more difficult. Go for organic, especially with strawberries and other berries because chemicals in pesticides can be linked to Parkinson’s. All fruits provide fiber which can counteract constipation. 1/2-1 cup daily.
Purine-rich foods which break down too uric acid and then urates: The chemical urate, a potent antioxidant which is known to cause gout in excess, appears to slow the progression of Parkinson’s disease. Foods that make uric acid include: fructose, asparagus, beer, heart, herring,mussels,yeast, smelt, sardines, and sweetbreads. Just don’t overdo it, especially if you are prone to gout or insulin resistance. A serving a day, but take it in the evening if you are on Levodopa or Carbodopa.
Fatty fish or fish oil including halibut, sardines, wild Alaskan salmon, anchovies and herring are rich in the DHA and EPA, Omega 3 fatty acids which go to the brain and help guard against dementia which affects some 40% of people with Parkinson’s. Fish oil improves cognition, protects against depression, boosts the immune system,relieves arthritis and protects the heart. I do not find flax oil as effective as fish or cod liver oil- it can require 30 times the dose, goes rancid very rapidly and some 30% of the population cannot convert it to DHA. (DHA makes up 20% of grey matter in the brain.) If you eat fish, eat the skin and check Seafood Watch to make sure that mercury levels are low. Beef that is 100% pasture-raised on grass has a fat profile similar to deep water fish but conventionally grain-raised CAFO beef does not. Otherwise get cod liver or fish oil and take enough to get 1000 mg of DHA. Since that can be 5 capsules, I generally get Carlson’s lemon-flavored fish oil or Green Pasture’s cinnamon fermented cod liver oil and use it to wash down supplements.
Iron is linked to dopamine production. Patients with Parkinson’s have lower levels of dopamine produced by the substantia nigra and may respond to iron administration. Iron, as a cofactor in dopamine production, plays a central role in the etiology of the disease. Low dopamine can cause other neurological problems such as restless leg syndrome and muscle spasms. Judging from the Parkinson’s people I see, Blood Deficiency is pretty widespread. I recommend pasture-raised organic red meat, liver once a week,and dark green and dark red vegetables. (Chlorophyll is hemoglobin with magnesium at the center instead of iron, but usually has non-heme iron as well.) To increase iron absorption, tincture of Yellow dock (Rumex crispus) given in drop doses to stomach tolerance, can be helpful. However taking iron as a supplement can be ineffective (hard to absorb), hard on your heart or absorbed by bad gut flora. Dr.Campbell-McBride advises against it :
Most people with abnormal gut flora have various stages of anemia. It is not surprising. They not only can’t absorb essential for blood vitamins and minerals from food, but their own production of these vitamins is damaged. On top of that people with damaged gut flora often have a particular group of pathogenic bacteria growing in their gut, which are iron-loving bacteria (Actinomyces spp., Mycobacterium spp., pathogenic strains of E. coli, Corynebacterium spp., and many others). They consume whatever iron the person gets from the diet, leaving that person deficient in iron. Unfortunately, supplementing iron makes these bacteria grow stronger and does not remedy anemia.” (Gut & Psychology Syndrome)
Vinegars made with live mothers are probiotic
Probiotic Foods help you develop good gut flora that can out-compete undesirable bacteria and to increase digestion. Live blue cheese, yogurt, kefir, sauerkraut, kimchee, vinegar with a mother like Braggs, kombucha, unpasturized pickles and olives, miso, fermented fish sauces and pickled vegetables should be taken at each major meal. Pickles and pickle juice helps the body free up magnesium which can reduce cramps. Other bacteria help absorb minerals. I prefer food-based sources of probiotics because you eat them fresh, they come with their own prebiotics which feed them and tend to have a variety of organisms that may not be in pill form. For instance, most probiotic pills only have lactobacillus or bifidobacteria but there may be another 500 species that are present in a healthy gut. If you do use probiotic supplements, look for them in a refrigerated case rather than a shelf.
Prebiotic foods feed the gut flora and can protect against iron depleting strains of bacteria. Prebiotics like fructooligosaccharide (FOS) and inulin feed the probiotic organisms and allow them to proliferate in the gut. They ought to be in probiotic supplements to help keep them alive. However your gut also needs to be receptive to them. Rather than purchasing a prebiotic supplement, eat a serving of Jerusalem artichokes, asparagus, onions, leeks, burdock root, garlic (in quantity), shallots, jicama root, chicory or dandelion root, barley or yacón each day.
Nuts from trees are great sources of Vitamin E in its various forms and trace minerals, as well as good fats provided you eat them raw. Roasting can easily change the fat profile and excessive conventional salt triggers indiscriminate consumption. You will absorb nut nutrients better if you soak them overnight- you can puree them into nut butter with a little sea salt, toss them into salad or a stir fry or make your own nut milks. They are storehouses of important trace minerals: Brazil nuts are high in selenium which can help the heart. Peanuts which are ground nuts are significantly contaminated with aflatoxin, a known carcinogen that is twenty times more toxic than DDT. Since toxins can cause some Parkinson’s, avoid peanuts. 1 oz . per day of tree nuts.
Beans in general are good for Parkinson’s because the fiber levels are high enough to prevent constipation while providing protein, reducing blood sugar spikes and providing protection from cancer. They can be consumed daily with herbs like rosemary or bay leaf to reduce flatulence and making them yourself will allow you to change the water enough to reduce that problem. But there are two beans in particular which provide special protection against Parkinson’s: fava beans and mucuna beans. These beans contain levodopa, the same chemical in Sinemet, Madopar, Dopar, Larodopa, and other levodopa-containing medicines used to treat PD which means that adding them to a well-balanced prescription can be problematic, although they can sometimes substitute for all or part of a prescription. According to Dr. Jame’s Duke’s database the entire fava plant, including leaves, stems, pods, and immature beans, contains levodopa, with the highest concentrations in the flowers and sprouting bean. The amount of levodopa can vary greatly, depending on the species of fava and where it’s grown especially since it has been cultivated as a food rather than a medicine for most of its history. Three ounces (about 84 grams or ½ cup every day) of fresh green fava beans, or three ounces of canned green fava beans, drained, may contain about 50-100 mg of levodopa. One small study showed that mucuna had better results than the form of levodopa given as prescription medication and anecdotal evidence shows it tends to work better than fava beans. Doses range from 22.5 – 67.5 g per day divided in 2 – 5 doses. Neither bean should be taken by persons with Monoamine oxidase inhibitors (MAOI) or elevations in blood pressure may result. If you have favism, a genetic susceptibility where you lack an enzyme called glucose-6-phosphate, eating fava beans could cause a condition called hemolytic anemia. This is ruled out by a test but it is unknown if mucuna also causes this reaction. Lacking either MAOIs or Favism, both beans are potentially good for people with Parkinson’s who work with an herbalist and medical doctor.
Cruciferous Vegetables like broccoli, cauliflower, cabbage, kale, bok choi, kohlrabi, brussels sprouts and mustard, rutabaga and turnip greens help reduce estrogen dominance which reduces magnesium and vitamin B. A deficiency in magnesium causes muscle tightening and that causes people to experience muscle spasms while deficiency in vitamin B can cause neurological problems like neuropathy. Cruciferous vegetables are rich in zinc, vitamins A, B, C, D and E and Indole-3-Carbinol (I3C) which is especially beneficial to estrogen metabolism. When I3C combines with stomach acid it creates 3,3-Diindolylmethane, or DIM. The metabolism of DIM overlaps with estrogen metabolism so that it promotes healthy estrogen metabolism. Eat 2-4 servings daily within your 9 servings of veggies and berries. They should be steamed or in the case of kale chips, dried with heat to protect the thyroid.
Coffee and Tea. Coffee has shown to be helpful at both preventing and slowing the progression of Parkinson’s disease in a dose-dependent way. Coffee consumption is associated with 60% fewer cases of Parkinson’s Disease in one study. Caffeinated coffee is better than decaf and coffee reduces symptoms better than other sources of caffeine, indicating that caffeine alone may not be the protective mechanism. (Coffee is much more than caffeine, with magnesium and potent antioxidants like the chlorogenic acids.) Caffeine as an isolate incidentally was associated with better motor control but had very little effect on daytime sleepiness. One caveat: some people don’t do well on coffee and tend to self-select out of the positive scientific studies (try making a coffee placebo!) Follow your own body. Tea has general health benefits from catechins which are powerful antioxidants and at least one study showed a reduced risk of Parkinson’s disease. There is some evidence that symptoms may be reduced with tea drinking, especially in studies of Asian populations.
Other Fluids: Since dehydration is a problem, you need to drink. Drinking more than a half cup at a time triggers the urinary reflex so does not hydrate your tissues. So put your water in a bottle with a drink-through cap and sip it through the day. If you drink coffee or soda, assume that the caffeine will reduce hydration by 25% and tea or iced tea by 10%. Don’t drink soda though, especially cola or artificially sweetened soda which contains potential toxins not known to be safe for Parkinson’s. If water seems too plain, add a spear of melon and a sprig of mint, or sliced lemons or fresh rosemary and orange slices. Coconut water has a good balance of electrolytes and isn’t too sweet. You can also get fluids from fruits like watermelon or citrus. But if you can get fresh vegetable juice with lots of greens, it would be better from a nutritional standpoint. Don’t forget good fats- think of oil floating on water to prevent evaporation.
Mai men dong (ophiopogon tubers) make a mild soup ingredient that strongly tonifies yin. Available at Chinese grocery stores.
Yin building herbs and foods: Parkinson’s disease can be dehydrating, drying out skin, muscles, the colon and joints. This is referred to as yin deficiency and can develop into deficient (friction) heat as it progresses. You need to nourish your fluids and tissues and there are a number of “Chinese grocery store” or food grade herbs and foods that can help. Seaweeds should be included in the diet at least twice a week, but dulse, nori and kelp are also available as sprinkles that can be used like a flavored salt inbetween. Seaweeds are good sources of trace minerals and iodine, since much of our healthy topsoil has blown out to sea. A table spoon or two of slippery elm or marshmallow powder can be stirred into applesauce or oatmeal. Mai men dong bulbs (opiophogon, liorope) are small, bland Chinese vegetables that nourish yin, go well in even western soup and can be found at Chinese grocery stores. So can white lily bulb (bai wei), broken into small bulblettes. Shatavari (asparagus tuber, tian men dong), the yin adaptogen food can be found online powdered, and can be used to thicken soups while nourishing fluids, hormones and tissues. Oatmeal, millet, alfalfa sprouts, artichoke, asparagus, kelp, mung bean sprouts, okra; peas, potatoes, black beans, avocado, aduki beans, seaweed, string beans, sweet potatoes, tomatoes (especially tomato paste), water chestnuts, yam, zucchini, berries, apricots, pears, watermelon, fish and shellfish, pork (especially liver and kidneys), beef, goose and duck, coconut milk and nuts all will help keep you supple. 9 servings of yin-tonifying fruits and vegetables a day.
Foods with B vitamins, especially B1 thiamine, B5 pantothenic acid, B9 folate, B12 cobalamin, B6 pyrodoxine help the mitochondria which power our cells . Foods high in B vitamins include purple and green kale, mushrooms, bok choy, collards, rare organ meats like liver, heart and tongue, and very rare muscle meat. Meats are better sources when organic and grass fed. However if you can’t find grass fed liver, the organ has numerous detoxification pathways so you are safe with conventional liver- akin to an apartment building with a full janitorial staff. This is not true of other organs.
Iodine is important for Parkinson’s. It not only necessary for the production of thyroid hormone, it is also responsible for the production of all of the other hormones of the body. Adequate iodine levels are necessary for proper immune system function. Iodine contains potent antibacterial, antiparasitic, antiviral, and anticancer properties. Iodine deficiency disorder can result in mental retardation, goiter, increased child and infant mortality, infertility, and socioeconomic decline. There is evidence that Parkinson’s is more prevalent where iodine is missing in the soil and in areas where goiters are frequent. Long-term iodine deficiency appears linked to abnormalities in the dopaminergic system that include an increased number of dopamine receptors. This raises susceptibility to dopamine oxidation which, in turn, causes deficiencies of the antioxidant enzymes Copper or Zink superoxide dismutase, glutathione peroxidase and catalase. Dopamine deficiency also leads to elevated cytotoxic glutamate levels. Iodine is primarily found in seawater in very small quantities and solid rocks (usually near the ocean) that form when seawater evaporates. Iodine can also be found in seafood like halibut, salmon and shellfish and seaweeds like kelp, dulse, nori and hijiki. In fact, seaweed is one of the most abundant sources of iodine because seaweed has the ability to concentrate a large amount of iodine from the ocean water. Seaweeds and seafood should be taken twice a week from low mercury sources.
Kitchen Spices: There is often a loss of taste or smell with PD, and the use of strong spices like thyme, oregano, rosemary, ginger, tulsi (holy basil which is sharper than regular basil), cardamon and star anise are not only strong antioxidants but have penetrating flavor and can enhance cerebral circulation. Do not forget that people with impaired taste can often perceive sour flavors like lemon juice, and vinegar or salty tastes (use seaweed granules, Celtic sea salt, Himalayan salt, iodized sea salt but no MSG.) But turmeric is the king of anti-inflammatory spices. Turmeric is an adaptogen that is strongly antioxidant and anti-inflammatory, which crosses the blood brain barrier and is neuroprotective. It is considered a panacea herb in Ayurvedic medicine. It is used in curries, soups, smoothies and in milk. My favorite way to take medicinal doses is to take 10 oz. dried turmeric, 1/2 ounce freshly ground black pepper and 1/2 oz. ground ginger and mix well. Then stir in a local honey until it has the texture of cookie dough. Take a heaping teaspoon once or twice a day.
Good fats and oils: Most seed oils or conventional cooking oils are too high in Omega 6 fatty acids at a time when the Omega 6/Omega 3 fatty acid ratio (PUFA) has gone from 2/1 to 30/1 today. I recommend avoiding seed oils in favor of fruit oils like coconut oil and olive oil. For cooking you need a more saturated oil like coconut oil that will not peroxidize (go rancid). Ghee or animal drippings from grass-fed organic animals won’t distort under heat either compared to other oils. For raw consumption, avocado, olive oil, black seed oil (see below) and lemon flavored fish oil are useful. Coconut oil with its ketones has, according to case histories, caused a reversal of Alzheimer’s dementia so is worth considering for the cognitive decline of Parkinson’s or Lewy’s dementia. It also offers protection from viral diseases. 1-3 tablespoons in oatmeal or other food. It is being sold as an expensive functional food for Alzheimer’s.
Fresh Turmeric Root
Seeds are something I tend to avoid because we get too many Omega 6 oils in our diet, but a few are outstanding exceptions. Flax seed, hemp seed, black seed and black sesame seeds all help nourish the bowel and help stop constipation, but each has specific virtues. Flax seed has Omega 3 fats that some people can, through genetics and good lifestyle, convert to DHA and EPA. You need to grind it to get the Omega 3s but the lignins in the skin do have some laxative benefit if you don’t. It goes rancid very fast and I recommend getting a coffee grinder and grinding immediately before eating. It is good in oatmeal, over salads, in yogurt and preground in smoothies. Hemp seed is currently either steamed or shelled in the US so that it cannot grow. It is a good source of Omega 3s but can also go rancid easily. I prefer to make hemp milk or to use it in smoothies. Black sesame seed (He zhi ma) tonifies both Liver and Kidney yin, nourishes blood and secures Essence. Black sesame seeds are very rich in iron, magnesium, manganese and copper. There are about 90 mg of calcium in one tablespoon of unhulled (black) seeds It is used in both food and medicine, especially for women and the elderly but since Parkinson’s patients of both sexes are often Blood deficient, don’t let tradition stop you. Black seed (Nigella, black cumin) is used widely in the Middle East, as seed or oil. It smells something like thyme and facilitates a healthy inflammatory response including cell signaling chemicals and hormone-like messengers. Small amounts are put in string cheese and pickled Moroccan lemons, over salads, in pilaf or it is used medicinally. According to Mahfouz and El-Dakhakhny:
Ladybug on Fava bean flower
“Two of the most volatile oils found in Black seed are nigellone and thymoquinone which were fist discovered in the herb in 1985. Nigellone offers both anti-spasmodic and bronchodilating properties which contribute to Black Seed’s potency against respiratory ailments. It also acts as an antihistamine which helps to reduce the negative symptoms of allergy sufferers. Thymoquinone contains excellent anti-inflammatory and analgesic properties. It is also a strong anti-oxidant and helps cleanse the body of toxins. Both nigellone and thymoquinone work in conjunction with one another to enhance Black Seed’s action against respiratory ailments. It also provides a healthy alternative to the more commonly prescribed cortisone based therapies used by allergy sufferers. Black seed provides a rich supply of polyunsaturated fatty acids. These ingredients play a key role in daily health and wellness. They help to regulate the metabolism, carry toxins to the skin’s surface for elimination, balance insulin levels, regulate cholesterol, improve body circulation, and promote healthy liver function. A deficiency in polyunsaturated fatty acids can lead to a wide number of health problems including nervous system disorders, uninhibited growths, and skin diseases. Black seed contains over 100 valuable nutrients. It is comprised of approximately 21% protein, 38% carbohydrates, and 35% plant fats and oils. The active ingredients of black seed are nigellone, thymoquinone, and fixed oils. Black seed also contains significant proportions of protein, carbohydrates and essential fatty acids. Other ingredients include linoleic acid, oleic acid, calcium, potassium, iron, zinc, magnesium, selenium, vitamin A, vitamin B, vitamin B2, niacin, and vitamin C.”
To summarize, you should get 7.5-8 servings of vegetables per day including at least 2 cooked cruciferous vegetables and the majority from the yin-tonifying list. Choose colored vegetables like butternut squash or cooked carrots for at least one serving. At least one serving should be fermented to provide probiotic organisms (sauerkraut, kimchee) and twice a week sea vegetables (seaweeds). One serving of berries or tart cherries a day and one-half to one serving of other fruit. Wild salmon or other fatty fish twice a week. Liver once a week. Organic pasture-raised meat, preferably organ meat on other days. Beans especially black beans several times a week. One ounce of tree nuts or nut butter daily. Organic eggs, preferably with a raw yolk daily. Spice your food with strong herbs, turmeric and ginger. Sprinkle in flax seed, black seed, black sesame or hemp seed daily. Two to four cups of coffee, two liters of water and two cups of other beverages.
Also see Kathrynne Holden‘s book on nutrition for people with Parkinson’s, Eat Well, Stay Well with Parkinson’s Disease which is available through Amazon or for download here. While she has somewhat more conventional food choices than make it through my Chinese medicine/herbalist lens, she has worked with PD for many years, has special expertise about food/medicine interactions and has dealt with malnourished people with Parkinson’s in both hospital and clinical settings.
I would be remiss if I did not mention Dr. Terry Wahls who suffers from MS but found a way of eating that took her from a tilt-recline wheelchair to riding horses and freely biking today. She eats a variation on a paleo diet that is primarily vegetable based, specifically designed to support the brain and mitochondria. This is especially important for people with Parkinson’s, ALS, Huntington’s, PTSD, migraines, dementia and MS. The vast majority of people do not eat to support life and need some significant changes. I urge you to take the time to watch her TED Talk. If you want more, she has a video class on nutrition and the brain :
On December 13, 2 2006 I went to New Orleans to do acupuncture under the sponsorship of CRREW. CRREW has been in New Orleans since last year doing volunteer acupuncture under the Louisiana temporary acupuncture license (which allows only NADA ear points.)
Karen Giving Acupuncture for the New Hope Ministries Health Fair in Algiers
Wednesday, Dec 13, 2006
I arrived in New Orleans at twilight, with little view of the destruction from Katrina. Huynh Quang, a Vietnamese-born acupuncturist picked me up at the airport. Occasionally he pointed out water marks, on the railroad tracks over the highway, by the water pumping plant that I had seen in Spike Lee’s film When the Levees Broke, and in formerly occupied shopping centers that had been completely inundated and were now vacant. Continue reading Relief Acupuncture Trip to New Orleans after Katrina→
