April is Parkinson’s Disease Awareness Month.
In a recent episode of the popular Apple TV show Shrinking, actor Michael J. Fox made a cameo appearance portraying a person suffering from Parkinson’s disease.
“I fall three times a day,” he said. “I’m thinking about becoming a stuntman.”
Loss of balance and uncontrollable body tremors are common symptoms of Parkinson’s disease. The progressive brain disorder occurs when the dopamine-producing neurons in the part of the brain that controls movement become damaged – hence the involuntary muscle contractions. The disease can also cause non-motor symptoms such as difficulty sleeping and constipation.
The cause of Parkinson’s disease is unknown, but a growing body of research suggests that the gut microbiome may have something to do with it.
What is the gut microbiome?
Your gut microbiome is a wild world of trillions of microorganisms, including bacteria, viruses and fungi, that live in your digestive system.
The complex ecosystem of microbes plays a huge role in your health and overall well-being. “The gut microbiome has many different functions such as the production of short-chain fatty acids, some vitamins and neurotransmitters, influences the development and regulation of the immune system, and helps maintain the integrity of the intestinal barrier,” said Kaylyn Koons, MS, RD, LD, clinical nutritionist at the Norman Fixel Institute for Neurological Diseases.
Each person’s gut microbiome is unique and consists of microorganisms shaped by, among other things, genetics, early life experiences (birth method and formula vs. breastfeeding), lifestyle habits and environment.
Read: The wonderful world of your microbiome >>
The gut microbiome and Parkinson’s disease
People with Parkinson’s disease often have significant changes in their gut microbiome compared to people without Parkinson’s disease.
Research shows that people with Parkinson’s have reduced overall microbiome diversity, which is due to an imbalance in the microbiome called dysbiosis. This means that the gut microbiome has an increased amount of bacteria that cause inflammation and a lower amount of beneficial microbes compared to healthy gut microbiomes. And dysbiosis increases the risk of chronic diseases such as Parkinson’s.
Koons said people with Parkinson’s disease also show changes within the metabolites (molecules needed for basic survival) produced in the microbiome. These changes include reduced production of short-chain fatty acids and increased production of the metabolite trimethylamine N-oxide – a potential biomarker of Parkinson’s disease.
This is significant because reduced levels of short-chain fatty acids can lead to the breakdown of the intestinal barrier – also known as “leaky gut” – which triggers inflammation in the brain and misfolding of a protein called alpha-synuclein, which is a key feature of Parkinson’s disease.
The brain-gut axis and Parkinson’s disease
iStock.com/ttsz
Although Parkinson’s is a brain disease, there is increasing interest in the idea that the disease develops in the gut.
A 2019 study found that the misfolded proteins that damage and kill neurons in the brain originate in the gut and travel to the brain via the vagus nerve.
When the abnormal proteins accumulate in the intestines and enteric nervous system, they cause symptoms such as constipation, which is very common in Parkinson’s patients.
“Nonmotor symptoms of Parkinson’s disease affect multiple organ systems, including the gastrointestinal system, and have been found to occur years, even decades, before motor symptoms,” Koons said.
Research also shows that common gastrointestinal diseases such as gastroesophageal reflux disease and H. pylori infections may be early risk factors to consider. A recent study found that damage to the lining of the upper digestive tract – erosions, esophagitis, ulcers or gastrointestinal damage – is associated with a 76% higher risk of developing Parkinson’s disease.
Although the exact role of gut health in the development or progression of Parkinson’s is still being researched, the gut-first hypothesis could open up new ways to detect and treat the disease.
How to support your gut microbiome if you have Parkinson’s
Many people with Parkinson’s disease experience digestive problems that affect the entire system, from difficulty swallowing to delayed gastric emptying. In fact, nearly four out of five people with Parkinson’s suffer from gastrointestinal problems, and women can experience more severe gastrointestinal symptoms than men.
“Women feel significantly more full after eating, are unable to finish a normal-sized meal, and experience upper abdominal pain,” Koons said.
For people with Parkinson’s disease, a high-fiber diet can help keep gastrointestinal symptoms at bay and balance the gut microbiome. When gut bacteria break down fiber, they produce short-chain fatty acids that can strengthen the gut’s mucus barrier to fight inflammation and protect the brain.
The addition of fermented foods or foods that contain live cultures, such as: Eating foods like yogurt can help balance the good bacteria in the gut and keep digestion on track.
Koons recommends the Mediterranean diet to her Parkinson’s patients. “The Mediterranean diet is associated with an increase in beneficial bacteria such as Faecalibacterium prausnitzii and Bifidobacterium bifidum and greater production of short-chain fatty acids,” she said.
Although there is no cure for Parkinson’s disease, treating gastrointestinal problems can help with non-motor symptoms and improve overall well-being. If you have Parkinson’s disease, talk to your doctor about what you can do to keep your gut as healthy as possible.
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