A paper by Robert Alan Bonakdar, MD, and Erminia Guarneri MD, published by aafp.org in 2005 looks at coenzyme Q10 and its use in the treatment of a variety of disorders including PD, plus cardiac, immunologic, and oncologic conditions. Coenzyme Q10 appears to be a safe supplement with minimal side effects and low drug interaction potential. As yet, coenzyme Q10 has not been approved for the treatment of specific diseases in the USA. A randomized, double-blind, placebo-controlled, multicenter study of 80 patients found that 1,200 mg per day of coenzyme Q10 was associated with up to 44 percent less functional decline in patients with Parkinson’s disease, including activities of daily living. A study of 28 patients with Parkinson’s disease also demonstrated mild symptom improvement with daily oral dosing of 360 mg of coenzyme Q10. These results are awaiting confirmation.
Vitamin K, as a Treatment, and its Interaction with Warfarin
An article published in U.S.Pharmacist in 2012 looks at the emerging role of K2. Recent research has found that vitamin K could be used to treat osteoporosis, cardiovascular diseases, and perhaps Alzheimer’s, skin aging, and various cancers. Vitamin K plays a role in regulating the healthy function of calcium and preventing pathologic calcification of the vessels and soft tissues. Vitamin K vitamers include K1 phytonadione; K2 menaquinone, and K3 menadione. The ability to convert vitamin K1 to K2 varies widely between species and breeds of animals. Vitamins K1 and K2 chemically share a common ring-structured nucleus but possess different types of side chains. Humans require dietary preformed vitamin K2 for optimal health, due to its superiority over K1 and for normal clotting of blood. The bones, liver, cartilage, and arterial walls can pull vitamin K from the blood. The current FDA recommendation is for the liver requirement only. Vitamin K antagonists include Warfarin, the blood-thinning drug that inhibits vitamin K-dependent clotting factors. Vitamin K can decrease the blood-thinning effects of warfarin and lower PT or INR value.
Source: The Emerging Role of Vitamin K2
What you Should Know About your Diet and Warfarin
The blood-thinning medication, warfarin decreases the chance of harmful blood clots by blocking the effects of vitamin K which helps blood-clotting proteins form in the liver. Your warfarin dose is determined by your PT or INR measurements that show how long it takes for your blood to form clots.
A document published by ImpactTeam looks at how your diet affects warfarin and how the amount of vitamin K in your diet will determine the warfarin dose needed to prevent bleeding. Warfarin may have possible interaction with cranberry juice, mango juice, grapefruit juice, caffeine, charbroiled foods, alcohol, garlic, soy, ginger, and green tea. In addition, there is potential interaction of dietary supplements with warfarin.
Source: Warfarin and your Diet
How Does Fasting Affect INR and %TTR?
A report published in the Journal of Thrombosis and Haemostasis looked at the effects of fasting in Muslim patients taking warfarin. The anticoagulation medication warfarin is influenced by changes in the diet and fasting might influence the INR and the %TTR. During the month of Ramadan, when Muslims fast during daylight hours (about 13.5hrs/24), stable warfarinised Muslim patients had their INR level tested before, during, and after Ramadan. Unsurprisingly the INR measurement and %TTR changed. The study concluded that fasting significantly increases the mean INR of medically stable patients taking warfarin and the likelihood of having an INR above therapeutic targets.
Source: The effects of fasting in Muslim patients taking warfarin
What are the Benefits, Side Effects, and Uses of Resveratrol?
A study published in the MDPI journal Biomedicines in 2018 looked at the pros and cons of Resveratrol. Resveratrol has a wide range of beneficial properties; it is cardioprotective, an antioxidant, neuroprotective, has anti-cancer activities, and anti-inflammatory properties. However, its hydrophobic nature gives it limited bioavailability resulting from its poor water solubility. Resveratrol has not been found to have any side effects but this may depend on the dosage. Resveratrol can effectively help with a number of conditions. Its neuroprotective properties can help with various neurogenerative conditions such as Alzheimer’s, Huntington’s, and PD. Although Resveratrol’s benefits are well documented some studies have shown that it may behave as a pro-oxidizing agent, thus it may also have implications in the pathology of several diseases.
Source: Resveratrol: A Double-Edged Sword in Health Benefits
Can you Take Fish Oil or Krill Oil Supplements with Warfarin Without Significantly Affect the INR~
A study published in the MDPI journal Nutrients looks at the use of fish oil with warfarin and whether it significantly affects the INR or incidence of adverse events in patients. Warfarin is an anticoagulant often used to manage atrial fibrillation and deep vein thrombosis. However, patients have to be careful about drug interaction with warfarin. Fish and krill oil products are among the many complimentary medicines which have been flagged as having a potential interaction with warfarin. This study assesses the influence of fish and krill oil supplements on warfarin and looks at patients that took warfarin simultaneously with fish or krill oil. The result was that overall, the oils did not significantly alter the efficacy of warfarin.
Ginseng May Modestly Reduce INR in Patients Taking Warfarin
A study published in Pharmacy Times looks at whether ginseng affects warfarin response. In one study Ginseng was associated with a modest reduction in both the INR and the warfarin area under the plasma concentration- time curve. It seems likely that the effect on warfarin could result in adverse outcomes in at least some patients who receive the combination. In one case, a 47-year-old man who had been stabilized on warfarin with an INR of about 3 had a reduction in his INR to about 1.5 after he took ginseng for 2 weeks. In another case of a possible reduction in warfarin effect with ginseng, thrombosis occurred in a prosthetic aortic valve. These results are consistent with the idea that ginseng may reduce the effect of warfarin. In conclusion, to reduce the likelihood of an adverse drug interaction between warfarin and ginseng, patients on warfarin should avoid taking ginseng products or be advised not to switch from one brand to another or vary the dose of ginseng. If a patient changes his ginseng intake any change in the anticoagulant effect of warfarin should be monitored.
Source: Does Ginseng Affect Warfarin Response?
Hawthorn herb/berries increase INR
Supplements the affect INR
final version will be here – food-as-medicine.org/inr/
q10 – reduce INR
vitamin B3, Niacin…
vitamin B-100 complex –
Use of Anticoagulants After VHD Valve Repair
A 2015 article published by the American College of Cardiology looks at Anticoagulation for Valvular Heart Disease. Surgical repair of VHD with either a mechanical or bioprosthetic valve is a common solution. Thrombotic and embolic complications and anticoagulation-related bleeding are by far the most prevalent contributors to morbidity and mortality after surgery for VHD. Furthermore, the presence of atrial fibrillation, also requires lifelong anticoagulation in the majority of patients. This article looks at the recommendations for use of anticoagulation after valve repair with a mechanical device. Subsequent studies have shown the addition of aspirin to VKA therapy in patients with mechanical valves leads to reduction in risk of thromboembolism and mortality. For bioprosthetic valve replacement the optimal antithrombotic regime is less clear. The article includes recommendations for antithrombotic therapy in patients with bioprosthetic heart valves. Recommendations from the ACC/AHA largely leave the choice of antithrombotic regimen in the setting of bioprosthetic valve replacement up to individual clinicians. Investigators have yet to establish the role for non-VKA oral anticoagulants (NOACs) in the setting of bioprosthetic valve replacement. however, a growing body of literature suggests better safety profiles of the NOACs in head-to-head trials against warfarin for non-valvular atrial fibrillation.
Source: Anticoagulation for Valvular Heart Disease – American College of Cardiology
Low‐Fat vs Ketogenic Diet for PD?
A 2018 study published in NCBI aimed to compare the plausibility, safety, and efficacy of a low‐fat, high‐carbohydrate diet versus a ketogenic diet in PD patients. Primary outcomes were within‐ and between‐group changes in MDS‐UPDRS Parts 1 to 4 over 8 weeks. 47 patients were randomized, of which 44 commenced the diets and 38 completed the study (86% completion rate for patients commencing the diets). The ketogenic diet group maintained physiological ketosis. Both groups significantly decreased their MDS‐UPDRS scores, but the ketogenic group decreased more in Part 1 (−4.58 ± 2.17 points, representing a 41% improvement in baseline Part 1 scores) compared to the low‐fat group (−0.99 ± 3.63 points, representing an 11% improvement) (P < 0.001), with the largest between‐group decreases observed for urinary problems, pain and other sensations, fatigue, daytime sleepiness, and cognitive impairment. The trial found that It is plausible and safe for PD patients to maintain a low‐fat or ketogenic diet for 8 weeks. Both diet groups significantly improved in motor and nonmotor symptoms; however, the ketogenic group showed greater improvements in nonmotor symptoms.
Could Creating a Healthy Gut Using FMD Prevent or Treat PD?
A 2018 study published by the NIH looked at neuroprotection of the fasting mimicking diet (FMD) on MPTP-induced PD mice via gut microbiota and metabolites. During the study the mice were put on a diet of fasting 3 days followed by 4 days of refeeding for three 1-week cycles. This accelerated the retention of motor function and attenuated the loss of dopaminergic neurons in the substantia nigra in 1-methyl-4-phenyl-1,2,3,6-tetrathydropyridine (MPTP)-induced PD mice. The findings demonstrated that FMD can be a new means of preventing and treating PD through promoting a favorable gut microbiota composition and metabolites.
ApoE4 Information for Alzheimer’s, and Chronic Diseases Including PD
The Wiki page, Apoe4 offers a collection of resources and information that can help you prevent and address health problems related to APOE -ε4 allele. APOE, short for Apolipoprotein E, is both a protein and a gene. As a protein, ApoE is involved in the metabolism of fats (lipids) in the body and comes in different isoforms. In our modern environment, the ε4 allele of the gene confers a higher risk for Alzheimer’s disease and other medical conditions. It is possible to be tested to see if you carry the E4 gene which would mean you are more likely to develop Alzheimer’s, although many other factors also determine vulnerability to Alzheimer’s. E4 is also associated with other chronic diseases including dementia, brain disorders, high cholesterol, infectious diseases susceptibility, gallstones, and cardiovascular disease.
Source: ApoE4.Info Wiki
Review of Possible Use of a Keto Diet in PD Treatment
A review focused on the role of ketogenic diets in neurodegenerative diseases (including PD) was published in the MDPI journal Nutrient in 2019. The goal of the review was to assess the effectiveness of ketogenic diets as part of therapy for neurodegenerative diseases. In PD, dopaminergic neurons in the substantia nigra are affected by a degeneration process leading to motor and non-motor disturbances. The available results of research projects dealing with the use of the KD and ketone bodies in neurodegenerative diseases are fairly promising. At the same time, the majority of studies reviewed were employed in vitro or by using animal models. The number of studies with human participation is rather small, and those that exist feature relatively short therapy duration periods.
Source: Role of Ketogenic Diets in Neurodegenerative Diseases (Alzheimer’s Disease and Parkinson’s Disease)
Fact Sheet: Dietary Supplements for Primary Mitochodrial Disorders
NIH publishes a fact sheet for health professionals on dietary supplements for primary mitochondrial disorders. The fact sheet summarizes published scientific trials, other studies, and reports on the use of dietary supplements to treat primary mitochondrial disorders. The most common ingredients in dietary supplements used in PMD therapy include vitamin C, vitamin E, and alpha-lipoic acid; electron donors and acceptors, such as CoQ10and riboflavin; compounds that can be used as alternative energy sources, such as creatine; and compounds that can conjugate or bind mitochondrial toxins, such as carnitine. A combination of these products is commonly called a mitochondrial cocktail. However, there are many combinations and dosages so the term is nonspecific and nondescriptive. Drug interaction needs to be taken into consideration as well as the level of evidence of efficiency, quality of ingredients, and dosage.
Source: Dietary Supplements for Primary Mitochondrial Disorders – Health Professional Fact Sheet
Review: The Role of Dietary Fat in Treatment of Brain Diseases
A review published in the Current Neuropharmacology journal in 2018 looked at the impact of dietary fats on brain function. It also examined gut-brain communication through microbiota; the impact of probiotics and prebiotics on brain functions; SCFA’s, microbiota, and neuroinflammation. It reviewed lipid sensing, satiety, and processing of hedonic food; the impact of diet on the hypo-thalamic control of reproduction; neuroprotective effects of N-3 PUFAs; dietary PUFAs, brain PUFAs and the role of PUFAs. The results of this review revealed that dietary fats are both friends and foes for brain functions. However, dietary manipulation for the treatment of brain disorders is not just a promise for the future, but a reality. In fact, the clinical relevance of the manipulation of dietary lipids, as for KDs, is well-known and currently in use for the treatment of brain diseases.
Source: Impact of Dietary Fats on Brain Functions
LGIT safe (see 305)
Whole Food Plant-Based Nutrition and Cardiovascular Disease
A review by Caldwell B. Esselstyn published in the Journal of Geriatric Cardiology in 2017 covered the connection between a plant-based diet and coronary artery disease. Caldwell states that in ignoring diet as a cause of CVD there is no hope for a cure as patients continue to consume the foods that destroy them. He discusses studies conducted using WFPBN in patients ill with CAD. The results showed that WFPBN can halt and reverse CVD. In summary, current palliative cardiovascular medicine consisting of drugs, stents, and bypass surgery cannot cure or halt the vascular disease epidemic and is financially unsustainable. WFPB can restore the ability of endothelial cells to produce nitric oxide, which can halt and reverse disease without morbidity, mortality, or added expense.
Source: A plant-based diet and coronary artery disease: a mandate for effective therapy – Coldwell
Suporting Articles:
Diet for Heart Health
A study by Caldwell published by the NIH set out to show that plant-based nutrition helps prevent coronary artery disease in a large group of patients. 198 patients with CVD were followed and given counseling on how to convert from a regular diet to plant-based nutrition. Results showed that 89% adhered to the diet and in the group of adherent participants major cardiac events recurred at a rate of 0.6%. This was significantly less than reported in other similar studies where a smaller group was used. Of the non-adherent participants, 62% experienced adverse events. Caldwell concludes that patients with CVD respond to intense counseling and when on a sustained plant-based diet for a mean 3.7 years they experience a low rate of cardiac events. Plant-based nutrition has the potential for a large effect on the CVD epidemic.
Source: A Way to Reverse CAD?
Supporting Articles: Evidence listed by Coldwell to support a low-fat vegan diet:
- www.ncbi.nlm.nih.gov/pmc/articles/PMC5466936/#b9
- Chriss Kresser’s ebook on debunking diet-heart hypothesis + Grain brain by Perlmuter etc … high-fat low carb advocates
2020 Clinical Trial: Mannitol for PD
The NIH Clinical Trial published information on a study provided by Arkadir David of the Hadassah Medical Organization. The study took 60 participants and ran a phase II single center, randomized, double blind and placebo controlled study assessing the safety, tolerability, and effects of progressively increased dose of oral mannitol in PD. The study began in November 2018 and will end in December 2020. There were 60 Participants of both genders and aged 40 to 75 years. The study assessed the safety of mannitol by the number of treatment-related adverse events and significant changes in vital signs. Tolerability was tested by the level of discomfort. Other changes in participants that were monitored included changes in constipation assessment; Montreal Cognitive Assessment; Brief Smell Identification; change in levodopa-equivalent dose units; change in non-motor symptoms of PD scale and the change in the ratio of total-to-proteinase K-resistant a-syn in red blood cells measured by enzyme-linked immunosorbent assay. Results of this study have not yet been posted.
Nattokinase as a Possible Treatment for Cardiovascular Disease
A 2018 review in the NCBI Biomarker Insights journal looks at nattokinase as a possible alternative in the prevention and treatment of cardiovascular disease. Nattokinase (NK), the most active ingredient of natto (cheese-like food made from fermented soybeans), possesses a variety of favorable cardiovascular effects. The review looks at the pharmacological effects and mechanisms of NK in terms of fibrinolytic/antithrombotic effects, anti-atherosclerotic and lipid-lowering effects, antihypertensive effects, antiplatelet/anticoagulant effects, and neuroprotective actions. The review also lists the few clinical studies that have been done with NK. NK is registered as a nutritional supplement and not a drug. In summary, compared with traditional antithrombotic and antihypertensive drugs, NK is characterized by high safety, low cost, simple production process, oral availability, and long in vivo half-life. As such, it is expected to become a new-generation drug for thrombotic disorders or CVDs.
Source: Nattokinase: A Promising Alternative in Prevention and Treatment of Cardiovascular Diseases