Does Parkinson’s Begin in the Gut? (2018) | Hacker News Reader

Does Parkinson’s Begin in the Gut? (2018)

scientificamerican.com

124 pointshaltingproblem57 comments

For something that is so central to our day to day lives and our health and well-being, it doesn’t feel like there is enough focus on what goes into our gut.

By that I mean the number of people that test for allergies and intolerance feels low when you consider the potential payoff.

Just knowing that avoiding certain foods your body doesn’t tolerate can massively improve your quality of life if you are indeed intolerant.

As someone who discovered their celiac disease late in life despite having onerous symptoms I wholeheartedly agree.

How long did it take for you to get rid of the symptoms completely (if ever)?

Asking cause similar case here, however, my symptoms have not gone completely despite being strictly GF for 2+ years now (my ttg iga levels are consistently below 4 units/ml).

Not the person you replied to, but took about 6 months for me the first time. After being "poisoned" by gluten a couple of times over the years, I tend to have symptoms for a month and then all gone within two. I am in the group who gets dermatitis rather than digestive symptoms though (though I also discovered in the process that onions give me the latter so I cut them out too!)

Maybe you should test if you have any other fodmap intolerance.

Monash University is doing a terrific job about it, and their 'Low FODMAP Diet' is the first approach working for me in almost a decade.

Yeah, just read about this recently. But man is following a low FODMAP diet hard!

Absolutely but the Monash app helps with the process, at least in my case.

I'm curious about what testing technology you trust. To diagnose celiac my doctor used TTG IGA values followed by an endoscopy to confirm villous atrophy.

I also recently got a Food intolerance IGG test and a LOT of things were marked red, however, I'm not sure I trust all food intolerance test technologies. Have to read up on this more before I start taking it super seriously (like I do with gluten).

You're right, not all food intolerance tests are the same. For example lactose intolerance tests are pretty accurate but fructose intolerance tests are not as reliable, and need more studies.

I got the full experience: endoscopy, colonoscopy, allergies (skin tests), celiac test, lactose test, fructose test, etc.

Very true, my wife discovered by accident 10 years ago she is fructose intolerant, didn't know before about it, and was basically always in pain as her family was focused on eating healthy by eating lots of fruit...

One of the most under-diagnosed conditions, very hard to figure out by yourself as fructose is everywhere. Staying down below maybe 5g/day for a few days to see the difference requires research. Doing a challenge at the doctor takes a day time and doctors have little awareness to push patients in that direction. Likely as they have little experience due to the treatment being purely nutritional awareness and discipline.

I'm fructose intolerant too, and when I discovered it, and I adjusted my diet accordingly, my life changed for the better.

Probably your wife knows about it but just in case, I've found a great relief in the low fodmap diet by Monash University.

I can not digest fructose, but what helps me is having glucose with every meal eating out, Being intolerant to fructose can also lead to depression if undiagnosed.

It feels a bit like the sea in that respect. Forms a massive part of the world, both in area, depth, biodiversity and climate and we know relatively vert little.

Are allergy tests actually a effective? I read they were a scam

Prick testing works pretty well right, I mean you can see if your immune system reacts to the different things. Where did you read it was a scam?

Some direct-to-consumer tests are a scam

https://sciencebasedmedicine.org/everlywell-at-home-lab-test...

That really depends. My understanding is that ones where they take some of your blood to do a sensitivity test aren’t real science, but the ones where they prick your skin with a bunch of allergens are. I’ve had the latter done by a real doctor in a real hospital and had real medical treatment done as a result of it.

I've been for skin prick allergy testing.

It accurately identified an allergy I knew I had.

What's a good array of tests to get? I feel like I need something more if I have to go to my family doctor and just ask them to "test my gut" ...

If you ask your doctor about testing for potential "food intolerance", I imagine they'll know what you're interested in. Many (most?)tests will cover an array of foods and/or food groups with a single blood test.

Speaking on this topic, is there any efficient way to figure out which foods bother you? Because sometimes I get headaches/digestive issues, but meals are typically so complicated and vary so much that its uncertain what caused the problem. I wish there was like a documented "top 10" or even a "top 100" common bad food reactions. Testing ingredients one by one seems ... tedious.

Cooking for yourself exclusively is a challenging but good start, as you will know exactly what went into it.

"top 10" might be the big 8 allergens plus celiac and the concepts of fodmap and glycemic index & load.

I'm also wondering this. I got sick with a stomach bug a few months ago (not covid) and since then i have a tremendous amount of gas (from both ends). It starts about 5min after i start eating and gradually gets less as the hours go on until i eat again, although it picks up again when i haven't eaten anything in a while too. I can't figure it out. I haven't changed my diet at all from before and after i got stick to start it. I've tried cutting out dairy and also just going straight fruits and veggies with at least a week between each change but no luck. I also tried going on a probiotic diet for a while to try and cycle through and replenish good bacteria. I'm noticeably tired too which is probably because i'm not properly digesting the food to get the required energy from it.

Look up SIBO. Talk to your doctor. Get the breath test.

Hmmm interesting, thanks for the lead! Although i don't have any pain or any of the other symptoms, just the gas.

It can be a good idea to start with a low "FODMAP" and then gradually add stuff to your diet again.

This 2018 article rests on the assumption that Lewy bodies [1] are associated with a pathogen that begins in the gut and works its way into the brain via the vagus nerve. The way I read the cell biology section, Lewy bodies are the artefacts of a broken process in nerve/neuron cells.

It seems to me that the broken process is more likely to be senescence related than a pathogen caused disease that mainly manifests in the elderly.

Regardless, the main take-away I have is that chronic constipation without prior history may be an early symptom of Parkinson’s. This fits the senescence model as degraded nerve function in the gut will cause constipation just like opioids do.

[1] https://en.m.wikipedia.org/wiki/Lewy_body#Cell_biology

I don't think anybody is discounting senescence being a factor, but rather theorising the likely pathology of the disease which may be a combination of different factors, including pathogens together with senescence.

Chronic constipation is also associated with some neurotransmitter disorders that can predispose people to PD. In my experience, doctors are not able to distinguish between PD that's neurodegenerative or neurometabolic during a consult. In addition, GI issues can also complicate neurometabolic PD/Parkinsonism/etc, and I imagine it's difficult to differentiate the two without a thorough evaluation and genetic testing.

I really wish it were this simple, and altering your diet was a way to stave off or treat this horrid disease. My grandfather died from Parkinson's and it was terrible watching this man who was strong as a bull - even in his 70s - degenerate into a helpless old man over the course of about 3-4 years.

Do you mind me asking what diet your grandfather was following?

My father died last year and he had a very bad case of Parkinson's. The diet does fit with the explanation to Parkinson's, although there is also sleep apnea that might have been an even bigger contributor to his Parkinson's development.

Not OP, but my grandfather who died from Parkinson's had two risk factors. Growing up on a farm with pesticides and serving in WW2. Also didn't drink coffee. So you wonder how theses factor are related to diet. Perhaps all associated with "constipation" diets. i.e low in fiber.

Anec-data but my grandpa had Parkinson's as well. WW2 vet, ended up getting a Ph.D in Chemistry and working with fuel additives, plus other interesting stuff. Meticulously planned eating habits, serious coffee drinker.

Interesting, my grandfather also grew up on a farm and served in Korea. Not that sure about his diet, but being from the Midwest I imagine it included lots of carbs and casseroles, probably not enough protein from meats, and certainly not enough fiber.

Recently we have a surge of research linking medical conditions affecting the brain to the gut. Often attributed to bacterial that found a way to bypass the blood brain barrier via the gut .

Yes, my thought exactly. Seems to be a recurring theme, especially with autoimmune diseases.

Is there some central source to follow on developments on all the research surrounding this?

She's not an immunologist, but I really like Dr Rhonda Patrick's podcast about the bleeding edge of medical research. She covers microfauna often. https://www.foundmyfitness.com/episodes

I think you meant "flora", relevant xkcd: https://xkcd.com/1471/ :)

A while ago I studied traditional medicine like Ayurveda for a while. A lot of them state that disease starts from the gut . At the time western medicine totally rejected this idea and most likely not all disease starts that way. But over the last years I read more and more news that the gut flora and nutrition may have more influence than previously thought.

This makes me wonder in what other areas we have blinders on and don’t want to see things that may be beneficial. Meditation is another area that was considered BS when started but suddenly is looked at more seriously.

I've long thought that Western science rediscovers what Eastern mysticism has known for ages.

(That being said, this is no slight against Western science - it's discovered a lot more as well!)

Well, yes and no.

People have known that the sky is blue for as long as we've had a word for the concept "blue".

It's only more recently that we've discovered the sky is blue because of how different wavelengths of light interact with the atmosphere. It's not that we rediscovered that the sky is blue, it's that we have a more precise understanding of the underlying physics.

Medicine isn't that much different. Most eastern medicine is based on cumulative observations made over centuries. If it's effective at treating disease it's the result of understanding the relationships between symptoms, food, and other inputs, even if the underlying pathways are unknown. Western medicine operates at a much lower level of abstraction, which necessarily means more discoveries that clarify the mechanisms of eastern or folk medicine.

Can you name one mechanism of eastern medicine clarified by "Western" medicine?

I am looking for clarification beyond a statistical effect (e.g. a clinical trial) which illustrates the underlying biological effect: in-vivo ideally but will take in-vitro or even in-silico.

I think inflammation is something we understand at a much deeper level due to western medicine. Chinese medicine has a number of herbs that are thought to reduce inflammation, without necessarily having an understanding of what is happening at a cellular or chemical level understood by western medicine. Western medicine would describe inflammation in terms of immune or hormonal response, down to a cellular, or even sub-cellular level.

Said more simply, Western medicine is founded on scientific proof while Eastern medicine is founded on folklore and word of mouth. This isn't to say that Eastern medicine is bad or doesn't work, it simply doesn't have scientific proof behind it (yet).

I think that’s too simplistic. Eastern medicine is based a lot on observation. Their explanation may be questionable but the observations are often very useful.

"When started"? I don't think it was ever really considered BS other than maybe specifically western medicine in the past max 100 years. Doesn't it make sense that with the progress medicine has done in the last century that we would scrutinise methods which couldn't be scientifically proven?

"eastern" practices are often described in such generic way that any "works / doesn't work" becomes meaningless. Especially in case of ideas connected to mysticism. What does "does meditation work?" even mean. It's like "do pills work?" What kind of pills, what kind of meditation, what kind of effect are we looking at. I've heard many people describing it as BS, but they also heard of it as a miracle cure.

I think what changed recently is that a lot more details are included in the conversations.

“I've heard many people describing it as BS, but they also heard of it as a miracle cure.“

This may actually be true. For some people it works and for others it doesn’t. I think western medicine’s main mistake is to come up with things that work for as many people as possible. But we are very different and may need different things to be healthy.

It's more cost effective if things work for everyone, but it's not like we reject things because they are not generic enough. See how many different statins you can be on for example if one doesn't work for you. If RNA testing was cheaper we could skip the guessing part (for statins) though and know which one to start with. Same with different techniques in psychology.

I don't think any serious professional disagrees with different needs.

yeah, try and explain the concept of 'agni' to people on HN lol

Or Panch maha bhuta.

That’s one of the easier ones :).

I really get sad seeing wishfull thinking like this. In mice, it has been demonstrated that parkinsons is linked to damaged neurons - the cells are damaged for the lifetime of the animal and the symptoms appear only later in life. I have parkisons on both sides of my family tree, I've watched people die from it , I'm watching close loved ones wither away even now. I despise these feel good articles that offer false hope to the aflicted...

Not all bacteria is bad. In fact, without bacteria within our bodies there would be no us. It's been a long dirty and evolving road to get to this point. The First World's modern obsession with hand sanitizers and such is having unintended consequences. We should not be surprised.

>The First World's modern obsession with hand sanitizers and such is having unintended consequences

It's not...obvious...that hand sanitizers screw up your digestive bacteria. Compared to just soap? It's also not obvious, if it is a concern, why toothpaste and mouthwash aren't more of a concern.

First, do note "and such." The point being the obcession with being hyper-clean is an historic blip.

We don't use soap as often. Hand sanitizers are a modern convenience. They're everywhere. In your purse. In your backpack. And so on.

Our normal and natural exposure to bacteria is being diminished. As our awareness of our bacteria-driven internal systems increases, pattern _are_ in fact starting to develop.

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