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A Five-Arm Treatment Plan for Parkinson’s Disease

Oct 21st 2021

A Five-Arm Treatment Plan for Parkinson’s Disease

Parkinson’s disease (PD) is a progressive neurological disease second only to Alzheimer’s as a thief of brain cells and quality of life.

Although everyone’s PD journey is different in terms of the appearance and intensity of symptoms, and how quickly the disease progresses, the central feature of PD is that brain cells responsible for producing the neurotransmitter dopamine begin to die off. The resulting dopamine deficiency produces PD’s characteristic symptoms, including tremors, rigidity, posture and balance problems, slowed movement and difficulty initiating movement, and non-motor symptoms such as depression, anxiety, fatigue, insomnia and other sleep disorders, cognitive impairment and dementia.

Allopathic medicine manages PD motor symptoms by replacing or boosting dopamine production. Most PD patients will need these drugs because by the time PD can be diagnosed, 60-80% of dopamine-producing brain cells are already gone. There is also a surgery called Deep Brain Stimulation that has been very helpful in controlling tremors and other motor symptoms.

But neither drugs nor surgery stop the inexorable destruction of dopamine-producing brain cells leading ultimately to dementia and complete disability.

To address both symptom control and the preservation of dopamine-producing brain cells, Frank C. Church, M.D., at the University of North Carolina School of Medicine, recommends an “integrated approach” in dealing with PD.

Church’s treatment plan has five arms. Drugs and Surgery are two arms. Rehabilitation is a third. This involves physical therapy and often voice therapy (in PD the voice often becomes soft and hard to hear).

The fourth arm, which he calls “Restorative,” starts getting into protecting and preserving brain cells. The central therapy in this arm is exercise.

Exercise has been well-studied for its effect on PD, and studies show that while moderate exercise improves quality of life in people with PD (PwP), strenuous aerobic exercise likely has a neuroprotective effect on dopamine-producing brain cells. Strenuous exercise has antioxidant and anti-inflammatory effects both in the brain and systemically, and it has been shown to inhibit the accumulation of a harmful protein in the brain characteristic of PD called alpha-synuclein.

Practicing stress-reduction techniques, although not as well-researched, appears to be neuroprotective as well.

The last arm of Dr. Church’s treatment plan is “Maintenance” of dopamine-producing brain cells by reducing damaging neuroinflammation (brain cell inflammation). This is done with antioxidant and anti-inflammatory supplements that protect brain cells and the “energy factories” that exist inside each brain cell called the mitochondria.

Dr. Church recommends and provides study citations documenting the effectiveness of the following supplements in PD: vitamin D3, magnesium l-threonate (a form of magnesium that can cross the blood-brain-barrier and enter the brain), vitamin B1 (thiamine), taurine, curcumin, alpha-lipoic acid, acetyl-l-carnitine, n-acetyl-cysteine, trans-resveratrol, and melatonin.

Our blog readers will recognize these familiar nutrients as working best within a healthy, anti-inflammatory lifestyle. We also advise protecting your precious brain cells from neurotoxins, found especially in processed foods and pesticides.

Although many PwP and their doctors will rely solely on Dr. Church’s first three arms, it is important to remember that drugs and surgery lose their effectiveness over time as the disease progresses and more dopamine-producing brain cells die. Although most PwP will need to use some form of dopamine replacement or enhancement medication to control symptoms, those who include arms four and five will need less medication and may be able to prevent losing more brain cells and stabilize their disease at a point where it is still quite manageable.


Church FC. Treatment options for motor & non-motor symptoms of Parkinson’s disease.
Biomolecules. 2021 Apr 20;11(4):612.




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