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Glutathione: New Hope for Parkinson's?

A new therapy for Parkinson's disease is making inroads in some clinics and alternative healing centers--but the jury is still out on how effective or safe it really is. Pioneered by Florida neurologist Dr. David Perlmutter, the new treatment showing promise involves high doses of the potent antioxidant, glutathione, which are given intravenously.

In Parkinson's disease, the area of the brain that produces dopamine, a vital substance controlling body movements, gradually withers away. For some time, researchers have speculated that one cause of the disorder's devastating symptoms-tremor, shuffling gait, rigidity-might be damage from destructive oxygen molecules known as free radicals. To battle such oxidative injury, many Parkinson’s specialists think antioxidants may be a very effective therapy.

Recently, for example, there have been inklings that another antioxidant, the popular supplement coenzyme Q10, may indeed be able to reduce Parkinson's symptoms. A well-designed (randomized, placebo-controlled) study of 80 patients with early Parkinson's disease found that coenzyme Q10 slowed the progressive deterioration characteristic of the condition. However, the authors of the study, which was reported in the October 2002 Archives of Neurology, caution that much more research is needed before this antioxidant can be widely recommended for the disease.

Chance Discovery
Glutathione is an important antioxidant in the brain and the rest of the body. One of its primary roles is to protect cells from destructive free radicals, chemicals formed by normal biological processes and exposure to environmental toxins. Glutathione also enhances the action of dopamine, levels of which are often critically low in people with Parkinson’s.

"Clearly in Parkinson's and other neurodegenerative diseases, the brain is literally on fire," explains Dr. Perlmutter. "All the inflammatory chemicals that are normally elevated in an arthritic knee, for example, are found in the brains of people with Parkinson's. Our society tends to treat the smoke, meaning the symptoms, but not the fire."

Originally, Dr. Perlmutter used glutathione to treat chronic fatigue syndrome. One of his CFS patients also had Parkinson's and reported dramatic improvements in his Parkinson's symptoms after receiving the glutathione. Perlmutter researched the topic and found that a small study in Italy had shown similar benefits. He then began in 1998 to administer glutathione to Parkinson's patients at his Naples, Florida, clinic.

"Since that time, we've amplified the protocol, increased the dosage, and have now treated hundreds of Parkinson's patients successfully," says Dr. Perlmutter, who was awarded the prestigious Linus Pauling Award in May 2002 by the Institute for Functional Medicine on the basis of his research. His definition of success, he adds, is not only that PD symptoms improve, but that many patients are able to subsequently reduce the dosage of dopamine-boosting drugs, such as L-dopa, that constitute the crux of current Parkinson's therapy.

Innovative Protocol
Glutathione is not an FDA-approved pharmaceutical but instead a relatively inexpensive dietary supplement (it costs about a dollar for every 100 mg). For various reasons it can’t be patented by drug companies, which do the bulk of clinical trials on new medications. Dr. Perlmutter contends that this inability to patent glutathione (and thus anticipate profits to support the initial research) explains why there have been so few trials on its use for Parkinson’s so far.

For most patients, Dr. Perlmutter recommends 1400 mg glutathione mixed with saline and given intravenously (over the course of 15 to 20 minutes) three times a week. At his clinic, the herb milk thistle (Silybum marianum), believed to increase glutathione retention, is added to the regimen, along with the amino acid N-acetyl cysteine (NAC), another nutritional therapy that actually enhances the body’s own production of glutathione.

So far, IV administration has been the only effective way to give sufficient dosages of glutathione, although an oral formulation is now in development, according to Dr. Perlmutter. The problem with an oral dosage is that the delicate glutathione molecule is damaged during the digestive process and it may be difficult to get an adequate amount into the bloodstream.

Some Skepticism--and a New Study
Because even the most enthusiastic testimonials and patient anecdotes are not considered reliable scientific evidence, most Parkinson's experts are withholding judgment on glutathione therapy until more convincing evidence is clearly proved. Some are concerned, for instance, that a placebo effect-the hope and belief that a treatment will work-might be at play.

Their wait may be shorter than once thought. The Food and Drug Administration has just approved a large, randomized, placebo-controlled study at the University of South Florida, which Dr. Perlmutter hopes will validate his work.

Date Posted: 10/31/2002

Date Published: 10/30/2002
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