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Fermented products are full of good gut bacteria or probiotics that your digestive system needs to break down food and absorb nutrients. For people living with Parkinson’s disease, these helpful bacteria can be the key to easing some uncomfortable symptoms and improving quality of life.
This article will discuss how your gut health is linked to Parkinson’s disease and how probiotics can help relieve some of your symptoms. While it’s still unclear whether supplements improve motor symptoms, evidence shows that probiotics can aid digestion, reduce constipation, and help manage other digestive symptoms of Parkinson’s disease.
Parkinson’s disease is a neurodegenerative disease that affects muscle control, movement, and balance. In this disease, your brain’s nerve cells, also called neurons, die off. These neurons are found in the midbrain, which is closely connected with the basal ganglia, the area of the brain responsible for controlling your body’s voluntary motions, like reaching for an object or walking.
In Parkinson’s disease, the death of brain cells leads to lower levels of specialized chemicals known as neurotransmitters. Without enough of a specific neurotransmitter called dopamine, Parkinson’s symptoms occur.
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Researchers have found that many people with Parkinson’s disease have an imbalanced gut microbiome, a pattern known as gut dysbiosis. Scientists are still trying to figure out what this means.
Changes in the gut microbiome could contribute to Parkinson’s, develop as a result of the disease, or both. So far, research hasn’t established a clear cause-and-effect relationship.
Your gut is home to more than 100 trillion bacteria from over a thousand species. These microorganisms make up your gut microbiome, which is key to a healthy digestive and immune system.
So, what do your gut microbiota and your brain have in common? Quite a lot, according to scientists. Research has found that these bacteria play a significant role in central nervous system function. This connection is known as the gut-brain axis, and it’s been largely studied in Parkinson’s disease.
Researchers have proposed a possible mechanism to explain this connection: an out-of-balance gut microbiome may lead to inflammation that damages the gut’s lining. This damage could increase intestinal permeability — sometimes called a “leaky gut” — allowing bacteria, pathogens, and other molecules to move out of the gut and into the bloodstream.
Scientists believe this intestinal inflammation may also play a role in the production of alpha-synuclein proteins. When these proteins clump together in the brain, the clusters are called Lewy bodies, which are often seen in people with Parkinson’s disease.
Researchers are also studying whether this inflammation affects the blood-brain barrier and contributes to further dopamine loss, though this pathway hasn’t been fully confirmed in people with Parkinson’s disease.
Although Parkinson’s disease is primarily considered a movement disorder, it also causes nonmotor symptoms. Up to 80 percent of people with Parkinson’s also experience gastrointestinal (GI) symptoms.
This is because the disease affects the autonomic nervous system, which controls the muscles in the digestive tract. Gut dysbiosis can also lead to uncomfortable GI symptoms.
Digestive symptoms commonly seen in people with Parkinson’s disease include:
In many cases, these symptoms appear years before a Parkinson’s diagnosis. Many of these GI symptoms also affect how well the Parkinson’s drug levodopa (combined with carbidopa in the brand names Crexont, Duopa, Sinemet, and Rytary) and other medications are absorbed in your stomach and intestines.
Since people with Parkinson’s disease may have an imbalanced gut microbiome, studies have begun looking into treating this problem. One possible solution involves probiotics.
Probiotics are beneficial bacteria and yeasts found naturally in the gut. Probiotic supplements put more of these good microbes into your intestines, which may help change the makeup or activity of your gut microbiome.
The bacteria and yeast found in probiotics can:
How well this works can depend on the specific probiotic strain and the person taking it. Research hasn’t yet shown that probiotics restore a gut microbiome in someone with Parkinson’s to look like that of someone without the disease.
Researchers have started to investigate whether probiotics can treat Parkinson’s symptoms. Most research so far has been in animal models, but a handful of small studies in people have been published.
Motor symptoms are common in people with Parkinson’s disease. One example is akinesia, which makes it difficult to move your muscles. It may take longer for your muscles to react to your attempt to move them, or you may freeze in the middle of an action.
The probiotic PS128 is being studied as a way to combat these symptoms. PS128 comes from the bacteria Lactobacillus plantarum, which is naturally found in some fermented foods.
In one study, 25 people with Parkinson’s disease were given a PS128 supplement along with their standard levodopa treatment. The participants reported that their motor function improved, based on the Unified Parkinson’s Disease Rating Scale. They also saw a 16.8 percent improvement in their akinesia symptoms.
This early study didn’t include a placebo group for comparison, so it can’t confirm on its own whether PS128 caused the improvement. Since then, researchers have studied probiotics, prebiotics, and other gut-focused supplements more broadly in larger trials and combined analyses of multiple studies.
So far, the evidence is more convincing for improving constipation than for improving motor symptoms. PS128 itself is not yet considered an established treatment for Parkinson’s motor symptoms, and more research is needed to know whether it can reliably help.
Since probiotic supplements support a healthy digestive system, they may be useful for relieving GI symptoms in Parkinson’s disease. Researchers who pooled the findings of 12 studies found that probiotics were linked to more frequent bowel movements, improved stool consistency, and less need for laxatives.
In another small study, taking probiotic supplements after meals helped reduce bloating, constipation, and abdominal pain in people with Parkinson’s disease. If you’re interested in learning more about probiotics’ beneficial effects for your GI symptoms, talk to your doctor.
MyParkinsonsTeam members have discussed the topic of probiotics. “Does anyone have a good experience with probiotics?” asked one member. “I hesitate to take additional capsules but am curious about other views.”
“I take probiotics and the jury is still out,” replied one member. “I’ve been taking them for over a year, and I can’t tell if I’m worse, better, or unchanged.”
Another responded, “I agree. I’ve been taking a probiotic for years, but I can’t tell if it’s helping.”
Members have also asked specifically about PS128: “Is anyone taking the probiotic PS128? If so, can you please share any positive or negative results?”
Another reached out and said, “I take probiotics and prebiotics. They contain PS128. I found them helpful for my upset stomach and balance sometimes.” Prebiotics are specialized sugars that probiotic bacteria and yeasts like to eat.
If you’re interested in taking a probiotic supplement to treat your symptoms, talk to your doctor. They may have some suggestions that have worked for other people with Parkinson’s disease.
You can find many probiotics available as powders, pills, capsules, or liquids in stores’ nutritional supplements sections. Check product labels for the names of beneficial bacteria such as Lactobacillus acidophilus and Bifidobacterium bifidum.
You can take prebiotics and probiotics together. Supplements that combine the two are known as synbiotics.
Harvard Health Publishing notes that there isn’t a recommended daily dose for probiotics. The U.S. Food and Drug Administration (FDA) regulates supplements less rigorously than medications, so dosing and bacterial makeup differ from brand to brand.
Some fermented foods and beverages can also be a source of probiotics, but fermentation alone doesn’t guarantee a food contains live bacteria. Vinegar-based pickles, for example, often have no live cultures, and the cultures used to make sourdough bread are largely killed during baking.
Check labels for the phrase “live and active cultures” to know if a product still contains them. Foods and drinks that commonly contain live cultures include:
Consider adding more of these choices to a Parkinson’s disease diet, along with plenty of fruits and vegetables. A registered dietitian can offer more suggestions on how to get probiotics in your diet.
Probiotics are generally well tolerated by healthy people, but they can occasionally cause more serious problems, including infections, in people who are severely ill or have a weakened immune system. More common, milder side effects include:
As always, check with your doctor before using any supplements, including probiotics. They can help guide you toward achieving more of the positive effects and fewer of the unwanted ones.
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I have been taking a probiotic supplement for a couple years now to combat the malfunctioning micro biome associated with Parkinson’s. I had a conversation with a Michael J Fox reasercher who said… read more
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