Why MJFox did well in the mountains

[reverett123]

You remember the discussion of possible reasons? I think I know now. It is time to think seriously about the acid-base balance and system pH. And how we breathe.

Because we breathe shallowly (and maybe other reasons) we tend to be acidic. That leads to a number of problems that I'm going to post later. For now let's just say that an acidic state makes PD worse.

An alkaline state (alkalosis) makes PD less of a problem. As the following study shows, the act of going to high altitudes creates just such a state.

"
1. Respir Physiol Neurobiol. 2005 Jan 15;145(1):41-52.

Changes in respiratory control after 5 days at altitude.

Somogyi RB, Preiss D, Vesely A, Fisher JA, Duffin J.

Department of Physiology, University of Toronto, Medical Science Bldg, Room 3326,
1 Kings College Circle, Toronto, Ont., Canada, M5S 1A8.

These experiments examined changes in the chemoreflex control of breathing and
acid-base balance after 5 days at altitude (3480 m) in six healthy males. The
partial pressures of carbon dioxide (P(CO2)) at which ventilation increased
during isoxic hypoxic and hyperoxic modified rebreathing tests at sea level fell
significantly at altitude by mean+/-S.E.M. of 12.8+/-2.51 mmHg and 9.5+/-1.77
mmHg, respectively, but response slopes above threshold were unchanged. Altitude
exposure produced a respiratory alkalosis evidenced by a decrease in mean resting
end-tidal P(CO2) from 41+/-0.84 mmHg at sea level to 32+/-2.04 mmHg at altitude,
but pH did not increase significantly from its sea level value. Blood samples
were analyzed to discover acid-base changes, using a modification of the
equations for acid-base balance proposed by [Stewart, P.A., 1983. Modern
quantitative acid-base chemistry. Can. J. Physiol. Pharmacol. 61, 1444-1461].
While strong ion difference at altitude was not significantly different from its
sea level value, albumin concentration was increased significantly from
38.6+/-0.30 g L(-1) to 49.8+/-0.76 g L(-1). We suggest that the respiratory
alkalosis was produced by a fall in the chemoreflex threshold and pH was
corrected by an elevation in the concentration of weakly dissociated protein
anions.


PMID: 15652787 [PubMed - indexed for MEDLINE]

[reverett123]

(I hate to argue with myself. I always lose.)
Along with the acid-base change comes increased blood to the brain.
"
1. J Physiol. 2010 Feb 1;588(Pt 3):539-49. Epub 2009 Dec 21.

Influence of high altitude on cerebrovascular and ventilatory responsiveness to
CO2.

Fan JL, Burgess KR, Basnyat R, Thomas KN, Peebles KC, Lucas SJ, Lucas RA,
Donnelly J, Cotter JD, Ainslie PN.

Department of Physiology, Otago School of Medical Science, University of Otago,
Dunedin, New Zealand.

Comment in:
J Physiol. 2010 Jun 1;588(Pt 11):1811-2.
J Physiol. 2010 Jun 1;588(Pt 11):1815-6.

An altered acid-base balance following ascent to high altitude has been well
established. Such changes in pH buffering could potentially account for the
observed increase in ventilatory CO(2) sensitivity at high altitude. Likewise, if
[H(+)] is the main determinant of cerebrovascular tone, then an alteration in pH
buffering may also enhance the cerebral blood flow (CBF) responsiveness to CO(2)
(termed cerebrovascular CO(2) reactivity). However, the effect altered acid-base
balance associated with high altitude ascent on cerebrovascular and ventilatory
responsiveness to CO(2) remains unclear. We measured ventilation , middle
cerebral artery velocity (MCAv; index of CBF) and arterial blood gases at sea
level and following ascent to 5050 m in 17 healthy participants during modified
hyperoxic rebreathing. At 5050 m, resting , MCAv and pH were higher (P < 0.01),
while bicarbonate concentration and partial pressures of arterial O(2) and CO(2)
were lower (P < 0.01) compared to sea level. Ascent to 5050 m also increased the
hypercapnic MCAv CO(2) reactivity (2.9 +/- 1.1 vs. 4.8 +/- 1.4% mmHg(1); P <
0.01) and CO(2) sensitivity (3.6 +/- 2.3 vs. 5.1 +/- 1.7 l min(1) mmHg(1); P <
0.01). Likewise, the hypocapnic MCAv CO(2) reactivity was increased at 5050 m
(4.2 +/- 1.0 vs. 2.0 +/- 0.6% mmHg(1); P < 0.01). The hypercapnic MCAv CO(2)
reactivity correlated with resting pH at high altitude (R(2) = 0.4; P < 0.01)
while the central chemoreflex threshold correlated with bicarbonate concentration
(R(2) = 0.7; P < 0.01). These findings indicate that (1) ascent to high altitude
increases the ventilatory CO(2) sensitivity and elevates the cerebrovascular
responsiveness to hypercapnia and hypocapnia, and (2) alterations in
cerebrovascular CO(2) reactivity and central chemoreflex may be partly attributed
to an acid-base balance associated with high altitude ascent. Collectively, our
findings provide new insights into the influence of high altitude on
cerebrovascular function and highlight the potential role of alterations in
acid-base balance in the regulation in CBF and ventilatory control.


PMCID: PMC2825616 [Available on 2011/2/1]
PMID: 20026618 [PubMed - indexed for MEDLINE]

So we have an acidically reduced blood flow to the brain??

[Conductor71]

I have been turning that very same question around myself ever since he clued us in. I imagine the rate of Parkinson's near the Continental Divide is fairly low.

I thought hypoxia would be a negative for us. I was confused and still am by people using hyperbaric chambers to treat PD. I had read that the YO basketball player Brian Grant is treated in one a weekly basis. Those simulate the air pressure inside a submarine. How does this all tie together?

Laura

[moondaughter]

Originally Posted by Conductor71

How does this all tie together?

Laura

Take a look at videos 2,4,6 at www.tmjstack.com - what interests me is the immediate response to aligning the jaw bone...testimony to the power of alignment. something VERY powerful is going on here....the tmj regulates breathing (gateway to the airway and bloodflow to the brain through the carotid artery by increasinng its diameter)

how about a study wheree we all go on a trek to the Himalayas and to Lasa? Now THAT would be the absolute coolest pd study ever!

breathing .....breathing......breathing aaaaaaaahhhhhhhhhhhh

[reverett123]

Originally Posted by Conductor71

I have been turning that very same question around myself ever since he clued us in. I imagine the rate of Parkinson's near the Continental Divide is fairly low.

I thought hypoxia would be a negative for us. I was confused and still am by people using hyperbaric chambers to treat PD. I had read that the YO basketball player Brian Grant is treated in one a weekly basis. Those simulate the air pressure inside a submarine. How does this all tie together?

Laura

It may be premature to try to tie it together, but I will try. (BTW, I think this has a lot to do with our shared problems.)

Our bodies tightly control the pH of our system. We seem to be designed to function best with a slightly alkaline value but certain things push that into acidic territory. Among those things are low oxygen levels (hypoxia) such as one encounters when breathing shallowly. This is called respiratory acidosis. Another is metabolic acidosis which can arise from a number of causes such as kidney problems or glucose issues. Regardless of type, acidosis is not good, especially with PD.

An acidic environment in the brain causes glial swelling and neuronal death, for starters.

But in the body as a whole it becomes more a problem of electrolytes. The lungs and kidneys are the way our bodies regulate our electrolytes. When we found ourselves so weak, we were in an acidic state and barely breathing. CO2 built up and the situation worsened. Our kidneys entered the picture and urine output sky rocketted to get us back to a balance point.

So where from here? There are a couple of tools for the white rat. One is deep vigorous breathing - what the Yogis call "Breath of Fire". I started experimenting with it yesterday afternoon. Among the changes I noted was that I slept through the night without a bladder break. Very unusual for me.

The second tool is baking soda, but be cautious. Overdoing it can cause you to overshoot on the correction. I took a half-tsp this morning and seem to be doing better than usual on less medication.

[just_me_77]

Originally Posted by reverett123

It may be premature to try to tie it together, but I will try. (BTW, I think this has a lot to do with our shared problems.)

Our bodies tightly control the pH of our system. We seem to be designed to function best with a slightly alkaline value but certain things push that into acidic territory. Among those things are low oxygen levels (hypoxia) such as one encounters when breathing shallowly. This is called respiratory acidosis. Another is metabolic acidosis which can arise from a number of causes such as kidney problems or glucose issues. Regardless of type, acidosis is not good, especially with PD.

An acidic environment in the brain causes glial swelling and neuronal death, for starters.

But in the body as a whole it becomes more a problem of electrolytes. The lungs and kidneys are the way our bodies regulate our electrolytes. When we found ourselves so weak, we were in an acidic state and barely breathing. CO2 built up and the situation worsened. Our kidneys entered the picture and urine output sky rocketted to get us back to a balance point.

So where from here? There are a couple of tools for the white rat. One is deep vigorous breathing - what the Yogis call "Breath of Fire". I started experimenting with it yesterday afternoon. Among the changes I noted was that I slept through the night without a bladder break. Very unusual for me.

The second tool is baking soda, but be cautious. Overdoing it can cause you to overshoot on the correction. I took a half-tsp this morning and seem to be doing better than usual on less medication.

Rick,

I have been adding 1/8 teaspoon of Arm & Hammer to a bottle of spring water (do not drink tap due to area source pollution). Found that a paternal cousin (dad's first) has had Lupus for several years among other ailments. She told of a mixture of baking soda and maple syrup to help with cancer. (She had malignant tumor removed from brain in 1987; said it was due to exposure to industrial solvents working cleaning aircraft fuel tanks). My PD issues w/ left side seem much improved while drinking this bottle @ rate of one to two per day.

It has been said cancer needs an acidic environment to grow; alkaline is the best way to go for overall health of anyone with or without PD.

[tulip girl]

Frequency
United States
Metabolic alkalosis is the most common acid-base disturbance observed in hospitalized patients, accounting for approximately 50% of all acid-base disorders.

Mortality/Morbidity
Severe metabolic alkalosis (ie, blood pH >7.55) is a serious medical problem. Mortality rates have been reported as 45% in patients with an arterial blood pH of 7.55 and 80% when the pH was greater than 7.65.

Severe alkalosis causes diffuse arteriolar constriction with reduction in tissue perfusion. By decreasing cerebral blood flow, alkalosis may lead to tetany, seizures, and decreased mental status. Metabolic alkalosis also decreases coronary blood flow and predisposes persons to refractory arrhythmias.

Metabolic alkalosis causes hypoventilation, which may cause hypoxemia, especially in patients with poor respiratory reserve, and it may impair weaning from mechanical ventilation.

Alkalosis decreases the serum concentration of ionized calcium by increasing calcium ion binding to albumin. In addition, metabolic alkalosis is almost always associated with hypokalemia, which can cause neuromuscular weakness and arrhythmias, and, by increasing ammonia production, it can precipitate hepatic encephalopathy in susceptible individuals.

http://emedicine.medscape.com/article/243160-overview

[dbring]

I was diagnosed with PD in 1999, had bilateral DBS in 2007, and currently take high doses of carbidopa/levodopa and entacapone as well as 135 mg/day of amantadine.

My home is near sea level in the Bay Area. I just got back from four days in the eastern Sierra at 7-10+ thousand feet. *I was able to do 4-5 miles a day of hiking, with significant elevation gain and loss. *I noticed a clear improvement in my Parkinson's symptoms. *I used less levodopa, had little tremor and no foot cramps (which I often get when walking late in a dose cycle), slept in 3-4 hour stretches instead of 2 hour and felt better in general. On returning home two days ago, my symptoms and dosing needs returned to usual levels.

These effects were so striking that I Googled "Parkinson's altitude", which led me to this forum thread and to Michael J. Fox's Bhutan video. I had no prior knowledge of either before the trip, and was actually worried that my symptoms might be worse at high altitude.

In several of your posts, you state that acidosis has particularly bad effects in PD patients. Can you be more specific on details of how and why acidosis is worse for PD patients and can you provide some links or references?

Thanks,

Dave Ring

Originally Posted by reverett123

It may be premature to try to tie it together, but I will try. (BTW, I think this has a lot to do with our shared problems.)

Our bodies tightly control the pH of our system. We seem to be designed to function best with a slightly alkaline value but certain things push that into acidic territory. Among those things are low oxygen levels (hypoxia) such as one encounters when breathing shallowly. This is called respiratory acidosis. Another is metabolic acidosis which can arise from a number of causes such as kidney problems or glucose issues. Regardless of type, acidosis is not good, especially with PD.

An acidic environment in the brain causes glial swelling and neuronal death, for starters.

But in the body as a whole it becomes more a problem of electrolytes. The lungs and kidneys are the way our bodies regulate our electrolytes. When we found ourselves so weak, we were in an acidic state and barely breathing. CO2 built up and the situation worsened. Our kidneys entered the picture and urine output sky rocketted to get us back to a balance point.

So where from here? There are a couple of tools for the white rat. One is deep vigorous breathing - what the Yogis call "Breath of Fire". I started experimenting with it yesterday afternoon. Among the changes I noted was that I slept through the night without a bladder break. Very unusual for me.

The second tool is baking soda, but be cautious. Overdoing it can cause you to overshoot on the correction. I took a half-tsp this morning and seem to be doing better than usual on less medication.

[Canna]

Rick, I start off the day with the juice of 1/2 lemon in a coffee cup of hot water. Goes down much easier than baking soda. I feel good and it gets things going as well (though some add cayenne to enhance this effect.) About the alkalinizing effect of lemons:

http://www.livestrong.com/article/49...ater-alkaline/

[Nan Cyclist]

In 2011 four of us with PD summited Mt. Kilimanjaro, 19,340', as part of Lori Schneider's Empowerment Through Adventure program. The three men were in their 50s and all had prior mountain climbing experience. One has had DBS. One lives at 6,000' elevation in Colorado. I was 65 and live at sea level. One scooted to the top so quickly I never even saw him on summit night. Of the other guys, the CO was in great shape but a little silly on top. The DBS guy was all over the place, which he attributed to taking his meds at the wrong time. None of us showed signs of Altitude Mountain Sickness (AMS). I was fine, even though I was the last of the group of get to the top. It was hard to say anything definitive about our PD symptoms. We all kept up with our meds although I took mine about three hours later than normal, which I often do on busy days. I can't say anything definitive about the effect of altitude on PD or the possibility that PD helps with AMS. Several people in the group of 28 had AMS and one person needed oxygen, but all came through the adventure.

In May 2012 I trekked to Annapurna Base Camp (ABC) in Nepal, 13,500'. I was the oldest woman in the group and the only one with PD. Although several people had mild AMS (headache, nausea), no one had any major problems.

My tremor continued in both locations, exacerbated when I was particularly tired and/or cold. I have few other PD symptoms but found that going without cycling for weeks on end brought back the cramps, rigidity, etc. These are on their way out as I am back on the bike.

The average elevation in Bhutan is 8,000'. I don't know how high Michael went, although when we talked about it this spring, he said he didn't go nearly as high as we did. My understanding from him and others is that the culture in Bhutan is similar to that in Nepal, where I felt utterly safe, cared for, welcomed, and in a peaceful place. I made a video at the ABC in which I said, "This is a holy place." Several times along the trek I just stopped and wept at the beauty of the place and the overwhelming sense of peace I felt. I would not be a bit surprised if Michael felt that too in Bhutan. Perhaps it's the altitude. I think it's something else.