Which Probiotic Is Best for Parkinsons?

Parkinson's Disease (PD) is a well-known neurodegenerative disorder, the second most common behind Alzheimer's. Although it affects roughly 10 million people worldwide, it does not have a cure, and several different types of treatment exist. In an effort to better understand the body's role in PD in a patient, researchers have begun looking into overall gut health and the gut-brain axis for answers and possible treatment options. The connections between the gut and the brain have led researchers to investigate probiotics for their neuroprotective effects and ability to help support people with Parkinson's Disease.

In order to fully grasp the potential benefits of probiotics for PD patients, it is vital to understand the ins and outs of Parkinson's Disease, the science behind probiotics, and how the gut-brain axis research connects between the two. Keep reading to learn more about how probiotics are being encouraged as a way to relieve PD patients of some of their symptoms and even used as a possible preventive against PD. 

Understanding Parkinson's Disease

Parkinson's Disease is a progressive movement disorder that worsens over time. Most commonly, patients develop PD symptoms after 60 years of age. However, there are cases of early-onset Parkinson's Disease, which affects roughly 5-10% of those that are diagnosed

In PD patients, cell loss occurs in the region of the brain known as the substantia nigra. The neurotransmitter created in this region of the brain is dopamine, which helps facilitate and regulate movement. This is where the motor symptoms of PD come into play, as the low dopamine levels cause the patient to lose the regulation of their movement. Patients typically only begin to experience motor symptoms after about 50% of the cells have been damaged or lost

In a Parkinson's Disease brain, the protein alpha-synuclein clumps up into aggregates called Lewy bodies. Researchers believe that this aggregation within the substantia nigra may be a cause of PD and have begun working on treatment and prevention options centered around this theory.

Parkinsons is a neurodegenerative disease that may be helped by probiotics

Symptoms of Parkinson’s Disease

PD patients experience both motor and non-motor symptoms. These symptoms are important to note, as they are the main ways that physicians diagnose PD in their patients. However, not all of these symptoms may be present in a patient, especially in early stages, and further neurological testing can be used to confirm a diagnosis of PD.

Common Motor Symptoms:

  • Tremors
  • Rigidity
  • Slow movement
  • Balance problems
  • Vocal changes

Common Non-Motor Symptoms:

  • Cognitive changes
  • Depression and anxiety
  • Vision changes
  • Fatigue
  • Gastrointestinal problems
  • Personality changes
  • Psychosis
  • Sleep problems
  • Urinary issues
  • Weight loss


As neurons within the substantia nigra die, dopamine levels decrease, leading to the symptoms of Parkinson's. Dopamine is a neurotransmitter in the brain and nervous system that helps control movements in the body. When these levels are compromised in a patient, they can experience slow or abnormal movements. 

Although we know that loss of dopamine-producing neurons causes the symptoms of PD, what remains open for debate is what causes these neurons to begin to die in the first place. Some studies have pointed to genetics, with variations in over a dozen different genes correlating with  increased risk of developing Parkinson's Disease. However, not everyone with these variations goes on to develop the disease. Another inconclusive theory points to the environment as a contributing factor by exposing people to pesticides and herbicides, as well as traffic and industrial pollution. It’s likely that for many PD patients, a variety of risk factors were involved.

Interestingly, many PD patients experience GI symptoms many years before developing motor symptoms, prompting researchers to look into a gut-brain connection for the cause of PD. In so-called “gut-first” patients, aggregation of alpha-synuclein starts in the enteric nervous system (ENS) and spreads to the brain. In these studies, researchers pointed to a protein called alpha-synuclein as a primary contributor to PD and recognized that in some patients, it was found originating in the ENS in the gut and later affecting the CNS. However, not all patients have this “gut-first” accumulation of ⍺-synuclein, which led to the separate subtypes of gut-first and brain-first PD.

Current Medical Treatment Options

Medication is the most common form of treatment for PD patients, allowing them to manage their motor symptoms. The most common medications are designed to replace dopamine function. When it comes to medication, there is no one-size-fits-all, but instead, a medicine management plan is used to adjust to the patient's specific needs. 

Physical, occupational, and speech therapy are other commonly used and effective forms of treatment for PD patients. Since Parkinson's Disease presents itself through several motor symptoms, partaking in physical and occupational therapy can help patients to improve their balance and adapt to the changes brought on by PD. This can be done in various ways, including using weighted silverware to adjust to the tremors that make eating difficult. Speech therapy can help some patients whose speech patterns are severely affected to the extent it disrupts their communication with others.

Deep brain stimulation, or DBS, is a surgical procedure that eligible patients can utilize as a way to manage their PD symptoms. This surgery implants electrodes into the brain and is powered by a device placed under the skin in the chest area. This helps patients who have medicine-resistant tremors and other motor symptoms.

What About Probiotics?

Clasped hands of elderly people. What about probiotics for Parkinson's?

The medical therapies available for Parkinson’s don’t work well for all people, and many prefer a non-medical route where possible. In addition to a wide variety of vitamin and mineral supplements and supplements that appear to boost dopamine, PD patients may also choose to support their health with probiotics. Probiotics are live organisms that can confer benefits for both gut health and neurological health, depending on which strain of probiotic bacteria you choose to add to your microbiome.

Our bodies harbor many microorganisms, both outside and in. The microbial community in the gut is the largest, containing bacteria, yeast, viruses, and protozoa that digest food, synthesize vitamins, and help us maintain a healthy barrier between what’s inside our gut and our own intestinal cells. The skin, mouth, vagina, and other organs also have their own microbial inhabitants that help us to maintain good overall health and wellness.

The microbiome contains both good and bad forms of bacteria, and poor gut health can result when these good and bad forms are out of balance - a state called gut dysbiosis. Sometimes balance can be restored simply by adding prebiotic foods to the diet to support growth of “good” bacteria. Other times a probiotic supplement is needed to achieve the health benefits that are desired.

Although probiotics can be found in many fermented foods, probiotic supplements give you much more control over the precise probiotic strain you’re taking and the dose that you’re receiving. Because probiotic strains can have different benefits, this allows you to choose the strain that could help you most. Probiotic supplements and medical foods are typically packaged in the form of a pill, capsule, drink, or powder. Probiotic supplements are a great option if you do not have a consistent diet or want to take extra measures when it comes to your overall wellness.

Best Probiotics for Parkinson's Disease - Gut Health

Over 80% of PD patients deal with constipation, whether because of a degeneration of the vagus nerve, lack of enteric dopamine, or a side effect of levodopa. 

Two useful remedies can also be used by the general public: a diet low in protein/sugar and high in fiber, and stimulant laxatives like polyethylene glycol. Abdominal massage can also be helpful in stimulating movement of the intestinal contents. 

Probiotics offer an easy and low-risk option for dealing with constipation. They may even do more than just help you move your bowels. Studies have suggested that gut microbiome dysbiosis can contribute to inflammation, which can trigger a chain reaction of metabolic effects. These metabolic effects – intestinal inflammation, weakened intestinal barrier, and reduced short-chain fatty acids – have all been demonstrated in cases of PD. Returning the gut microbiome to a more healthy status with the addition of beneficial bacteria from a probiotic supplement may help with some or all of these issues.

Probiotics have been accepted as safe and effective for PD-associated GI problems, including constipation, by the International Parkinson and Movement Disorder Society Evidence-Based Medicine Committee. While human clinical studies are ongoing, certain Lactobacillus and Bifidobacterium strains have shown positive results for constipation in PD patients to date:

  • Lactobacillus casei Shirota - In one study in which PD patients were given either a placebo or a fermented milk containing the probiotic Lactobacillus casei Shirota, it was found that those who took the probiotic drink experienced a significant improvement in bowel movements, along with relief from associated symptoms of abdominal pain, bloatedness, and a sense of emptiness in the stomach.
  • Hexbio - Hexbio is a multi strain probiotic supplement containing a mixture of Lactobacillus and Bifidobacterium species. Fifty-five patients with PD and constipation were recruited into an eight week study. Compared with placebo, Hexbio improved bowel opening frequency for these PD patients.

Probiotics have a strong reputation for their gut health benefits, and the evidence above demonstrates their efficacy for gut problems that are often associated with PD. But probiotics become even more interesting when we examine evidence surrounding their neuroprotective benefits, which are paramount when it comes to managing life with PD.

Best Probiotics for Parkinson's Disease - Neurological Health

While most people think of gut health when they think of probiotics, there is more to the story. The gut and brain can influence each other through the activity of neurotransmitters like serotonin and dopamine - neurotransmitters that are synthesized and active in both gut and brain. Certain probiotics strains called psychobiotics appear to influence the activity of neurotransmitters as well, allowing them to affect the brain from their home in the gut.

Unique probiotic strains called psychobiotics can influence dopamine and inflammation levels in the brain, provide protection against neurodegeneration, and improve movement in animal models of Parkinson’s. Initial studies suggest that some psychobiotics may provide neurological support relevant to Parkinson’s patients as well. 

Animal studies show that multi-strain mixtures of relatively common probiotics can be neuroprotective because of anti-inflammatory activity. After 4 months, motor symptoms improved in a mouse experiment vs. placebo using a mixture of 6 strains: Bifidobacterium bifidum, Bifidobacterium longum, Lactobacillus rhamnosus, L. rhamnosus GG, Lactobacillus plantarum LP28, and Lactococcus lactis subsp. Lactis. In another study, a mixture of L. rhamnosus GG, Bifidobacterium animalis lactis, and Lactobacillus acidophilus conferred a neuroprotective benefit on mice

Interestingly, L. plantarum PS128, a unique strain of Lactobacillus, has also been shown to increase dopamine activity, which is a critical factor with PD. Several animal studies have shown that mice taking PS128 have higher dopamine levels in their brains compared to the mice that did not take the probiotic.

PS128 is a probiotic derived from fermented vegetables, and it has also been studied in patients with Parkinson’s. In one study, twenty-five patients who were taking levodopa and had had Parkinson’s for an average of 10 years took two capsules of PS128 per day for twelve weeks.

At the end of the study, there was a significant improvement in motor function, as measured by the participants’ ability to perform finger, hand, and leg movements with agility. The majority of participants also said they received a noticeable benefit from PS128.

The Food and Drug Administration (FDA) has yet to approve any specific probiotic as a treatment for PD; however, PS128 is available commercially as a medical probiotic in the United States.

Probiotics & Parkinson’s Disease

Two elderly men playing chess outside

In the past, Parkinson's disease was recognized as a neurological disorder that was caused by and affected the brain. However, many researchers and physicians are beginning to point to the microbiome of the gut as a clear connection to PD. A common denominator between PD patients is their gastrointestinal issues which, in some cases, even present as the very first observable symptom of PD. This finding has led researchers to wonder if getting ahead of gut health could help manage GI symptoms of, and possibly slow neurodegeneration processes that start in the gut. 

Psychobiotics like PS128 that can have a positive effect on the brain through the gut-brain axis may be a useful support for patients wanting to manage their PD-like symptoms before or after diagnosis. The clinically researched PS128 strain is present in Neuralli, which is a medical probiotic for the nutritional support of neurological conditions like ASD and PD.

Get ahead of your gut health and overall brain health by introducing Neuralli into your daily routine. Your brain will thank you!

Recommended reading:

PS128 Probiotic & Parkinson’s - How Does it Work?

Which Supplements Can Increase Dopamine Levels?

Probiotics for Parkinson's Disease


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