Yogurt, cheese, sauerkraut, pickles — what do these foods have in common? They’re all fermented products, loaded with 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 the jury is still out on whether supplements improve motor symptoms, evidence shows that probiotics can aid digestion, reduce constipation, and help manage other digestive symptoms of Parkinson’s disease.

How Are Parkinson’s Disease and Your Gut Related?

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. Specifically, these neurons are found in the basal ganglia, the area of the brain that’s 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.

Researchers have discovered that gut dysbiosis (an imbalance of bacteria in the gut) could be a culprit in Parkinson’s disease. Specifically, they believe that this imbalance may be responsible for the breakdown of the brain cells that make dopamine.

Gut Dysbiosis Drives Inflammation in Parkinson’s Disease

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 researchers, who’ve 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.

An out-of-balance gut microbiome leads to inflammation that damages the gut’s lining. This damage increases intestinal permeability, which means that bacteria, pathogens, and other molecules “leak” out of your gut and into your bloodstream.

In people with Parkinson’s disease, the extra intestinal inflammation also triggers 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. The inflammation also affects the blood-brain barrier and leads to further loss of dopamine.

Gastrointestinal Symptoms of 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:

• Nausea
• Vomiting
• Constipation
• Gastroparesis (delayed stomach emptying)
• Changes in bowel movements
• Bloating
• Bowel inflammation or colitis

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 Duopa, Sinemet, Parcopa, and Rytary) and other medications are absorbed in your stomach and intestines.

Probiotics for Parkinson’s Disease: What Does Research Say?

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.

According to Cleveland Clinic, probiotics are beneficial bacteria and yeasts found naturally in the gut. Probiotic supplements put more of these good microbes into your stomach and intestines, rebalancing your gut microbiome. The bacteria and yeast found in probiotics can:

• Support a healthy gut lining, stopping bacteria from leaking out
• Help your body better break down food for nutrients
• Control levels of bad bacteria growing in your digestive system

PS128 Supplements for Parkinson’s 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.

These results are promising, but more research must be done in larger groups of people with Parkinson’s disease to see if PS128 supplements really do improve motor symptoms.

Probiotic Supplements for Gastrointestinal Symptoms

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 concluded that probiotic supplements helped improve constipation and stool consistency.

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.

What Do MyParkinsonsTeam Members Say About Probiotics?

MyParkinsonsTeam members have discussed the topic of probiotics. “Anyone have a good experience with probiotics?” asked a 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.

Adding More Probiotics to Your Parkinson’s Diet

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.

You can also get probiotics from fermented foods and beverages. Examples include:

• Fermented milk products like yogurt and kefir
• Pickles
• Sourdough bread
• Sauerkraut
• Kombucha
• Tempeh
• Kimchi

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.

Although probiotics are considered safe, they do have some side effects, including:

• Bloating
• Upset stomach
• Flatulence
• Allergic reactions

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.

Talk With Others Who Understand

MyParkinsonsTeam is the social network for people living with Parkinson’s disease and their loved ones. On MyParkinsonsTeam, more than 99,000 members come together to ask questions, give advice, and share stories with others who understand life with Parkinson’s disease.

Do you take a probiotic supplement for your Parkinson’s disease? Has it helped your symptoms? Share in the comments below, or start a conversation by posting on your Activities page.