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An Integrative Approach to Parkinson’s: Gut-Brain Axis, Toxins, Pro21 Diet, Testing & Key Supplements | Dr. Karin Duncan
Dr. Ben Weitz introduces a Rational Wellness Podcast episode on Parkinson’s disease with naturopathic physician Dr. Karin Duncan, who is launching the Integrative Neurology Wellness Center in Hayden, Idaho in partnership with the Northwest Parkinson’s Foundation to provide accessible integrative care. They discuss Parkinson’s as more than dopamine deficiency, emphasizing toxins, inflammation, mitochondrial dysfunction, oxidative stress, and the gut-brain axis, with increasing young-onset cases. Duncan explains clinical diagnosis, limits of DaTscan, and her reliance on the CND/Syn-One skin biopsy for alpha-synuclein. They cover prodromal symptoms (constipation, loss of smell, REM sleep behavior disorder), alpha-synuclein and Lewy bodies, and her evaluation approach including nutrient and inflammatory labs, omega-3/6 targets, iron, thyroid/hormones, microbiome testing, and caution with detox. They review ProPD symptom tracking, Pro21 diet (avoid dairy, beef/pork/chicken, fried/refined/canned foods), exercise, glutathione, DHA, low-dose lithium, vitamin D/K2, LDN, and careful use of methylene blue, plus community and mental health support.
Dr. Laura Mischley’s Pro 21 diet was published: Beyond MIND and Mediterranean Diets: Designing a Diet to Optimize Parkinson’s Disease Outcomes.
Laura Mischley’s Parkinson’s symptom tracking (Pro-PD) app can be found here: lauriemischley.com/pro-pd-app
00:00 Podcast Intro
01:02 Parkinsons Overview
02:30 New Clinic Foundation
04:41 Toxins Call to Action
07:41 Young Onset Cases
08:37 Diagnosis Testing Tools
12:49 Prodromal Warning Signs
14:44 REM Sleep Explained
16:32 Constipation Mechanisms
20:29 Alpha Synuclein Gut Brain
24:25 Tracking Symptoms ProPD
29:28 Lewy Bodies Basics
30:07 Integrative Lab Workup
31:45 Methylene Blue Safety
34:02 Omega Fats Targets
36:50 Iron Thyroid Hormones
38:38 Gut Testing Dysbiosis
39:59 SIBO Testing Alternatives
41:28 Microbiome Testing Roadmap
43:47 Stool Tests and Gut Function
46:02 Diet Strategy and Pro 21
48:57 Pro 21 Foods to Avoid
51:09 Toxins and Detox Caution
53:13 Supplements That Move the Needle
59:58 Probiotics Targeted Not Empirical
01:01:24 Exercise and Realistic Outcomes
01:04:15 High Tech Therapies and Palliation
01:05:33 Methylene Blue Safety and Dosing
01:08:45 LDN and Mental Health Support
01:11:25 Tremors Vagus Nerve and DBS
01:13:10 Build Your Care Team
01:15:09 Resources and How to Connect
Karin Duncan is a naturopathic physician who recently launched her new office, the Integrative Neurology Wellness Center in Hayden, Idaho in partnership with the Northwest Parkinson’s Foundation to provide accessible integrative care to patients with neurodegenerative disorders. Her website is the Integrative Neurology Wellness Center and her phone is 208-480-4692.
Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.
Dr. Weitz: If you’re looking for clinically useful insights, not wellness hype, then this is the place for you. Welcome to the Rational Wellness Podcast, the podcast for functional and integrative practitioners who want to practice with greater clarity and precision. I’m Dr. Ben Weitz, and each week, I sit down with the leading clinicians, researchers, and lab innovators to explore the science, lab testing, and clinical reasoning behind modern root cause medicine. This is a show focused on practical, evidence-informed insights that you can actually use in patient care. Please subscribe to the Rational Wellness Podcast on Apple, Spotify, or YouTube. Please tell your friends and colleagues, and if you could give us a ratings and review on Apple or Spotify, we would certainly appreciate it. Finally, to access the show notes and the full transcript, please go to my website, drweitz.com.
Hello, Rational Wellness podcasters. Dr. Ben Weitz here, and we are going to have a Detailed discussion about Parkinson’s disease with Dr. Karin Duncan, who’s making her third appearance on our podcast.
Parkinson’s disease is often viewed primarily as a disorder of dopamine deficiency, with treatments centered around medications designed to replace or mimic dopamine. But Parkinson’s is far more complex than that. It involves neurodegeneration, mitochondrial dysfunction, oxidative stress, inflammation, environmental exposures, the gut-brain axis, and a wide range of other factors. And while conventional neurological care is essential, there is growing interest in how an integrative approach can address some of these additional factors and potentially improve quality of life and resilience in patients with Parkinson’s. Our guest today is Dr. Karin Duncan, a naturopathic physician whose practice focuses on neurological health, and specifically an integrative approach to Parkinson’s. So Dr. Duncan, welcome. Tell us about your new office.
Dr. Karin Duncan: Well, thank you very much, , Dr. Ben. I’m, I’m happy to be here, and it’s great to reconnect with you. The Northwest Parkinson’s Foundation, they are my partners in this. They’ve actually been established since the ’90s.
Dr. Karin Duncan: So they date back. They’re a regional Parkinson’s foundation. Excellent resource, because every dime that comes in goes right back into the community, so they do a great job serving four states. But to be honest, I get patient referrals that find me through their website from all over the country and the world. The clinical practice that I’m setting up here, Integrative Neurology Wellness Center, we’re located in Hayden, Idaho. And my office…
Dr. Weitz: You’re in the middle of nowheres.
Dr. Karin Duncan: You would think so, but it’s actually one of the fastest-growing areas in the country.
Dr. Karin Duncan: So yeah, people are migrating in at warp speed. Bringing their conspiracy theories and their politics with them. But it’s, we just, we roll with it. But no it’s really exciting. As far as I know, it’s either the first or one of the first medically driven non-profit centers for people with Parkinson’s and their care partners which means it’s not just support groups and therapies, which are essential but of course it’s guided by me as the physician to provide actual integrative care.
The goal being that most naturopathic doctors in the country may not take insurance, and so it… And even if they do, Medicare doesn’t accept naturopathic medicine, so we really want to be accessible, affordable, and available for our greatest generation. You listed all the things that influence Parkinson’s disease, and I always tell people, I’m like, “The big one is aging.” Man you’re going to get something, and that’s a huge factor in the development of the disease as well, so it’s a conversation to be had.
Dr. Weitz: Yeah. Yeah, there’s definitely… It’s the fastest growing neurological disease, correct?
Dr. Karin Duncan: It is. Yep. It is. Lots of factors in- included in there, and and it’s getting younger. We talk about aging, but the number of young onset patients that have come into my office in the last year is pretty staggering, so- Wow … we’re really driven to get to a deeper level of root cause.
Dr. Weitz: Isn’t that interesting? We’re seeing the same trend, younger people with colon cancer, younger people with prostate cancer, younger people with a whole series of diseases.
Dr. Karin Duncan: Yeah. Well, are you familiar with the terrain theory, Ben?
Dr. Weitz: The train theory? No, I’m not.
Dr. Karin Duncan: Terrain, sorry.
Dr. Weitz: Terrain. Oh yeah. Yeah.
Dr. Karin Duncan: So as the foods we’re eating and- … as a naturopathic provider that’s what we’re looking at, where, I tell people anytime I lecture, I say, “Now, you hold a responsibility with this information to protect our earth.”
I’m giving you this information to say we are actively poisoning ourselves and our population and our next generations. And so, you follow the works of Dr. Ray Dorsey, and you see how that’s influencing neurologic health, and Dr. Dale Bredesen, and it’s, obviously Dr. Mischley. But it’s, it essentially comes to be a no-brainer is the more toxic our world becomes, we’re poisoning our generations much earlier, and we’re hitting that tipping point much sooner in their lives, and it’s unfortunate. And I think it has to be a call to action, so I guess we’ll start with that as- Yeah.
Dr. Weitz: No, there’s no doubt- …
Dr. Karin Duncan: anybody tuning in, this is your call to action. …
Dr. Weitz: that we’re all getting exposed to more toxins. I live in Los Angeles, and last year we had the fires, and we all got exposed to all these toxins with the smoke and, it carried with it heavy metals and all the different things that are in the home, so it wasn’t just trees burning. It was just lithium batteries and, and- Oh … a- all the toxic substances, so. Yeah. We- And this is becoming a common occurrence
Dr. Karin Duncan: … we’ve been shrouded now since day 11. We’re neighbors with Spokane, so the Spokane fires are going on day 11, and of course all of our thoughts and prayers are with them in Spokane, but even over here in Idaho, we’ve been shrouded in smoke for 11 days. And I was going to tell you, like, hey, my, my public service announcement today is if I have a brain fart, it’s, I haven’t had fresh air in 11 days, so-
Dr. Karin Duncan: That’s amazing … it’s affecting my health and my, my brain function and my headache. It’s… a super healthy person is still going to… It’s just a foundation of health, and we take it for granted until it’s not there.
Dr. Weitz: Yeah, absolutely. And we know about the importance of toxins, and there’s been a lot of research tying toxins to Parkinson’s disease.
Dr. Karin Duncan: Mm-hmm.
Dr. Weitz: There was that paper in JAMA that showed the connection between living near a golf course and Parkinson’s, and-
Dr. Weitz: and we’ve had the association with dry cleaning fluids and the lawsuits with Camp Lejeune, right? Right. Yeah. And there’s been so much information about toxins playing a role in Parkinson’s disease. Maybe we’ll talk about that for a minute.
Dr. Weitz: so, so which of the toxins have you found that are playing a role in patients with Parkinson’s?
Dr. Karin Duncan: Yeah. The very first one that I’ll mention is our food sources. Right. It’s not this big headliner. It’s not on the EWG, right? It’s we’re poisoning ourself with our food every day. Right. We’re poisoning ourself with the air that we breathe, the water that we drink. And so I think, I’d be remiss to jump right into Ray Dorsey’s research and start talking about, all the other ones that he’s proving to be true and really say, we’re doing it, we’re doing it to ourselves on a regular basis if we’re not intentional. You’ve got your TCE- And- Oh, go ahead. Sorry.
Dr. Weitz: No, I was going to say before we got on the air, you mentioned that Parkinson’s is starting to occur in younger and younger people.
Dr. Weitz: What ages are we seeing it in?
Dr. Karin Duncan: The youngest I have in my office is actually younger than me. She was 40 years old.
Dr. Karin Duncan: Yep. And she came in, and it was… that was probably one of the more emotionally pulling visits that I’d had because she had been bounced around, I think, three separate neurologists. She was foreign. She moved to Idaho, but she’s from, I believe, Ukraine, and went and saw a naturopathic doctor, and then the, that doctor called me and she goes I think she has Parkinson’s, but I just, I can’t do it. I can’t make the diagnosis.” And apparently these neurologists couldn’t either. So by the time she got in with me, it was a pretty emotional conversation ’cause I think everybody had punted her ’cause they didn’t want it to be true.
Dr. Karin Duncan: But of course, we, we got her on treatment, and the carbidopa/levodopa, and she, her symptoms improved significantly, and it kinda, that’s your diagnosis, and here we go.
Dr. Weitz: How did you diagnose that particular patient?
Dr. Karin Duncan: It’s a clinical diagnosis. So you watch her gait, you watch her movement, you monitor the tremor blink rate, and then there’s, the non-motor questionnaire that we talk about. How many of these do you answer yes to? But really, the confirmatory way to diagnose is a trial of CL. If you’re suspicious of it, then we do a small dose of the carbidopa/levodopa, and if you respond, then that’s likely what it is, and we move forward from there.
Dr. Weitz: Do you rely on the DaT scan or the skin test?
Dr. Karin Duncan: Yeah, so the DaT scan has i- a little bit antiquated. It’s still up for debate. I often joke that I can tell which neurologist in my area somebody comes from based on what meds they’re on and what diagnostic tools they run through- Okay … because everybody’s got their flavor and their preferences. The DaT scan is still being used widely. I don’t ever send for it. I find it to be pretty useless, to be honest, is, you know-
Dr. Karin Duncan: if it’s a negative, we don’t know that it’s negative. It might not be bad enough yet. If it’s positive, we don’t necessarily know it’s Parkinson’s disease. So it can be useful if you’re like, “I’m on the fence, but they’re not reacting to meds very well, so we just want to get, like, one more egg in that basket to, to give us a more I don’t know, confirmation there. But the CND BioLife Sciences skin biopsy has just proven to be essential in my practice. Okay … so that’s the one that I rely on most and I advertise it big. I’m loud about it because following Dr. Mischley’s research protocol, right, we’re late to the game in diagnosis. You and I talked about this before.
We’re 20 years late. So you get a diagnosis, you’ve already had it for 20 years. So if we can do a test that discovers an alpha-synucleinopathy even 10 years prior, could we prevent the d- the, the development of a full-blown diagnosis? And so when I talk to patients and they’ve had the genetic testing done or they just want their children to have the biopsy and they want to be on the front end of it, especially if they’re meeting some of those prodromal symptoms, and it’s a skin biopsy. It’s a punch biopsy. It’s super easy procedure, and have the results in a couple weeks. So, that one has been my go-to.
Dr. Weitz: Okay. So DaTscan is no longer state-of-the-art. It’s not very accurate, but the Syn-One test that involves looking for misfolded synuclein proteins in the skin, is that correct?
Dr. Karin Duncan: Yep. Mm-hmm. Yep. And- And of course it, it’s pretty darn accurate unless it’s a brain first presentation, right? If it’s a body first presentation, which the majority of people with Parkinson’s are, it’s going to catch it. If it’s a brain first presentation, then it might not have hit those capillary beds in the end-
Dr. Weitz: Can you explain what’s the difference between a body first presentation and a brain first presentation of Parkinson’s?
Dr. Karin Duncan: Yeah. I think the big thing is keep in mind we’re late to the diagnosis, right? So body first means those were the first symptoms we saw to start suspecting a diagnosis. That’s your tremor, that’s your gait shuffling lack of arm swinging hunched posture, bradykinesia. So all of those different physical motor symptoms that we’re seeing indicates the body’s effect by Parkinson’s disease. If we’re looking more at a brain first presentation it can be fatigue, it could be weakness, it could be cognitive impairment some mood changes. So it’s a little bit more vague in presentation. A more difficult one to diagnose, for sure.
Dr. Weitz: Yeah. That could indicate a million other things. Yeah. That must be very difficult to diagnose.
Dr. Karin Duncan: It is. That’s a tough one, but I rely on my counterparts pretty heavily when they’re… Anybody shows up a little atypical, you want to build a team, and I have an excellent team of neurologists here in the area that we work together closely on those patients.
Dr. Weitz: What percentage of patients are brain first?
Dr. Karin Duncan: Ooh, that’s a good question. Offhand, I can’t tell you that
Dr. Weitz: My, I don’t remember off the top I would guess it’s a small percentage, right?
Dr. Karin Duncan: That would be my guess, too. I think because, honestly, we’re probably missing a lot of them. Okay. I think it’s a small percentage for many reasons, but I would imagine that we’re missing a lot of them and giving them a, a different diagnosis first.
Dr. Weitz: Now, are those patients who are going to get the body symptoms later?
Dr. Karin Duncan: Yeah, potentially.
Dr. Karin Duncan: Yep, they absolutely can develop those as, as those, dopamine receptors are down-regulated, and we’re losing the dopamine signal, the- they can develop, for sure.
Dr. Weitz: Right. And when you say we’re diagnosing Parkinson’s later we know that there’s these prodromal symptoms that patients have. They often get 10, 15, 20 years, they first get them earlier. And we could, we c- we should talk about those symptoms. Those are constipation, loss of sense of smell, REM sleep disorder, which maybe you can explain mood disorders, and some others, correct?
Dr. Karin Duncan: Yeah, you hit the first, the top three. Those are the big ones. We want to be on the rooftops about, I’ll often tell people, you can ask any Tom, Dick, or Harry on the sidewalk, what are three risk factors for a heart attack?” And we know that. We’re educated in that. The general public is educated in that. And we continue to promote neurologic diseases as grand mystery. We don’t know where it came from, right? Parkinson’s disease is idiopathic Parkinson’s disease, and, we’re throwing noodles at the wall and hoping something sticks. And I’m not saying I’m above that method. I’ve definitely used that before because we don’t have a cure yet. But I think, I think it’s unfortunate that we’re not doing more education as a greater medical community to say, “These symptoms that you’re having in your body can lead to something,” right? Maybe it’s not Parkinson’s disease, but we have the data to show that it is with those three together, that constellation.
But with the research that we’re doing on that whole body method and the microbiome and everything else that’s coming down the pipe I really would like to see more of the medical community being on that proactive state. If, “Hey, I’m coming in with constipation, here’s your MiraLAX, go home.” Hey this has a domino effect, right? Let’s see what that could look like and try to stop it rather than let it keep going and perpetuate. And I think, I truly do think Parkinson’s disease is preventable.
Dr. Weitz: Right. Mm-hmm. So we know what constipation is. We know what sense of smell is. Can you explain the REM sleep disorder?
Dr. Karin Duncan: Yeah, REM sleep disorder is essentially when you don’t sleep well during your REM sleep cycle, right? That’s your rapid eye movement. It’s when your body is supposed to become paralyzed. We consolidate thoughts, memories, emotions. It’s the, the primary time that our brain… I tell my six-year-old all the time, it’s when your brain flushes the toilet, right? Your glymphatic system is moving, and we get rid of everything there, because he’s at the age where he tells me, “I hate sleep. Sleep is a waste of time.” And I’m like, “That’s not true.” So, the poor kid’s going to need therapy later, but- … it’s this essential phase of sleep where our body really it shuts down, it paralyzes, and it allows us to essentially rest in the truest form of the definition. And when we have that disorder, when we have that dysfunction, you’ll see the vivid dreams.
You’ll see the acting out in your sleep. Y- you’ll see the, anxiety grow because we haven’t consolidated those emotions, right? We haven’t prioritized what mattered from the day before versus what didn’t. So, we wake up and everything is a pirate ship. And your memory consolidation, right? That’s, it’s really hard to have a memory consolidation when everything is a pirate ship. Like, what am I going to remember? What’s essential, and what can get, put into a different filing cabinet? So, in my opinion, I… And it changes regularly, but that’s, sleep is one of those, those essential pieces of health that if somebody comes in and they’re not sleeping well, they’re not having bowel movements, they’re not moving, they’re not drinking water, right?
We don’t do anything else, because that’s not a baseline presentation of somebody’s health, right? I don’t… That’s not a baseline presentation of disease. That’s missing the whole foundational part. We get those in order, and now I can say, “Here’s how the disease is affecting you,” right? Now, this is a clean slate presentation because up until then you’re missing that whole, like I said, foundational piece.
Dr. Weitz: Can we explain how those three symptoms relate to Parkinson’s? Does constipation occur because you get a buildup of misfolded alpha-synuclein in the gut? And does it arise from a particular alteration of the microbiome? What, how does Parkinson’s play a role in causing constipation?
Dr. Karin Duncan: Yeah. So first I’m just going to say yes. Throw another hypothesis out there, right? Yes. Th- there’s, there’s a lot of different things that are going to cause constipation, but I really like to walk my patients through, the, the sensory neurons that are in your nose are close to your brain, and it is thought that a lot of those alpha-synuclein aggregates start there. And so the loss of sense of smell or lack of sense of smell is one of the primary symptoms, prodromal symptoms. And then I talk to them about, the cephalic phase of digestion. We talk about digestion from our mouth down, but it starts in our brain, right? What are we making? What are we smelling?
What do we have to go hunt or forage to prepare our bodies? And inevitably every time I have this conversation, my mouth waters, right? ‘Cause I’m preparing my body for food subconsciously by talking about preparing my body for food. But so you lose that primary signal to your stomach in your saliva to make those enzymes, and then your stomach doesn’t make your hydrochloric acid, and then we’re not digesting our food properly.
And so that sits in your stomach and ferments and releases gas. So now we think you have GERDs, so we put you on a PPI, and then that bolus eventually does get into the small intestine, and your small intestine’s, “I don’t know what to do with this. I don’t know what it is. We didn’t digest it properly.” And so that inflammation, that lack of absorption will slow down gut motility, and inflammation will shut down gut motility, and lack of fiber in your diet will shut down gut motility, lack of hydration and movement, so stress.
So what I like to start with the nose, because so many people show up with that lack of sense of smell, and we have been trained as a population to just shovel food in our face while we’re working or while we’re driving and, lost some of that mindfulness or that preparation and I think that’s really an essential piece of it when you’re talking about full digestion.
The other thing about constipation is they’re muscles, right? Parkinson’s disease is a disease of slowing down, and so, that’s… We have blurred vision because those six ocular muscles in each of our eyes are slowing down in their coordination. We have swallowing difficulties. We have peristalsis impaction. So every muscle in your body, I like to tell people, if you see it on the outside, it’s happening on the inside. It just might not be as overt and obvious to you.
Dr. Weitz: And what does that say about the fact that we have millions of people now in society, and the number’s growing rapidly, that are taking medications that slow their gut motility in order to lose weight?
Dr. Karin Duncan: Yeah. Well, it’s interesting, and I just heard of this, so I can’t even cite the research. But I was sitting with, one of the drug reps came and bought me lunch, which was lovely. But told me about an Alzheimer’s trial, you might be aware of that, that actually got stopped dead in its tracks ’cause they were talking about GLP-1s for Alzheimer’s, and they had invested oodles of money into it thinking it would improve outcomes and it didn’t. There was nothing there that demonstrated anything that changed in the prognosis, so they had to shut that down early. Now, I got the giggles with him a little bit because it said, he told me, “Well, it changed a lot of these other metabolic numbers and, inflammatory markers and things like that.”
So they were super surprised that it didn’t change the diagnostic prognosis. And I said, “Well, are you?” I said, you live 60 years in this metabolic dysfunction and inflammatory state, and then we’re trying to undo something that’s already been done.” Right? We crossed that threshold into a disease state, and so by doing the GLP-1, we can improve metabolism in your blood sugars and markers in that way but you’re going to have a tough time reversing a disease once you hit that space in your body, and that’s…It’s unfortunate. I wish it was the golden ticket, but I don’t believe that it is.
Dr. Weitz: So we’ve mentioned alpha-synuclein, which is this protein that plays a role in Parkinson’s. Can you talk about the role of alpha-synuclein? What is it? Why does it build up? And is that one of the central factors resulting in Parkinson’s?
Dr. Karin Duncan: Yeah, as far as what we know, alpha-synuclein has been named, I guess, is charged with the assault of causing Parkinson’s disease. It is a protein. It becomes misfolded somewhere in the bloodstream, and then as we know, misfolded proteins, if you think of them as zippers, become sticky, right? They stick to each other in, in ways that we don’t want them to, and they create these aggregates of proteins that accumulate in the basal ganglia of the brain and cause the death of the dopaminergic neurons. A lot of the, the conventional side research are going after those immunotherapies, right? Trying to target alpha-synuclein, trying to go get it. I am excited to see some of the results of that. I think that would be great for quality of life, for maybe slowing down progression. But the interesting thing, Ben, is that, we know, the royal we, it’s not just me, it’s, our enteroendocrine cells, so those cells that are lumen-facing in the intestines, actually produce alpha-synuclein on purpose.
We have all these cytokines and inflammatory signals in the body so our body can communicate with itself, right? “Help, SOS, I’m in trouble. I don’t like this.” And we know that alpha-synuclein is produced by those intestinal cells, and they’re r- right directly linked to the enteric nervous system.
And so we’re making this alpha-synuclein, we have inflammation in the GI system. That can be where it is. That’s the leading hypothesis with the metabolic causation of Parkinson’s disease, is that these are being released because of intestinal inflammation. They’re aggregating, traveling up the vagus nerve and depositing in the brain. I like to tell my patients we haven’t flagged one yet and watched it creepy crawl up the vagus nerve, but we do have rat studies that demonstrate if you sever that vagus nerve in these situations that, symptoms improve. So we know it’s the highway, we know it’s a communication road, and so oftentimes what I’ll tell people is step one after facing the obvious, after, blood labs and evaluation and symptom palliation and foundations is, analyzing that microbiome. If we know there’s factories making alpha-synuclein, maybe they’re not the only ones, maybe they’re not, the only thing that’s in there, but why wouldn’t we shut down a known factory if we’ve got it, right? If we know that it is producing alpha-synuclein, why not go shut it down, so.
Dr. Weitz: And by the way, these patients have gut disorders, they have leaky gut, and patients who have leaky gut have leaky brain, so it makes it easier- Oh, yeah for a protein like alpha-synuclein to get into the brain, and-
Dr. Karin Duncan: Absolutely …
Dr. Weitz: should we think of alpha-synuclein as we think of amyloid as related to Alzheimer’s?
Dr. Karin Duncan: I would say so. I, there’s a lot of comparisons, a lot of similarities between, those diagnoses, and then there’s a lot of differences as well. I really just, I call it a messenger. In naturopathic medicine, right, we look at symptoms as messengers. We don’t look at them as problems. We’re like, “What are you trying to communicate with me?” The body is wise. What is it that you’re trying to tell me? And I think when we really embrace the fact that the body is making this protein on purpose, right? This is trying to send a message to us.
Dr. Weitz: Right. So then what’s its purpose in the body? Because we now know we know that amyloid is an antimicrobial peptide, and it’s protecting the brain against infections and potentially against inflammation and toxins. Yeah. What about alpha-synuclein?
Dr. Karin Duncan: That’s a good question. I don’t know what its innate purpose is in the body. I- as far as the only research that I see, you know, through Dr. Mischley is that it’s this SOS, protein that it’s being called, so I’m not sure if you have the answer to that or not. But it’s it’s a help. It’s a distress signal.
Dr. Weitz: Right. So, as part of your evaluation of patients with Parkinson’s you mentioned that skin test. Do you do… Which of the questionnaires, and do you do the UPDRS test, which by the way is very long test?
Dr. Karin Duncan: Mm-hmm. So the UPDRS are lovingly, called the chicken dance in my office, is i- it’s a great exam.
It’s a, it’s an objective exam for a neurologist to be able to see how patients are performing. I like to remind people, and I’ll remind you, too, you go to a conventional neurologist office and they’re probably seeing five times more patients than I do in a week, right? Just by nature of duration of visits and hours worked, and 90% of their patients may respond really well to their protocols, right?
But the 10% who don’t make up about 100% of my patients. So when we look at, when we look at standard of care evaluation methods, the majority of the patients that I see don’t fit the mold, right? They’re not fitting that. The other thing is even the ones who do, one of two things can happen.
They can be completely freaked out in the neurologist office, ’cause they give you 15 minutes to do the chicken dance and stand up, and their anxiety gets ahold of them and they freeze, right? We know freezing is a huge- Right … part of Parkinson’s disease. Or my super competitive athletes that I have, they get that adrenaline going and they ace their UPDRS, and then they can’t get in their car five minutes later.
Dr. Karin Duncan: And so when I look at that, I’m like, what an objective measurement that’s based on so many confounding factors. The exciting part of this, Ben, is that Dr. Lori Mischley’s ProPD symptom tracker, and I think we had talked about that in previous podcasts, but as of March, the patient-reported outcomes in Parkinson’s disease tracking method has become approved.
Trying to think of the word. There we go. It’s the smoke ring It’s become approved as a valid validated as a measuring tool for progression of Parkinson’s disease, and in a more sensitive way- Oh,
Dr. Karin Duncan: and approach than, the UPDRS.
Dr. Karin Duncan: it makes sense ..
Dr. Weitz: . can you tell us exactly what that test is, and how can we find out about it?
Dr. Karin Duncan: Yeah, absolutely. You s- you can download an app on your phone. It’s called Patient Symptom Reporting or Patient Symptom Tracking in Parkinson’s, or just ProPD. And I can send you the links to all those as well, so you can throw them up on the- Great … podcast. Okay. But essentially, after years of research and thousands of people with Parkinson’s reporting their symptoms and their progression, you can call it a report card, and patients reporting of their symptoms is so sensitive that we can actually see between a 50-point difference in symptom, whether or not they’re progressing or improving.
And over that time, like I said, it’s become a validated tool globally- That’s great … to assess that. So I’m hoping that it’s going to come in the neurologist office quickly, ’cause it’s… They don’t have to do anything. The patients bring you in a PDF of the report card. They come every visit. They have to come in with a report card for me before they get there.
And we go through, here’s the top five symptoms, and the funniest part is, many of the times, they weren’t even going to bring up two of the top five, right? They’re just… It’s stress-based. So I’m like, “Man, you haven’t pooped in a week.” And they’re like, “Oh, yeah, I forgot about that.” I’m like, “Okay, well, we should probably address that piece of it.”
And so it really… She’s done it across the mean, how most people progress, and there’s the line there. One of the coolest things that she and I have embarked on as of late is a little healthy competition between offices of how steep our slopes are the opposite direction in our patients.
So we take all those variables, and of course, she isolates them to show which ones are attributing to progression or regression. And then at the end of the day, I say, “I had an average of 100-point decline in my patients this month.” And, you know- Wow … it’s nice to go back and forth on that.
Dr. Weitz: Can we think of this test- She wins a lot. … similar… Can we think of this test similar to the MoCA test in Al- A- Alzheimer’s disease?
Dr. Karin Duncan: No, unfortunately. The MoCA test is it’s one I use on a regular basis just as a general screening. But no, the ProPD is much more in-depth. It takes about 20 to 30 minutes- Oh, okay
to answer all the questions. It’s a sliding scale between zero and 100, rate your symptom over the last seven days or two weeks. It takes in a lot more,
Dr. Karin Duncan: in account as far as a patient is doing. And it’s whole body. It’s- Okay … it’s mood, it’s GI, it’s movement. I- it’s just urinary symptoms, sexual dysfunction.
So it’s all across the board for these patients to say, “Hey, here’s how I am.” And i- and they’re super sensitive. They’re, they really do… I would say it takes about two or three evaluations to i- iron out the, “It was beautiful today, so I feel better,” versus, “It was cold today, and I don’t feel great.” But overall it’s become a super sensitive tool in my practice, and I tell all my patients, “You do this before your neurology appointment, and the only way it’s going to get in their office is not by me, it’s by you.
You take this in there every time and say, ‘I want you to see my report card. Here’s how I am. Don’t tell me how I am based on my test,’ right? I’m going to tell you- That’s great … how I am.” Mm-hmm.
Dr. Weitz: Now, the other the other in, the, the other protein you hear about related to Parkinson’s disease, I’m not sure if it’s a protein, are Lewy bodies.
Can you explain the part that Lewy bodies play in Parkinson’s?
Dr. Karin Duncan: Yeah, absolutely. The Lewy bodies are this-
Dr. Weitz: What are Lewy bodies?
Dr. Karin Duncan: What are Lewy bodies? Yeah. Lewy, Lewy bodies are just big aggregates of the proteins, right? Okay. They’re just, when those alpha synuclein clump together and they get sticky, then that’s what they produce is the
Oh, okay. That’s our- So that’s what Lewy bodies are. Okay.
Dr. Karin Duncan: Yep. Yep, those are just the big clumps. So.
Dr. Weitz: Okay, All right, great.
Dr. Karin Duncan: Sticky.
Dr. Weitz: So let’s talk about your integrative approach. What what types of labs do you like to do? Which are the most important, interesting ones?
Dr. Karin Duncan: Yeah. So I run something called a Parkinson’s panel. Again, this is based off the research of Lori Mischley, and it’s available on her Parkinson School online to see, what indicators are in there. Outside of a conventional lab test, which I, I bring a lot of humor to my patients, is it prove you’re not dead, right? You get a lab panel back, and it’s like, “Well, you’re not dead. Your liver works, your kidney works, you have blood.”
Dr. Karin Duncan: The end.
Dr. Karin Duncan: So that, it’s not
Dr. Weitz: really a wellness panel. Yeah, you’re basic- you’re, the convent- for people who are listening, conventional lab panels are basically a CBC and what they call a metabolic panel or a chem screen.
Dr. Karin Duncan: Yep. Maybe you get a lipid panel in there, maybe you get a TSH.
Right. But we’re not even looking at B vitamins and in the Parkinson’s population similarly to diabetes, w- metformin we know depletes the body of B12, and why is that not a concomitant prescription, right? “Hey, you have type two diabetes, here’s your metformin, here’s your B12.”
Boom. They should just be hand-in-hand. Statins and CoQ10. We know that carbidopa/levodopa depletes the body of B12, and B12 is an essential nutrient for neurologic function. So the amount of times that I see a B12 level in my patients below 200 is scary. It just has never been read or, yeah, ordered.
So we look much deeper. We go beneath the surface there, so we’re not just looking at your B vitamins as a full panel, we’re looking at your homocysteine, your MMA, right? I want to see how your B12 is utilized. I want to see if you can methylate these a- vitamins. I want to see how you’re excreting them, how you’re storing them.
So we look deeper there. I will run a G6PD on every panel. I’m really excited about the use of methylene blue in my neurologic population, and maybe that’s something we can chat about later. So I’ll throw that in there for sure. I look at your-
Dr. Weitz: So what was that last panel you mentioned?
Dr. Weitz: Can you explain
Dr. Karin Duncan: what that is? So that’s that big enzyme in the red blood cell that’s going to help with our redox, Biochemistry. And without that function, methylene blue is contraindicated. So I will take this opportunity to say, “Hey, folks, it’s out there, it’s readily available, and it is not safe.”
It is something that should be prescription only. That, it just blows my mind how some of this has come to the storefronts without being properly evaluated and I hold my, my profession very accountable for some
Dr. Weitz: of that. So, so let me just clarify. Yeah. Methylene blue is available as a nutritional supplement.
Dr. Weitz: However, patients who have a certain value of their G6PD enzyme- Yeah … should not be taking it.
Dr. Karin Duncan: Should not be taking it. It can actually cause hemolytic anemia-
Dr. Karin Duncan: if you do. Yep. And then kidney function, right? We’re talking about a population for the most part that’s above 65. And so kidney function, I’ve seen folks come in and say, “Oh, my naturopath gave me so much methylene blue,” and I run their labs and their kidney function’s in the 30s, right?
Their GFR. Oh. I’m like, this is… and methylene blue was one of the very first synthetic medications utilized to treat malaria, and so this isn’t a, this is not a supplement. It has strong MAOI functions. It inhibits serotonin production, so it can’t be mixed with SSRIs. So, you’re looking at polypharmacy, and I know we got off on a, side street here, but you’re looking at polypharmacy again in these 65 and up.
And I just talked to a caregiver group the other day, like, your best friend should be your pharmacist. Y- supplements, medicines, y- you go in and you really understand how to take those and what interacts because it’s just, it’s a hurdle that I see way too often in my practice, and it annoys me a bit ’cause we spend a lot of time backtracking.
When did you start this? This interacts with that. Now we have to take something out and start over. So, y- that supplement industry is, it can be a dangerous one, so.
Dr. Weitz: Good. Interest, caution. Yeah … so continue with your lab tests.
Dr. Karin Duncan: Lab tests, yeah. So then we’re looking at, full lipid panels.
We look at an omega-3 to 6 profile, so those ratios, the OmegaCheck or Omega through the Cleveland Heart Lab in Boston. And the really cool thing is in Lori’s lecture in December when she talks about some of these lab values and what was new in the research, those omega-3 to 6 values just skyrocketed to the top as influence and progression of disease.
So- Huh … looking at those omega-6, saturated fats in an improper ratio.
Dr. Weitz: So what is the omega-3 to 6 ratio that you think is ideal?
Dr. Karin Duncan: We’re looking for four Yep. So we want that to be above four. So you just want to, whether it’s fish oils or foods or whatever the case may be, we really want to drop that omega-6 impact in your
Dr. Weitz: system. Is one to one ideal?
Dr. Karin Duncan: Not in her research. Nope, we’re looking for that four, ratio of four.
Dr. Weitz: You want four.
Dr. Karin Duncan: Four to one. Four to one. Mm-hmm.
Dr. Weitz: Okay. And i- is there a omega index? I- is that something that you look at as well?
Dr. Karin Duncan: Yep, yep. So we run that full index and we see, which ones are prevalent.
Big things that we look at, we supplement with DHA a lot, so not DHEA, although we utilize that one too. Right. But DHA as a type of omega-3 fish oil has been shown to be more beneficial in Parkinson’s disease, is neuroprotective. It’s the main fatty acid that’s up in the brain. So when we do high doses of DHA and we have compliant patients on the Pro21, we see those ratios start to improve, and that’s- So
Dr. Weitz: will you have them take an EPA/DHA plus an additional DHA, or do you have a particular product that’s higher in DHA that also has EPA?What… Can you name a product- Yeah … that you like?
Dr. Karin Duncan: Yeah, so I like, Designs for Health has a great blend, so like Omega Veil has a great blend if you’re looking for both. They have a pretty high dose in there, especially the liquid forms f- for our folks who have dysphagia. And you still have to take, like, two teaspoons a day.
Protocol For Life has a great just DHA 1000. You take one capsule a day, which is unheard of in fish oil world, right, to get your therapeutic dose. So one to two of those, depending on the dosing. We start at two grams a day of DHA fish oil. So I like to just focus on that. I’m not as concerned about EPAs, because dietarily we move that direction.
So we’re getting the fish, we’re using the olive oils, we’re moving more towards a plant-led diet. We’re just really focused on, the data showing us those DHAs. Okay. And it’s the big four Ds, right? When I tell people, like, “This is what it’s protective is depression, dyskinesia dementia, and death,” those are the big four markers that we’re seeing in the research.
And when I tell patients that it’s like, “We don’t want any of those.” I’m like, “Cool.” Just I don’t want you to have them either.
Dr. Weitz: Great. So continue with your labs.
Dr. Karin Duncan: Labs. Oh, iron. Iron’s a big one. I could do a whole hour on iron, Ben. It’s… No one runs it. It- it’s unbelievable to me how many deficiencies I see, and then nobody had prepped me for how many diagnoses of HH I would make in my practice of hereditary hemochromatosis- Right
which is the iron overload. Right. Extremely inflammatory. Gets stored in the tissues like the heart, the liver, and the brain. Completely reversible, right? Which is really exciting. But, running a lab on a new patient and seeing them come in at a ferritin of 1,200 or, you’re just like, “Oh my God.”
Right. Like, how long has this been in there? Right. And can we back up? But iron is a big one, for sure to be aware of. Talked about D- I think those are the big… homocysteine’s a big one.
Dr. Karin Duncan: So we’re just, we’re looking at a lot of nutrients. Full thy- thyroid. There’s more inflammatory markers.
Right. You’re looking at your sed rate and your HSCRP, that sensitive-
Dr. Weitz: Okay … c-reactive protein. Do you look at any other inflammatory markers? Do you look at inter- interleukin six or any of the others?
Dr. Karin Duncan: Not in a first screening. Okay. It so wouldn’t be on the PD panel, but if we’re suspecting more of an autoimmune profile, we’re seeing high inflammatory markers, then we can go down that kind of breaking that down a little bit and seeing what that looks like.
Dr. Weitz: Right. And thyroid and hormones, I’m sure you’re looking at?
Dr. Karin Duncan: Yes. Yep. Thank you. You jogged my memory. So the thyroid for sure. I… Right off the bat I’ll do a full thyroid panel. Too often I have to send folks back for, reflex. So just right off the bat, let me see how this whole gland is functioning ’cause we see Hashimoto’s hiding all of the time.
And then your, yeah, your hormones. We really… I’ll run a testosterone, free testosterone, DHEA, and a sex hormone binding globulin. So those are- Kind of the screening ones there.
Dr. Karin Duncan: Mm-hmm.
Dr. Weitz: So, let’s start by talking about the gut-brain connection, and w- we know that this is a big factor. How often do you screen your test- your patients for, do you do a stool test on a regular basis, or is it only when they have gut symptoms? And then when you do a stool test w- what do you tend to see? Is there a certain pattern of dysbiosis that happens?
Dr. Karin Duncan: Yeah. So you know, we’ve got… You’ve got your big three. You’ve got your SIBO, you’ve got your intestinal methanogen overgrowth, the IMO, and then you’ve got your fungal overgrowth that we’re really screening for going- So
Dr. Weitz: I- IMO is a big cause of constipation. Do you often see that as occurring in Parkinson’s?
Dr. Karin Duncan: Oh, yeah. Yeah. Okay. We see methanogens at a very high level, folds above what the reference range is. And as I said, is this the cart or the horse? Was this here first, or, were you constipated first and this is what happened to your microbiome?
‘Cause that really, that ecosystem should be living in your colon, right? And so we creepy crawl up into the small intestine ’cause of slow gut motility or food poisoning or poor diet. Now we’re starting to see that inhibition of, metabolite production, big inflammatory downstream effects affecting the migrating motor complex and that motility.
So yeah, we do- we see a lot of IMO in the tests. I’m a huge fan of doing a stool analysis testing for SIBO. The, not the gold standard, but the gold-ish standard is a breath test. Right … it’s a challenging one. It’s a challenging one for, folks like you and I, let alone you, you get somebody in there with a little cognitive slowness and, timing it and breathing it and doing all the little tubes.
It… For me, what I’ve seen most clinically relevant is I want to see who’s living in there. I want to see what your population is. My assumption is that there’s some SIBO- in there and we’re going to- Right … treat it anyway. I do a two-week prep phase before we even go into any treatment of a low FODMAP diet and anti-inflammatories, and if they respond well to that, then I’m like, “That’s a clinical diagnosis.
It’s a no-brainer. I don’t have to send you through this, this breath test,” and I get a comprehensive analysis of, what’s in your stool, that population there. So that’s where I opt. A lot of practitioners or a lot use a lot of testing. I’m, I guess I’m a little old-school traditional, is, p- people tell me what’s going on and I say, “Well, that sounds like this.
Let’s do a trial and see how you feel. It doesn’t cause any harm,” and then we can go from there and save them, $400 or $500. So it’s kind of a nice- Well,
Dr. Weitz: what about using something like this? This is the FoodMarble. Oh, yes. Can you see that?
Dr. Karin Duncan: Mm-hmm.
Dr. Weitz: Patients can do for about the cost of a SIBO breath test, they can measure- Yeah
their methane and hydrogen. They can do it every day. They can do it after s- a meal, see how different foods affect them.
Dr. Karin Duncan: Yeah. I think it’s a great tool. I’ll recommend it. It’s not something that I prescribe. Again, I’m pretty, “Hey, we’re going to do a low FODMAP, we’re going to do a therapeutic diet, and if you respond well, then it’s there.
We’re going go for it.” Right. And then we get those, the microbiome tests back and we can s- say, “Hey, based on this profile or these ratios, we’re going safely say, yes, you have SIBO in addition to IMO, in addition to fungal presence, in addition to low pancreatic function or low bile output.” And so we get all of these different markers- And that really, like I said, lays the yellow brick road for how are we going to approach this?
How are we going to go through this treatment process based on what those results are showing? And essential. I w- I will say at the beginning of my practice there’s that, like, guilt about saying, “Hey, you have to buy this test, and you have to look in here.” But over, and over again, we’d hit roadblocks with patients in saying, “I’ve done everything I know.
You have no digestive symptoms. You’re not getting where we think you should be. Let’s run this test.” And it is a mess, right? So you get in there, and I’m like, “Oh, Karin, like six months ago- Right … you could have run this and tested it,” and they’re-
Dr. Karin Duncan: their stools are not the only indication. And I used to give a list of, “Here are some side effects you might encounter through this treatment protocol.”
Now I don’t. I say, “Anything’s fair game.” That gut affects you in so many different ways. The mood stabilization. I just had a patient write me. I have stories of hope on my website now, and she was talking about the gut treatment we went through, and she wrote me a separate email.
She goes, “I just didn’t want to write about how all of my cognitive impairment went away, ’cause I thought that would be really strange for people to read.” And I was like, “Write it.” Like if somebody can feel like they have some sort of dementia, and all the fear that surrounds that, and we fix your microbiome, and that improves, people need to be educated about that, that possibility.
And I know Dr. Dale Bredesen, references it, and it’s, it is becoming more globally accepted. And when you talk about it with patients, the majority of the time they go, “Well, duh. I want to shut down those factories. I want to get in there and start here.” And, it’s funny ’cause I write them a little paper slip that they take to their neurologist to say, “My meds may work differently in the next three months, and I may need less.”
Which is exciting, because they’re actually absorbing it, and metabolizing it and processing it more efficiently.
Dr. Weitz: That’s great. What’s your favorite stool test, and is there a certain pattern of things that you tend to see?
Dr. Karin Duncan: Yeah, stool tests, I love Tiny Health. I think they do a great job. It’s a comprehensive, evaluation.
It gives you more markers than, sometimes you know what to do with. And the biggest, you look at that microbiome imbalance, but the first ones that I’m looking for, I’ll actually s- shuffle all the way to the end of the test and say, “Here’s your function. Here’s your elastase.
Here’s the amount of fat you have in your stool. Here are your short-chain fatty acid levels.” And really demonstrating to them that, and I think this is where the integrated medicine comes in. We have to do something now to affect the function of your gut before we can anticipate it to heal, right?
You have to be able to give your gut some nutrients or some support if we want it to heal, and a lot of that times that can look like IV or injectable medicines, right? Bypass it all together, give you the nutrients that you need. Intestinal anti-inflammatories, MiraLAX, whatever it takes, right?
Let’s get things moving. Let’s slow down inflammation. Let’s come back on the diet, remove those triggers because a lot of the anti, like I said, kind of that kill phase where we go in and affect the microbiome, it causes those die-off responses that can be debilitating w- when people already don’t feel good.
Dr. Weitz: Right. Okay, cool. So,
Dr. Karin Duncan: Oh, and to answer your question, sorry Yes … that’s what I see. That’s the pattern. So the microbiome population, there’s a lot of research being done on bug by bug, right? That is where I kind of say this is the universe of the sea for the gut. We’ve got a lot of work to do there.
But I really focus on that dysfunction in the gut, which is the primary thing that I’m seeing is, lack of enzymes, fat in the stool all of those things, and then if there’s an overt infection, of course, then we go treat that.
Dr. Weitz: Right. And if you see fat in the stool, you tend to look at gallbladder or bile production and, and- Yeah maybe fat enzymes.
Dr. Karin Duncan: Right. Yep, then we’re going to use some digestive support. Big on dietary restrictions there, right? Pull back on some of those fatty foods. Ask if they still have their gallbladder, right? There’s a giant part of this population who does not anymore. I love some topical castor oil packs, right?
Super non-invasive, anti-inflammatory, can help move things through. So, lots of tools there to mitigate where the body is not functioning well.
Dr. Weitz: Right. So when we talk about diet, what kind of diet pattern do you find helpful for patients with Parkinson’s? So far, you’ve already mentioned low FODMAP but some people recommend a ketogenic diet.
Some people recommend vegetarian. I think I’ve heard you recommend Mediterranean in the past. Mm-hmm … what, what kind of a pattern do you find is best, or is it depend on each person?
Dr. Karin Duncan: Well, yeah. So it’s, it’s always going to be person dependent, right? We’re looking at food allergies and intolerances and things like that.
Keep in mind, the FODMAP diet is a therapeutic diet. It should be short term. So anybody who’s on a FODMAP diet, and again, I’ve seen those you know, I’ll kind of call my profession to the table. This is your diet, right? For years and years. It’s a very nutrient deficient diet. Right. So it should be therapeutic.
We’re starving out the bad guys in an effort to rebalance the biome. So therapeutic short term use only to elicit a change in your population. Super glad you asked this question, ’cause the second thing I’ll jump on a rooftop to share is that as August of 2025, Lori Michielae’s paper on the Pro 21 diet was published, and it is a phenomenal…
It is right now the only tool that we have that’s slowing progression of disease. So 12 years of clinical research is demonstrating that eating according to a Pro 21 diet, and I’ll get into what that entails, is actually slowing progression of disease for those patients. It should be prescription level, right?
Right. You should walk into a neurologist’s office and say, “I have Parkinson’s disease,” and it should say, “Here’s your diet.” Like, it’s just, you take the individuality, of course, but in the paper, I think the most impressive piece of it is that it outperformed both the Mind and Mediterranean diet outcomes, including the ceiling effects, which as you know in research, there’s just a bigger population of people in that Mind and Mediterranean, so we trust those, those numbers better. But with that taking into account, the Pro 21 still outperformed it. Okay. And so it’s exciting. It’s prescriptive. It is a non-negotiable some people don’t want to do it.
Dr. Weitz: So the Pro 21 diet.
Dr. Karin Duncan: Pro 21 diet, yep, and the cool thing, you, even on ChatGPT, you can put in on the little box on the side, hey, Pro 21, and it’ll give you all the information you need, meal prep and grocery shopping and what does this look like for me?
Dr. Weitz: But what is the Pro 21 diet? You gotta give us something
Dr. Karin Duncan: … yeah, the Pro 21 diet is so the patient-reported outcome diet, and it’s based off the Mind and Mediterranean diet, right? Removing those red meats, removing those caustic foods that we know are harmful to the brain and the heart, and then there’s more restrictions, yeah. So it is a restrictive diet. It is a little bit more difficult to comply with. But it is essentially, if you think of the Mind diet, which is Mediterranean plus DASH diet, on steroids, right? There’s just a, there’s a few more restrictions there to follow then you get the Pro 21. And then the cool thing-
Dr. Weitz: So which are the foods that should be avoided in the Pro 21?
Dr. Karin Duncan: The foods avoid in the pro-21, so number one and probably the most difficult for everybody who walks in my office is dairy. So dairy’s a big no-no. We know that it increases the risk of being diagnosed with Parkinson’s disease. We also know that it speeds up the progression of people with Parkinson’s disease who eat it, who partake.
That includes all as Lori puts it, breastfeeding from any animal. So any dairy, any,
Dr. Weitz: Any, any dairy, even-
Dr. Karin Duncan: Any dairy … even yogurt- Yep, so if you’re trying to find a loophole … even cheese,
Dr. Weitz: even… Yeah. Okay.
Dr. Karin Duncan: Yep. Then you’re looking at your beef, pork, and chicken. Those are right up there on the top to avoid.
Your artificial sweeteners, soda, your juices. So,
Dr. Weitz: so beef, pork, and chicken, you said?
Dr. Karin Duncan: Yep, beef, pork, and chicken.
Dr. Weitz: Completely eliminate. Okay.
Dr. Karin Duncan: Yep. Take those out. Your refined grains and fried food and then food from a can. W- a lot of these things we’re not sure why, but again, after 12 years of studying and people reporting what they’re doing and what they’re not doing like I said we, Dr.
Mischley can confidently, report her research that was published on, these are the things that negatively influence you.
Dr. Weitz: When was her study published on this diet?
Dr. Karin Duncan: August of ’25.
Dr. Weitz: Oh, okay. Cool.
Dr. Karin Duncan: Yep. Yep. So you can find that. It’s readily available. It’s free to download. I have a copy of the paper framed in my office, so it’s,
Dr. Weitz: And what’s, what- it was really
Dr. Karin Duncan: exciting
Dr. Weitz: what’s the title of the paper?
Dr. Karin Duncan: Pff, ooh.
Dr. Karin Duncan: More Than… More, Over, More Than Mind and Mediterranean. I can find it for you.
Dr. Weitz: Okay. And it’s from Dr. Lori, how do you spell her last name?
Dr. Karin Duncan: Mischley. M-I-S-C-H-L-E-Y.
Dr. Karin Duncan: Yeah, it’s easy to
Dr. Weitz: So I want to go into-
Dr. Karin Duncan: Designing the diet? Yeah. Yeah. There’s a bunch of things.
Dr. Weitz: Okay. So let’s go into toxins.
Dr. Karin Duncan: Here you go. Beyond Med- Beyond Mind and Mediterranean Diets: Designing-
Dr. Weitz: Beyond, okay …
Dr. Karin Duncan: a diet to optimize Parkinson’s disease outcomes.
Dr. Weitz: Okay. That’s great. Yeah. Excellent. I’ll put that in the show notes.
Dr. Weitz: Environmental toxins. There have been a number of papers showing a connection. Do you screen for toxins?
Dr. Karin Duncan: I do, not ubiquitously. So if somebody kind of has a known toxin, they worked at a dry cleaners, they were exposed to chemicals on the farm. I had one patient who came in, both she and her husband had Parkinson’s disease, and then it was found years later their well water was toxic.
So, I kinda take that on an individual basis. I think it’s really important to screen for toxins. I think even more important, at least in my practice is your amongeries, right? Like, we’re, we all accumulate toxins, but in my opinion, there’s something that’s happening in our population that’s inhibiting your body’s ability to detox.
So we can go run all these tests and see what the patient burden is. But then you’re not going to do, detox protocols are a big no-no in my practice unless you have sufficient evaluation, right? They can cause a lot of harm. You’re mobilizing things back into the bloodstream, and if we can’t get them out then we cause a lot of harm.
So i- we do test, I definitely test for them, but it’s, when indicated, when I think it’s definitely playing a part in it. I would say at least two years into practice, there’s so many other things that come up more obvious in their evaluation tools that, that, that tends to be a little bit later on down the road.
Dr. Weitz: So, detox protocols are contraindicated in your practice?
Dr. Karin Duncan: Contraindicated unless you have thorough evaluation. I think those are a big fad. I think there’s a lot of influencers out there doing detox protocols. Our patients are constipated, right? You’re going to go mobilize a bunch of toxins and put it in their bloodstream, and then they can’t get it out.
They’re over 65, their kidney function might be impaired. Are they moving? Are they sweating? Are they drinking water? So those things have to be in alignment before I’ll even move into a detox protocol of any magnitude, right? We’ll work on the, on lower levels like fiber and hydration and sweating and some glutathione and NAC, definitely.
But those, those big pushes are I can see them being very damaging.
Dr. Karin Duncan: Yeah. S-
Dr. Weitz: So let’s go into, why don’t we go into nutritional supplements. You just mentioned glutathione. I know that’s a big one for Parkinson’s. Mm-hmm. Can you talk about the nutritional supplements you have found that may be beneficial for your patients with Parkinson’s?
Dr. Karin Duncan: Yeah. Glutathione definitely takes the cake. That’s the most researched. It’s the most well-studied one in Parkinson’s disease. We even have the data to show, right, that by the time of diagnosis due to motor symptom onset, we’re 60 to 80% deplete of our dopaminergic reserve. So like we mentioned before, we’re so late to the game, they’ve already lost the majority of their dopaminergic neurons.
In addition, they’re 40 to 60% deplete in their glutathione. Glutathione’s the primary antioxidant of the central nervous system. So oftentimes when I’m lecturing, I’ll have two people stand up, kind of join arms and say, “You might get killed because of alpha-synuclein, but because you don’t have glutathione to clean up your garbage, your oxidative stress is killing your neighbor Right?
So I look at, is this disease one of many branches and arms rather than a linear destruction of neurons? Is the actual destruction of a neuron with the lack of glutathione contributing to that progression and how quickly that moves forward? And so we use glutathione. We see great benefit in glutathione supplementation.
We see the motor symptoms improve. We see UPDRS scores improve. So that’s, top of the line. There’s been a lot of studies between IV, intranasal, and oral glutathione. Lori Bichell spearheaded the clinical trial of intranasal. What we found is that, one, she’s so charming the placebo group did just as well as the other one be- because they believed in her protocol so well, which is fun ’cause it, definitely goes into placebo.
But two, so many of them were swallowing it anyway when you shove it up your nose that, an oral glutathione that’s liposomal is a very appropriate prescription. So utilize that one. Interestingly enough- by
Dr. Weitz: the way, dosage is two to four sprays once a day, twice a day?
Dr. Karin Duncan: Yep, I do between, like, 200 and 400 milligrams twice a day away from food.
So kind of a first thing in the morning, last thing at night dosing there. Glutathione does have a side effect profile, right? Just like some of the pharmaceuticals. So I do tell patients, “Hey, watch out, maybe taper up on this.” It’s got a nasty taste, so we try to work with that for sure. I- interestingly enough, kind of going back to detox and the risk in that, there’s been several, enough patients who’ve had an adverse response to glutathione in that detox realm, right?
Passing out weakness, just really pushing their pathways too fast, and they weren’t able to eliminate. So even something as benign that you would think has those adverse responses in a detox methodology. Yeah, Lori, in the December seminar, right, we talk about lithium. Lithium is most well known in high doses to treat bipolar disorder.
We know there’s lithium deficiency in our upper parallels in the country. But lithium is a necessary co-factor for something called BDNF, right? Your brain-derived nootropic factor. How do we grow new neurons? How do we do this? Not only that, we see some good mood stabilization even from low doses of nutritional lithium.
So that was shown to be really effective in the data for patients who are taking that. Of course, your fish oil. Ang- Fish oil’s a biggie.
Dr. Weitz: Ha- hang on one second. So low dose lithium, you’re talking about, like, five milligrams?
Dr. Karin Duncan: I start at 10, move up to 20, and I’ll go up to 100.
Dr. Karin Duncan: Yeah. So-
Dr. Karin Duncan: low dose with a little taper, see how people do on it.
Dr. Weitz: Okay. St- start with 10, go to 20, and move up to 100.
Dr. Karin Duncan: Yeah, move up. And then, that’s where those hair tests can come in handy when you’re looking at nutritional deficiencies. You can look at those hair elements tests and see, if there are deficiencies first and foremost. But something like a nutritional supplement overall pretty benign, so you start low and go slow.
Dr. Weitz: Is there a particular hair analysis mineral test you like?
Dr. Karin Duncan: Yeah, I use a Doctor’s Data.
Dr. Weitz: Yeah, go ahead.
Dr. Karin Duncan: That’s my… fish oil. I was just going to say those high doses of fish oil, that’s right there on the top three. Your B vitamins can’t be far behind, but that’s kind of an obvious one, right?
We’re looking at B vitamins when there’s neurologic. Blows my mind how many B6 toxicities I see, right? Not B in tests. Patients get numbness and tingling and neuropathy, and they come in with a new prescription of gabapentin. We look at their B6, and it’s through the roof, and I’m like, “All right, well, your, your doc who gave you this multi-complex is a B6, supercharger.”
So we’re y- just kind of, again, taking a look at things through a different lens before you just see a problem. See is there a communication here instead. Is the body trying to communicate something rather than say, “This is new. Is it a side effect?”
Dr. Weitz: By, by the way, when it comes to B12- we have serum B12, we have methylmalonic acid, and we have homocysteine. All right? Mm-hmm. Those are the three main ones. Is there w- is one of them, you think, more accurate? Do you tend to rely on homocysteine? Methylmalonic acid is one that I hardly ever see elevated.
Dr. Karin Duncan: Yeah. I… We do see it pretty often, actually, elevated.
Okay. And it usually is concomitant with, like, a homocysteine, right? We’ve got a lot of B vitamins in the bloodstream. We’re just not using them, so your homocysteine is high. And then you’re not excreting them efficiently- Right … so you’ve got this up- uptick- Right … in the system. And it’s not super high, but you’re at 300, 400, right?
You’d be up a little bit elevated there. Yeah. I rely on homocysteine, right? So my patients are like, “Hey pick the one you need the most,” then that’s
Dr. Weitz: the one we go with. That’s the one I tend to rely on, too, as
Dr. Weitz: Yeah. Okay. Yeah. Vitamin D?
Dr. Karin Duncan: Vitamin D, absolutely. Yeah we’re running a vitamin D.
We’re supplementing with vitamin D. We know vitamin D overlaps with just about every neurologic disease out there, so really important nutritional supplement.
Dr. Weitz: And vitamin K?
Dr. Karin Duncan: With a K2?
Dr. Karin Duncan: Yep, so important to differentiate the K1 and K2, especially if they’re chatting with their GPs who worry about clotting risk.
But yeah- Right … a D3 and a K2 combo we find that really effective and, especially with bone health, so.
Dr. Weitz: I s- I saw a paper about lycopene as having some benefit.
Dr. Karin Duncan: Not surprising. It’s a great antioxidant. It’s a high potency one. You can get a lot of it through your foods, right? Lots of lycopene rich foods in the Pro21 diet, so.
Yeah. You kind of eat the rainbow there, but yeah.
Dr. Weitz: What do you think about creatine?
Dr. Karin Duncan: Creatine is excellent. There’s not a lot of reproducible research right now on creatine and Parkinson’s disease specifically. But creatine and cognitive impairment, right, creatine and brain health muscle building I’m a big fan of creatine.
It can cause some GI distress, so again, I start low and move slow with folks. I see that over-prescribed a lot in the influencer world, right? “Hey, if you take 20 milligrams right off the bat.” I’m like, “Oof.” Take it easy.
Dr. Weitz: There’s a particular probiotic Lactobacillus plantarum PS128.
Dr. Weitz: Any benefit there?
Dr. Karin Duncan: Yeah, that’s a big question that I’m asked a lot. So in general, the, the microbiome is unique as the person in front of you, right? And we just talked about all the overgrowth conditions that we have. We’ve talked about all the differences in the microbiome ratios. My favorite analogy to make is, if your microbiome’s a parking garage you’re double parked, right?
Good, bad, or otherwise, there’s too many bugs in there. And a lot of times I see that more than a deficiency of anything specific, so we’re trying to clean house first. Now, initial studies of PS128 have proven benefit, but the, the clinical effect is pretty small still. They’re not big study groups. The, the pilot group was out there.
We’re seeing some benefit in the animal studies. I’m a fan of probiotics. I just don’t like them empirically. I want to know what’s happening in there first. I want to understand your population and then-
Dr. Karin Duncan: you dose appropriately, right? You’ve got Akkermansia that can be hugely beneficial. Right.
You’ve got your bacillus. And I want to use… I, one of my favorite analogies, I probably use it for… I want to use a sniper rifle. I don’t- Yeah … want to use a shotgun-
Dr. Karin Duncan: when people are suffering.
Dr. Weitz: Yeah. Anaerobic strains is where a lot of the interesting data seems to be coming in right now with new anaerobic strains on the market.
Dr. Weitz: Okay, let’s let’s talk about exercise. Exercise we know is super important for Parkinson’s.
Dr. Karin Duncan: Mm-hmm. Well, yeah, prior to, the diet plan getting published last August- Right … it was the one prescription that is modify- modifying the disease progression, right? We have some neurologists prescribing exercise.
We do a great job with that. I’m just a big proponent of find something and do it every day. Find something you like. There’s studies on bike riding and boxing, of course, is huge, and dancing, and Tai Chi. In my opinion, it’s find something that you love, that you enjoy, and then, and do it on a regular basis.
It’s dose and frequency dependent, right? In the research. We know that if you do it less than four days a week, it’s not giving you any benefit. So that’s why it is prescriptive, is you have to do it at least four days a week to see any benefit in your disease progression.
Dr. Weitz: Do you have some patients who’ve actually reversed their Parkinson’s?
Dr. Karin Duncan: I won’t ever use the word reverse. I’m very cautious about that. We don’t have a cure
Dr. Weitz: yet. Okay, their symptoms have improved?
Dr. Karin Duncan: Yes. Yep. Okay. So that’s kinda where the competition between, Dr. Mischley and I comes into play, is with that PRO-21, I’ll often tell patients, and it’s at the bottom of their visit note, “If you don’t improve by 100 points in six months, fire me.”
Right? If we’re not lowering your symptom burden score by addressing your whole health, then I’m not, worth my salt. And it never happens, so I’m, I’m not trying to sound egotistical here, but I can say that confidently, saying, “You’re going to walk in my door and you’re going to feel better in three to six months.”
And oftentimes it’s sooner than that. There’s, like I said, so many overt deficiencies and things happening that you find and get after right away to, to make better health outcomes. But then yeah, over time, we study the decline. We, we study the, the rate of decline. How steep is your curve, right?
If the mean is going up this way over time, can we get it to go down? And I do. I do see it. It’s not something that I would say if I didn’t, right? Say, “Are we slowing it down? That’s, it’s not quite as steep.” But the exciting part is within first six months of working with me, we do see that take a, a sharp decline.
So I think we’re onto something. It’s exciting. I’m cautious with over-promising anything. I think there’s a lot of providers out there who are claiming to have a lot of benefits and cures, if you will. And, to be blunt if they’re not publishing, then they’re assholes. And if they’re lying to patients, then they are too, right? Like, we know this doesn’t have a cure yet. We don’t even know where it came from. So that’s… If you have a provider who can’t say, “I don’t know, but here’s what we’re going to do based on what we do know,” stick with them if they can go forward with you and treat you like an individual because it is idiopathic.
Everybody presents differently, and I thought it might be a little bit easier. I’m doing one disease. Not one person in my practice has ever presented the same way. So there’s no algorithm to this one, Ben.
Dr. Weitz: Are any of the high-tech devices, hyperbaric or a- any of these modalities, do you think they’re beneficial?
Dr. Karin Duncan: Oh, yeah. So, hey, I’m human, right? If I have a stomachache, I’m going to take something to help out. If I have a headache, I’m going to take something to help out. If I, I’m in the smoke for 11 days, y- something’s shifting in me, I’m going to take something. I think the biggest question to ask there is, is it palliative or is it curative, right?
Are we treating, preventing, addressing actual outcomes or is it palliating? And I’m all about palliation. If we’re seeing improvement in cognitive scores with HBOT, twice a week for eight weeks for an hour, excellent. Can you afford it? Can you do it? Have we addressed all of the foundational concerns in your health?
Are we normalizing your biochemistry and your microbiome? And, if all of those things are set up, then I want you to go do what you can do to feel better. We’re just not seeing, right, the data showing this is affecting disease progression. It’s much more, in my opinion, cellular to address that health piece.
But in the meantime, IV therapi- peptides, Low Dose Naltrexone, right? Methylene Blue. If there’s things out there that are supporting your quality of life and they’re not harmful, let’s do it. I’m all in.
Dr. Weitz: So talk about Methylene Blue.
Dr. Karin Duncan: Yeah, Methylene Blue, it came on the scene a couple years ago big.
And I took about six months, to study it. I studied the works of Dr. Paul Anderson and dug in deep to the research and really learned about, its origin and what it was used for. And I dusted off my biochemistry book, right, to look at the electron transport chain and what does this all mean and how is it working?
And I love it. I absolutely love it as a tool. I use it a lot with my cognitive impairment. I use it a lot with mitochondrial dysfunction, generalized fatigue anxiety, mood changes. I love to bring that on board. It just has so many contraindications and lab markers to evaluate before you use it safely that I’m cautious of being one of those, podcasters or influencers that are like, “This is the best thing since sliced bread.”
Because I would say just as often as I can prescribe it, I can’t. There’s something that’s inhibiting in that patient’s health. This is like y- we can’t use this as a tool, so But again, I’m seeing really great clinical outcomes with it, and I really do love that, the
Dr. Weitz: medicine Other than that particular enzyme you talked about, what other things would make methylene blue contraindicated?
Dr. Karin Duncan: So if you’re taking an MAOI medication, so like Rasagiline turmeric is an MAOI, right? A, a light one. SSRIs so your antidepressant medications, so those combined can cause a serotonin syndrome. It does have interaction with carbidopa/levodopa, so we have to be careful of, dosing and timing of dosing there.
Is some of the pain medications for sure, and then your kidney function. Well,
Dr. Weitz: mo- most of your patients are going to be taking carbidopa/levodopa, right?
Dr. Karin Duncan: Yep. So we add it in, we go slow and steady, and we monitor your kidney function, we monitor your symptoms and make sure that they’re aware of what the outcomes could be or what the side effects could be, but we start really low.
So- And to be honest, Ben, I only use compounding pharmacies. So that’s the other thing I wanted to say. I will only trust a, a compound, licensed compounding pharmacy. I don’t do anything over the counter with the methylene blue.
Dr. Karin Duncan: Mm-hmm.
Dr. Weitz: And how does it interact with levodopa/carbidopa? Does it just make it stick around the system longer?
Dr. Karin Duncan: It does. So as an MAO inhibitor, so that’s a brain enzyme that breaks down the dopamine, so it’s the enzyme that d- breaks down the dopamine in your brain, and so it can perpetuate the dopamine effects in the brain in that way
Dr. Karin Duncan: got, it’s got mild activities, right, in a lot of different places because I think of where it’s functioning.
So we just, we’re cautious, we’re low, we’re slow and it’s exciting to see some of the clinical outcomes there.
Dr. Weitz: You mentioned peptides. What peptides could potentially be beneficial?
Dr. Karin Duncan: I’m not using any peptides at the moment.
Dr. Weitz: Oh. Nope. Oh, I thought you mentioned peptides. Okay.
Dr. Karin Duncan: No, I know it’s big. I’ll send people as a…
if we look at a metabolic syndrome patient who I know your metabolic syndrome is really affecting your cognitive function, your your weight, your blood sugar regulation, different things like that, and we have really addressed everything, and we’ve got a compliant- Okay … motivated patient, then I will refer out for some peptide therapy because we know there’s downstream benefit, just like that trial showed, right?
We know this affects progression- Right … of disease. I’m, but I’m not using it as a Parkinson’s adjudicating.
Dr. Weitz: Okay. Anything else that you have found beneficial in terms of either supplements or drugs?
Dr. Karin Duncan: I’m a big component of low-dose naltrexone, so compounded low-dose naltrexone. Okay. Okay.
Has some good research behind it for pain, inflammation if there’s an autoimmune component that’s also presenting there. There’s good data points between that and neuroinflammation.
Dr. Karin Duncan: it can affect some cognitive pieces there. Patients have to be really careful. I’ve gotten some hate messages from neurologists saying, “They don’t, they’re not addicted to opioids.”
I’m like, “I know. I’m not prescribing them, high doses of naltrexone. This is a…”
Dr. Karin Duncan: So, lots of education comes along with that. But I really like that because I think sometimes when we use a little bit of the higher force interventions that are still safe overall, we can avoid the, 10, 12 supplements that are trying to act on the same pathways that might get blocked by absorption or, or the ability to use them downstream, so.
I really like a low dose Naltrexone. The other thing, that we haven’t chatted about is just, the mental health aspect of it. The making sure you have community. There’s data suggests that somebody answers a questionnaire, “I feel lonely,” whether they’re partnered or have family or not, if they feel isolated in their disease, they’re going to have worse outcomes.
Getting involved, staying involved, finding your village practicing gratitude. Those things can’t be underestimated in a brain that is resilient and fluid and adaptable to really learn how to create those new pathways. So I’m a huge proponent of that. And addressing childhood traumas.
When we look at… I use Crayons Brain Sciences as a cognitive assessment. Really effective and accurate tool to look at that, and the amount of questionnaires and the depth that it goes into to relate any impairment with a subjective depression, anxiety, sleep quality, attention span, i- is really empowering to the patient to say, “I don’t think that you have forgetfulness.
I think you have really deep anxiety,” or, “These trauma responses have actually inhibited your ability to bring back these memories.” And so it’s a heavy part of the job. It wasn’t one that I expected either. But I, I want people to know, I want people to hear that this is an age who has been forgotten.
This is a generation of people who are subject to ageism in the healthcare community on a very deep level. They are genuinely the most motivated humans I’ve ever met in my life. “Hey, take dairy out.” “Got it.” “Hey, let’s talk about your childhood trauma.” “Cool. When can I come in?” They’re ready to embrace these golden years of their life and have it be the best ones, and it is…
it’s just such a deep honor to join them in that and actually give them the attention, they deserve, and how much they teach me in every visit. Like, so the
Dr. Karin Duncan: to help is huge.
Dr. Weitz: Is there anything, have you seen anything in particular that can help with the tremors?
Dr. Karin Duncan: Outside of carbidopa/levodopa?
Dr. Karin Duncan: Yeah. DBS, great intervention if you qualify for it. I’ve seen DBS change lives.
Dr. Weitz: We get- what is DBS?
Dr. Karin Duncan: Deep brain stimulation.
Dr. Karin Duncan: They go into those, those nucleus and they find the right probes and things like that, and then currents and… Yeah, it’s a neurosurgeon job. But they, the ability to affect and change lives with that is phenomenal.
And so again, I think a lot of people walk into a naturopathic doctor’s office and don’t expect to hear, “Hey, we should send you to a neurosurgeon. You’re 60 years old and you’re otherwise a physical specimen, and your blood work looks great, and you just have this disease. Like, let’s go give it a shot.”
And so I really appreciate that. Glutathione is great at slowing down tremors. And then again, I work really deeply with the vagus nerve. So biofeedback, counseling assessing trauma. There’s so much power in looking at that. There’s some bugs that are associated with tremors in the microbiome, so you know, it’s a full, it’s a full frontal assault on your whole health.
Dr. Weitz: use any of the vagal nerves stimulators?
Dr. Karin Duncan: Yep. I’ll recommend a VNS once in a while. I like, gargling, I like humming, I like singing. I’m a big proponent of Dr. Andrew Weil’s 4-7-8 breath technique. I talk about, a trampoline a lot. If you don’t ever stop bouncing on the trampoline, you’re up in the stratosphere by bedtime, so you’ve got to give your nervous system that grounding.
And I’ve seen that work wonders. The people who are committed to breathing differently while they breathe is fun. It’s like I said, it’s just, it’s a… You’re looking at a whole human and how we were so intimately and beautifully designed and saying none of this is off, off limits.
Dr. Weitz: That’s great. … This has been an excellent discussion. Final thoughts for our listeners and viewers?
Dr. Karin Duncan: Yeah, I think the biggest thing is, I’ll say is make sure you build a team. Make sure you find people who will work with other people. One of my favorite jokes to make is people will come into my very private office and they’ll lean in and they’ll go, “My neurologist doesn’t know I’m here.” And I’ll look and I said, “Well, my husband doesn’t know you’re here either.” Like, we’re good. We’re not, this is not exclusive. So you want to build a team. This is the most humbling journey I think any medical provider could be on, is one of these diagnoses who doesn’t have a cure yet. And I think when we recognize humility in ourselves and each other, we’re only benefiting the patient.
So really, build a team, advocate for yourself care for the caregivers. If docs are listening here, like, they’ve gotta get involved, they’ve gotta get support, they’ve gotta get care. This is a big diagnosis to manage at home. And we have the data to suggest, in Alzheimer’s disease anyway, 40% of our caregivers die first.
So we just, we have to be looking out for who’s with our patients the majority of the time, and it’s not us. But I’m a huge fan of advocacy. You gotta ask for what you want, you gotta ask for what you need. And then it is tough, ’cause I, I am one of four providers in the country who’s following these protocols from Dr. Mischley. And I’m not saying they’re the only ones that work, but they’re pretty darn well-researched. So when you walk into a doctor’s office, ask them about their outcomes. That question doesn’t intimidate me. How do patients do? They do great. We’re seeing really great results. And they’ll say, “They have to be compliant,” right? This isn’t Harry Potter. But you need to ask your providers, “What are your outcomes? What are you seeing in your office to improve this?” Because there’s a lot of people who will tell you they’ve been treating Parkinson’s for 20-plus years it doesn’t mean they’re doing it right.
Dr. Karin Duncan: Or responsibly or, with any data behind them. So I just think it, it’s important to be an advocate. I cared for my dad for 25 years with a neurologic disease, and advocacy was something I learned in my teenage years. So you gotta go out there and ask for what you need and deserve.
Dr. Weitz: That’s great. And what are your best contacts?
Dr. Karin Duncan: Best contacts, so I really love Solace. It’s a, it’s an online company that assigns a medical advocate to you, so that’s a really great resource. They’ll say, “I don’t even know what questions to ask.” If you’re not in with a naturopathic doctor, somebody, that’s going to work integratively with your team it’s a great resource to have. The pharmacists, again, I already said that. Get on board with a pharmacist. They just sit there at Walgreens and hang out. That’s their whole job. Run through your med list, what works, what doesn’t, take ’em this way. Become best friends with them. And then, what you do for your body, the nutrition, the exercise, like, you have so much power in this disease that isn’t on a prescription pad. And so I just ask my patients all the time, like I told you at the beginning, if you know better, do better. Like, this is your call to action to, to take some of that power back and it’s exciting when you see people do that.
Dr. Weitz: And how can patients contact you if they wanted to get in touch with you? Are you available?
Dr. Karin Duncan: Yep. They can… I’m going to open my doors in September, so I’ll be taking new patients September 1, and I’ll be starting September 22nd. But my website is integrativeneurocenter.com, so they can jump on there, contact page is available, and we can get the ball rolling.
Dr. Weitz: Will they be able to see you remotely?
Dr. Karin Duncan: Yep. I do telehealth consults. Of course, licensure varies state to state. But as a health coach, advisor, hey, ask these questions I kinda turn into that medical advocate with the knowledge ingrained in Parkinson’s disease, so-
Dr. Karin Duncan: great … that can be helpful.
Dr. Weitz: Thank you so much, Karin.
Dr. Karin Duncan: Oh, my gosh, Ben, it was great to be on. Thank you for having me back, and I hope you continue to be well.
Dr. Weitz: Thank you.Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five-star ratings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition, and want to prevent chronic problems, and want to promote longevity, please call my Santa Monica White Sports Chiropractic and Nutrition office at 310-395-3111, and we can set you up for a consultation for functional medicine. And I will talk to everybody next week.
