Doc: Parkinson’s can cause an unusual breathing issue
Dear Dr. Roach: My husband has Parkinson’s disease. He also has a stent in his heart. We have been to many doctors to address a breathing problem: fast breathing. He experiences this daily, and we are told that it is anxiety. It is difficult to watch him go through this. It sometimes happens before he is due for his Sinemet, but other times right after taking it.
He has been prescribed Xanax, clonidine, cannabidiol-infused gummies and a few others. One doctor says it is from Parkinson’s, but the rest say it is anxiety.
Dear E.W.: Shortness of breath can have many causes, but someone with Parkinson’s disease has an unusual possibility, called “respiratory dyskinesia” (which just means “abnormal movement of the muscles of breathing”). This is an involuntary rapid breathing that causes distress, and it usually happens an hour after taking a medication like Sinemet. Changing the dose can help with diagnosis, and working with a neurologist to adjust the dose of the Sinemet (which comes in fast-acting and slow-release formulations) can solve the problem. I would start with an expert on Parkinson’s. Keeping a diary of when he takes his medication and when the breathing trouble starts and stops will be helpful, as would a video of what it looks like when happening.
Having Parkinson’s doesn’t make someone less likely to have other causes of shortness of breath, and anyone with a stent in the heart (meaning a history of blockages of at least one heart artery) is at risk of developing further blockages. Poor blood flow to the heart is another potential cause. Get the Parkinson’s evaluation first.
I would not recommend taking anti-anxiety medications unless there is clear evidence of benefit. Ascribing a physical symptom like shortness of breath to anxiety without a thorough workup is unwise.
Dear Dr. Roach: As a winemaker, I get my daily (small) dose of resveratrol through red wine. I drink about a half bottle daily. But I also take resveratrol supplements. What is the latest evidence as to the health benefits of this natural polyphenol? Am I ingesting too much?
Dear G.G.: Resveratrol is a substance found in red wine, coming from grape skins. One study in rats showed that it improved lifespan, and many people were interested in it. However, the dose of red wine needed to duplicate the study would be about 1,000 liters daily for a human; worse, a trial of resveratrol (in people with multiple myeloma) showed no benefit, and five of the 24 subjects developed kidney failure (it was not clear whether the myeloma or the resveratrol was responsible for the kidney damage. Also, the dose used was 5 grams, which is 10 to 20 times the size of the usual supplement). A trial in Alzheimer’s disease patients was too short to prove benefit, but did seem to show increased brain volume. A 2016 review shows that at high doses, it lowers blood pressure (which often is raised by alcohol) and cholesterol. For that reason, resveratrol still holds promise, but it’s too early to recommend as a supplement.
It’s not the resveratrol I’m worried about your getting too much of; it’s alcohol. A half a bottle of wine (assuming average alcohol content, which varies a little) for an average-size man is two and a half glasses, which contains alcohol that is over the level of most recommendations (one glass for women, two for men, with food).
For some people, wine enhances pleasure in life when taken moderately, and that’s the only reason it should be consumed. Alcohol should not be taken for health reasons.
Email questions to ToYourGoodHealth@med.cornell.edu.