Parkinson’s disease is a progressive condition, but there are several things that may worsen your symptoms, such as reactions to medication, treatment changes, and stress.

Parkinson’s disease (PD) is a chronic, progressive neurological disease. There’s no cure, and in the years after diagnosis, many people in this condition may notice their symptoms often fluctuate or worsen over time.

Common things that may worsen your symptoms if you have PD include:

Chronic stress

Past research has identified chronic stress as one of the possible initial triggers for the onset of PD.

In one survey in 2021, people with PD reported increases in the following symptoms when their stress levels were higher:

  • tremors
  • movement problems
  • sleep disturbances
  • depression
  • balance and gait
  • dyskinesias like muscle weakness or twitching
  • memory problems
  • speech and communication difficulties

The study authors noted that tremors seemed to be the symptom most affected by stress.

Discuss with your healthcare team

While a gradual worsening with age is expected with Parkinson’s disease, sudden changes in symptoms or an overall worsening of your health is a cause for concern. Discuss any sudden or extreme worsening of your symptoms with a healthcare professional.

Emotions

Stress, emotional turmoil, and other mood changes can have an impact on symptoms in people with PD. Anxiety and depression are common emotional symptoms that often develop in people with PD.

Research has found that motor symptoms were worse in people with PD who were in a depressed, anxious, or otherwise emotional state.

Medications

Levodopa, one of the most commonly prescribed medications for PD, may cause significant complications.

One report suggested that almost everyone who takes this medication will experience fluctuating responses to their treatment at some point. The problem is especially pronounced in people who take higher doses of levodopa.

Severe symptoms can appear on these higher doses, including:

The solution is usually to adjust dosages to provide you with a more consistent level of the medication throughout the day or to add on additional adjunctive treatments.

However, the study also notes that the stage and severity of your Parkinson’s disease, as well as your age and cognitive health, can limit the use of other therapies in treating PD.

Caution: Medications to watch if you have Parkinson’s disease

Beyond levodopa, a number of medications are associated with an aggravation of Parkinson’s symptoms. Examples of medications that fall into this category include:

Let your healthcare professional know if you’re taking or are prescribed one of these medications.

Foods

Recent research has suggested that the balance of good and bad bacteria in your digestive system may have the biggest effect on symptoms.

Your belly and your brain are connected, and some byproducts of your metabolism can have a negative effect on your central nervous system. Specifically, the study pointed to chemicals including:

These chemicals can play a role in PD and other chronic neurological diseases like Alzheimer’s disease, autism spectrum disorder (ASD), and even anorexia nervosa.

Additional research points to certain foods in particular as being linked to poor gut health and a more rapid progression of PD:

  • foods high in saturated animal fats
  • canned fruits and vegetables
  • sodas
  • fried foods
  • beef
  • ice cream
  • cheese

One study reported that Mediterranean-type diets appear to produce the best results for people with PD.

Health changes

Changes in your overall health can also impact PD symptoms. Some of the following health concerns can be linked to an increase in symptoms or worsening of the disease:

  • infections
  • surgery
  • medication changes
  • other diseases or conditions (comorbidities)
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PD is a complex neurodegenerative disease that usually requires a variety of medications, treatments, and therapies, such as:

Medication

Levodopa is the gold-standard medication in PD treatment, helping the brain produce more dopamine, a chemical that helps signals move through the brain.

Other medications that may be used include:

Other treatments

Other treatments include things like deep brain stimulation and surgically implanted pumps to deliver consistent and precise levels of medication. This medication combines levodopa with carbidopa and helps your body better use levodopa.

Home remedies

Maintaining your safety at home is important for managing PD, including steps like:

  • clearing clutter, rugs, and cords that could cause falls
  • raising your bed height
  • adding a side rail or handles to your bed
  • moving items you use often so they’re easily accessible
  • using a urinal or bedside commode at night
  • installing an elevated toilet seat

Enlist the help of family members, friends, or outside caregivers to help you with your daily activities as your disease progresses.

There is no cure for PD. As a neurodegenerative disease, PD worsens over time. However, there are a variety of treatments and medications that may be able to help reduce your symptoms or slow the progression of your disease.

Do symptoms of Parkinson’s disease usually come and go?

Yes. “Off-periods” can happen when dopamine levels become too low, and PD symptoms increase as a result. Off-periods commonly occur in people with PDs, even while taking medications like levodopa. A doctor can help you manage symptoms during off-periods.

Is there a certain time of day when Parkinson’s symptoms are worse?

An increase in movement problems, also known as morning akinesia, is common in people with PD. In fact, this is sometimes the first sign of PD and results from the effects of a typical decline in dopamine while you sleep.

Does exercising make Parkinson’s disease worse?

Exercise has been linked to improved symptoms, increased balance, reduced falls, and even slow disease progression in people with PD. Talk with your doctor or physical therapist about the best exercise strategies for your particular stage of PD.

Parkinson’s disease has no cure and progressively gets worse over time for most people with the disease.

Talk with a doctor if you notice a change in your symptoms. Although worsening symptoms could indicate the progression of your disease, there are also other things that can cause temporary or fluctuating increases in your symptom.