When it comes to implementing lifestyle changes to outpace Parkinson’s, there is so much that can be done, but there’s only so much one can do! If you try too many things, you may not be able to maintain these practices, and consistency is key. Additionally, if you make too many lifestyle changes at once, you won’t be able to distinguish what is effective from what is not. So, I have adopted an incremental change approach – trying to add only one new practice at a time, assessing its effectiveness, then maintaining it, tweaking it, or parking it depending upon the results. It is far from a precise science. In the absence of clones in my closet, there is no replication, and my assessment of effectiveness is inevitably somewhat subjective. My adoption of lifestyle practices to outpace Parkinson’s is based upon the following fairly systematic process:

• Learn about approaches that people have done to outpace Parkinson’s via scientific and popular literature, social media, word-of-mouth, etc.
• Learn about the putative mechanism of action of the approach, which helps establish credibility in my eyes.
• Adopt the practice.
• Observe any changes in PD symptoms in the ensuing weeks and months.
• Depending upon the results, keep, park or adapt the approach.

The reason I use the word 'park' rather than 'abandon,' 'drop,' or 'reject' is that I may reinstate the approach at some point, so it is good not to be too definitive in my judgment.

There can be no doubt that dopamine replacement therapy has massively enhanced the quality of life for many people with Parkinson’s (PwPs) in the half-century or so since it became widely available, at least to people in more developed parts of the world.
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Dopamine replacement therapy (DRT), as the name suggests, supplements natural dopamine, which is in short supply in PwPs. Initially, I did not observe any beneficial effects, but a few weeks into my treatment, I noticed that my tremors appeared to ease. I did not feel any other symptom relief. However, at various times, I have inadvertently or deliberately reduced the dose, and I have found that tremor and neuropathy symptoms do increase, although the effect is somewhat delayed. Dopamine replacement therapy does not delay Parkinson’s progression, but it helps to provide a window of opportunity during which you can practice lifestyle interventions that go beyond symptom relief. Despite its imperfections, I’m very grateful for DRT. Levodopa/carbidopa is a safe and effective treatment option for Parkinson’s. In stark contrast, despite enormous research investment, there is no equivalent for Alzheimer’s disease.

While dopamine replacement can alleviate PD symptoms, exercise of various kinds can actually reduce Parkinson’s rate of progress and even, in some cases, reverse specific symptoms. While there is widespread disagreement on the efficacy of many therapies for PD, the medical establishment is unanimous in its support for the benefits of exercise. There are various opinions on what the most effective exercise regimes are, and numerous studies have examined the benefits of single exercises or combinations. When it comes down to it, the most effective exercises will be those that people end up doing on a consistent basis. As somebody who has exercised throughout my life, a lack of motivation/apathy is not a major issue for me, but this can be quite a barrier for many people with Parkinson’s. Dopamine plays a central role in motivation, and PwPs produce insufficient dopamine. Dopamine production, in turn, is stimulated by exercise, which, in the best-case scenario, can create a virtuous circle. Of course, the converse also applies; many PwPs are caught in a vicious circle from which it is difficult to escape.

But while motivation is not a limitation in my case, I do have an issue that constrains the amount and intensity of my exercise. I have a congenital heart issue, hypertrophic cardiomyopathy (HCM), which never gave me any problems in my youth, but now limits my ability to do very strenuous workouts. So, things like high-intensity interval training, which I used to thrive on, are now beyond me.
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My exercise regime, however, is very consistent, consisting of regular morning dog walks, weight training, cycling, swimming, Qigong, dancing, and play-fighting (also with our dog). I notice an increase in sluggishness and rigidity if I miss a day or two of exercise.

Ozone therapy has been successfully employed for a variety of conditions, ranging from cuts, bruising, and contusions to COVID-19, and even Ebola haemorrhagic fever. It is not a new therapy, having been used since the late 19th century, but it fell out of prominence with the rise of antibiotics, although it has experienced a resurgence in recent years. Ozone gas (O3) can be administered through various means, including blood transfusions, ozonated water, ozonated oil, and rectal ozone. Its healing effects are believed to work through its role in the modulation of cellular antioxidants and inflammation, among other mechanisms. 

I invested in a home ozone setup in May 2024 and almost immediately felt the positive impacts. Among the symptomatic benefits I noticed were diminished anxiety levels, reduced neuropathy and increased flexibility. Setting up the equipment takes some time and expense, but ozone generation is straightforward once the setup is in place, and the running costs are minimal. The mainstay of my ozone therapy is ozonated water, which I drink every day. I also have a small portable infrared sauna into which I discharge ozone gas. I find the sessions to be very invigorating, but I cannot say they are any more effective than drinking the ozone water.

Having been a competitive athlete for much of my life, I have never been too far away from injuries of various sorts. There are the aches and pains that come from exercise and day-to-day activities, as well as those associated with ageing and those associated with PD. It isn't easy to disentangle cause and effect. Whatever the root causes, these various aches and pains, if not addressed, could prove to be barriers to regular exercise. This is problematic for everybody, but the consequences of physical inactivity for PwPs are particularly severe.

My fortnightly osteopathy and massage sessions help to alleviate aches and pains, mobilise my limbs, which have become far less fluid since PD raised its ugly head, and correct my posture, which would otherwise become more stooped and asymmetric over time. This is more than a cosmetic issue, as these changes reduce our ability to undertake simple day-to-day tasks, increase our vulnerability to falls, and impact our self-confidence. 

​Additionally, osteopathy and massage are likely to enhance the benefits of other lifestyle practices. One of the tenets of osteopathy is the ‘rule of the artery is supreme.’ In other words, improving blood flow by moving things around and stretching tight muscles that impede local capillary flow enables nutrients to reach the cells more effectively. Therefore, one could envisage that all the other beneficial effects of practices such as magnesium supplementation and ozone therapy are enhanced by the manual therapeutic benefits to blood flow.

I am lucky to have access to the services of Esther Barton and Braam van der Walt of Wrington Vale Osteopaths, who are outstanding practitioners and wonderful people. I cannot recommend them highly enough.

What is the point of having a mind if you can’t change it? This statement very much applies to me and my opinion of the ketogenic diet. Long story short, simple carbohydrates formed the foundation of my diet from my days as an endurance athlete until recent times. Last year, I first encountered the work of Matthew Phillips on the benefits of the ketogenic diet for people with Parkinson’s. In the words of Gloria Gaynor, “At first I was afraid…” and considered this to be a fad approach. It was only in 2025, after watching a video by Nick Norwitz — A Ketogenic Diet for Parkinson’s Disease: Shaking Up the Science — that I became receptive to the idea of the ketogenic diet. I dove into the admittedly limited research literature and became convinced that this approach could be beneficial.

In a nutshell, it is thought that people with Parkinson’s do not process glucose efficiently but can become more metabolically healthy by using ketones as fuel. A state of nutritional ketosis can be induced by a high-fat, moderate-protein, low-carbohydrate diet and fasting. Since adopting this practice only about three months ago, I have found much greater levels of mental clarity and an amelioration of numerous PD symptoms. It is early days, but it appears that the ketogenic approach, coupled with intermittent and prolonged fasting, is also alleviating my hypertrophic cardiomyopathy symptoms. I sincerely believe that I will maintain a predominantly ketogenic diet for the rest of my life.

As the saying goes, “If you see one person with Parkinson’s, you have seen one person with Parkinson’s.” In other words, every PwP manifests the condition in a different way. Some people are initially troubled by tremors. Others are overcome with anxiety. My most debilitating symptom from the outset has been a deterioration in the quality of my voice. I tried various therapies with mixed results until I came across SPEAK OUT!® Therapy as pioneered by Parkinson Voice Project – a not-for-profit organisation based in Dallas, Texas.

SPEAK OUT! Therapy is based around a daily home practice which consists of several exercises which help people with Parkinson’s and related conditions retain and regain their speech and swallowing. The exercises make use of the fact that you can consciously activate your intentional motor system, which is less dependent on dopamine, to override the dopamine-based automatic motor system. Thus, activities such as speech, which are automatic for most people, can be made intentional through consistent, purposeful practice. The importance of the intentional system to PwPs and its role in retaining and regaining speech and swallowing is beautifully explained in the 25-minute video What is Parkinson’s? Which I recommend to everybody with a skin in the Parkinson’s game.

It is important to work with a certified SPEAK OUT! Therapist, both for an initial evaluation and periodic refresher sessions. I have been working with Louise Lim of Recommunicate Speech who provides excellent support.

​Meditation has become mainstream in the Western world in recent decades, and convinced of its value, I have long maintained a stop-start practice. In recent months, my practice has become much more consistent because of the clear positive impacts on my anxiety levels. If my masked face represents the visual signature of my Parkinson’s, and the slurred speech represents its auditory signature, it is heightened anxiety levels that represent an internal, largely invisible, but highly significant aspect of my condition. Whether it's breath work, mindfulness, or balancing the chakras, meditation helps in the moment and beyond. Its calming influence is the incentive that I need to maintain the practice. It has now become a non-negotiable.

Tapping or Emotional Freedom Techniques (EFT), sometimes known as “acupuncture without needles,” is an energy healing and talking therapy. Involves tapping with your fingertips on various meridian points whilst saying how you feel about a particular issue that is troubling you. Despite the name, the problem does not have to be purely emotional. My issues de jour are usually work-related and involve anxiety, which leads to procrastination and further anxiety! The tapping sends calming signals to the brain, thus bringing down anxiety and ushering in a resourceful state, which enables me to do the work at hand and further reduce my anxiety levels. For those who are interested, I often practice the WOOP-Tap, which I summarised in a blog a few years back. Tapping is an invaluable tool for anybody, but I think it has particular value for people with Parkinson’s, many of whom suffer from chronic anxiety, which is untouched by dopamine replacement therapy. Full disclosure: my wife Julie is a qualified EFT therapist and her expertise and support help keep me on the straight and narrow... in all aspects of life!!

Most of our physiology is tied to the predictable cycles of night and day. The importance of these cycles of light to life has given rise to the discipline of Chronobiology – the study of the biological rhythms that exist in all living organisms. Biological rhythms are classified according to their cycle length into three main types: (1) circadian rhythms (from the Latin circa diem – about a day, characterised by a period of approximately 24 hours), (2) ultradian rhythms (period shorter than 24 hours, e.g. hours, minutes or even seconds or fractions of seconds), and (3) infradian rhythms (period longer than 24 hours, e.g., days, weeks, months, or years). Circadian rhythms are the most studied of these rhythms and ultimately govern almost every aspect of our biology.

Thomas Edison’s first commercial incandescent light bulb was invented in 1879, launching a change unprecedented in planetary history, the health effects of which are only recently being elaborated. Re-establishing natural circadian rhythms can be challenging, but it can be hacked in various ways, such as using apps that reduce blue light, wearing blue-blocking glasses, taking regular breaks outside to bask in natural light, walking barefoot on the ground, and using circadian-friendly nightlights.

Unlike many people with Parkinson’s, I sleep very well at night, which is something I do not take for granted. However, for as long as I can remember, I have suffered a massive post-lunch dip in energy. This post-prandial tiredness became a thing of the past once I adopted a suite of circadian rhythm hacks. I do still indulge in the occasional afternoon nap, but it is now more of an optional extra rather than a near necessity.

For a detailed account of the health impacts of unnatural light regimes and how to mitigate these impacts, check out my recently published Big Book of EMFs: Everything You Need to Know about Electro-smog to Optimise Your Health without Living in a Cave. 

I am not a big fan of supplements, as in an ideal world, the vast majority of our energetic and nutritional needs should be met by food and exposure to natural light. Unfortunately, however, the world we live in is far from ideal and nature and the food we eat are very different from what our distant ancestors would have experienced. Even still, I prefer nutrients contained in food to those synthesised into a pill. However, I do have particular go-to supplements, and I find that magnesium is beneficial for various PD symptoms. 

Magnesium is a common deficiency in people with Parkinson’s and indeed the population as a whole. Magnesium is essential in many physiological processes, including sleep and the maintenance of circadian rhythms, as well as the regulation of our autonomic nervous system, thereby impacting stress levels. Additionally, a vicious circle appears to exist, with increased stress heightening magnesium loss, thereby exacerbating the initial magnesium deficiency.

​The most obvious benefit of magnesium to me is its ability to mitigate restless leg syndrome at night. I take a daily dose of 1000 mg 6 in 1 magnesium (providing 300 mg of elemental magnesium) and magnesium glycinate (providing 200 mg of elemental magnesium) every day. I virtually never get restless legs, except if I forget to take supplemental magnesium. The twitching and discomfort are cues to take the magnesium, and within half an hour, things return to normal. I cannot speak to its effect on anxiety levels, but I would not be surprised if it is helping in that regard as well.

This may seem like quite a daunting to-do list. Indeed, it can be, and in the absence of multiple clones against whom to monitor treatment effects, I cannot objectively verify that any of it is working. All I can provide is anecdotes – I can do my tie up now whereas I couldn’t last year, I can eat food in an aeroplane without fear of spilling things everywhere whereas I couldn’t last year, I virtually never choke my food now, and I am overtaking people on the bicycle now whereas I wasn’t last year. All very subjective, but to my mind, the plural of anecdote is evidence, so my positive felt experience in multiple dimensions is sufficient proof for me.

Another subjective but useful indicator of symptomatic change is the Patient-Reported Outcomes in Parkinson’s (PRO-PD) score, a self-reporting scale that assesses the nature and severity of Parkinson’s disease symptoms. It combines the scores of 35 symptoms of PD to give a rating of up to 3,500 (0-100 for each symptom). I test myself periodically. At diagnosis, I had a score of 468. At the time of writing, my score was 285.

​Currently, I am able to find enough time to do all that I seek to do, work-wise, home-wise and outpacing Parkinson’s-wise. That said, I cannot continue to layer intervention upon intervention, unless I wish to become the Bryan Johnson of Parkinson’s – a prospect that does not appeal to me. So, I do not envisage adopting many new practices unless there is compelling evidence for their efficacy, or they are neither time-consuming nor expensive to implement.

I will post some more detailed, referenced descriptions of each of these interventions in the coming weeks. In the meantime, I would love feedback from people with Parkinson’s on the positive impacts of your favourite lifestyle intervention(s). I’m very keen to learn from the community.

​My daily duel with the pleasure monkey
​​Everybody feels the pain of procrastination – when you have an important, but not always urgent, task to do but instead that you decide to just take a ‘just one minute’ to check the football results, look at Facebook, make a cup of coffee, anything to avoid tackling the job in hand. And one hour later you’ve followed the click bait trail until you are checking out 50 Hollywood actresses that are hot after 50! Then as the day progresses you decide that you’re a little tired so will invest your remaining working hours in clearing your desk and dealing with a few emails in preparation for tomorrow; the day when everything happens. Not such a problem if you act out this scenario from time to time but for the chronic procrastinator this is a daily occurrence which can, with no exaggeration, lead to a wasted life of tomorrows that never come.  

In his incisive and amusing TED Talk, Inside the Mind of a Master Procrastinator, Tim Urban, calls these ‘easy and fun’ diversionary tactics the Dark Playground. They are those things that are supposed to make us feel good but they don’t; because we know that we should be doing something else, plus we haven’t earned these “rewards” for doing what needs to be done so we feel a double pain. This is what Brian Johnson has termed ‘procrastipain’. Tim Urban jokes that we have two entities struggling for control of our brain – the ‘rational decision-maker’ who works for our long-term good and the ‘pleasure monkey’ who lives only for the moment. Oftentimes, extrinsic motivations, such as an impending deadline or a looming boss, help the rational decision-maker wrestle control of our brain from the pleasure monkey via Urban’s ‘panic monster’, and we move from the Dark Playground to productive work. Everybody has deadlines but not everybody has a boss. So which groups are most vulnerable to the pain of procrastination? In my humble opinion, higher education students and the self-employed?

Ways of winning the daily duel
As somebody who has spent many years in both categories, I think I know a bit about procrastination and over time I have discovered a number of ways to win my daily duels with that pesky pleasure monkey: Goal-setting including daily and weekly mini goals; David Allen’s two-minute rule – if it takes less than two minutes just do it; the Pomodoro Technique – set your timer for 20-25 minutes, get started and allow motivation to flow from action; becoming more attached to the process (the now) rather than to outcomes (the future and never entirely controllable results of the process), accepting the fact that I cannot multitask, etc. Most of the tools in my toolbox have been gleaned from others and if you suffer from procrastination like I do I would recommend you consult the references listed at the foot of this blog. But my go-to procrastination-busting tool is the WOOP-Tap, something that you won’t find in any text that I know of. I put it together a couple of years ago as a way of combining EFT (Emotional Freedom Techniques) or Tapping with the WOOP technique detailed by Gabriele Oettingen in her paradigm-shifting book Rethinking Positive Thinking. This new mind tool thus takes its place in the proud tradition of amalgamating two powerful entities to make something new and beautiful, alongside a lengthy list of notables including the teasmade, the sofabed and Brangelina.
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The WOOP Strategy: Mental Contrasting and Implementation Intentions
Before I explain my WOOP-Tap, I will give some brief background on its components. First the WOOP. Gabriele Oettingen, a Professor of Psychology at New York University and the University of Hamburg, sought to test the widely-held notion that positive thinking leads to success. Unfortunately, and contrary to what you may read in countless self-help books, the research was unequivocal; if you only focus on the positive you are less likely to achieve your intended outcome – losing weight, becoming rich, meeting the man/woman of your dreams, etc., etc., etc. Read the book for the full details of why this is but, in a nutshell, your brain cannot distinguish imagination from reality so positive visualisations trick your brain into thinking that the outcome has already been achieved. So why do the work when you are in a blissed-out state? 

These findings were a blow to Oettingen because she had hoped that her research would confirm the power of positive thinking. But here’s the good news. Oettingen developed a technique she called ‘mental contrasting’; visualising your objective and then immediately confronting these dreams with the realities standing in their way in order to “circumvent the calming effects of dreaming and mobilize dreams as a tool for prompting directed action.” Unlike pure positive thinking, mental contrasting did help people to reach their goals but with one important caveat. These goals had to be believable to those holding them. If not, the motivation levels of the mental contrasters fell below those of the dreamers. This is actually a good thing as it helps us to pursue realistic goals instead of forever chasing that crock of gold at the end of the rainbow.

The final piece in the WOOP jigsaw was provided by Peter M. Gollwitzer — a fellow Professor of Psychology at New York and Oettingen’s husband. His research findings indicated that if you added an “if-then” plan to the mental contrasting you further improved people’s power to attain their goals. The ‘if’ is the stimulus for action and the ‘then’ is the action: If my boss challenges me, then I will take a deep breath before responding; if I am tempted to look at Facebook when I should be working, then I will turn off the Internet; and my personal favourite, if I don’t feel like doing [insert task here], then I will just get started because I don’t need to have it all figured out in advance - ‘Just get Started’ mantra courtesy of Timothy Pychyl. 

These implementation intentions when combined with mental contrasting became the WOOP Strategy: Wish, Objective, Obstacle and Plan. 

• Wish: What you want to achieve. The size of the goal and the time period is not important; it can apply to a life time goal, the next task you wish to focus on or anything in between.
• Outcome: How this achievement will benefit you.
• Obstacle: The internal obstacle or obstacles that are standing in your way.
• Plan: What simple action you can take to implement your wish.

I use the WOOP Strategy most days as a way of overcoming inertia when switching from one task to another, which includes the task of switching from not working to the task of working. 

My typical WOOP goes like this:

• Wish: Start to write an introduction to the report on x,y,z.
• Outcome: Build-up of momentum and the generation of a feeling of satisfaction.
• Obstacle: Inertia and lack of momentum.
• Plan: Set my timer for 20 minutes and just get started.

The ‘if’ in my plan is usually implicit. So, the full, ‘if then’ version would be ‘if I have feelings of inertia and lack of momentum, then I will just get started’. 

So where does the tapping come in?

Well, I tap as I WOOP so for those of you who do not know, I will explain the basics of Tapping or Emotional Freedom Techniques. 

Tapping or Emotional Freedom Techniques (EFT)
Thanks to my wife Julie, who is a Certified EFT Practitioner, I learned the basics of Tapping and, before I discovered the WOOP, I had been using EFT for some time when I felt emotional blockages, large or small. Tapping your fingers on acupuncture points on the face and body calms the amygdala (the part of your brain that triggers your fight or flight response) and helps energy to flow freely throughout the body. Tapping has been shown to provide effective relief for a myriad of issues such as anxiety, depression, obesity, high blood pressure and chronic pain. 
The classic EFT process involves tapping nine acupuncture points in turn and saying (aloud or to yourself) “even though I have this problem” [insert problem here], “I love and accept myself.” Following this ‘set up statement’, you come to name the problem, explore its root cause and find your own solutions while you are in a resourceful state, rather than sitting or lying passively. Tapping can be done on your own but it is better to work with a qualified therapist if you are a beginner or have complex issues to deal with. Tapping is easier to conceive of when watched rather than read about so I recommend that you consult the YouTube video  linked to below for a clearer idea of what it is all about and how to do it. 

WOOP-Tapping
Given that I knew a bit about tapping before I discovered WOOP, it seemed natural to combine the two. It is just a matter of tapping on the acupuncture points while articulating your wish, outcome, obstacle and plan. I generally do one tapping cycle of the nine acupuncture points for each letter of the WOOP but there are no hard and fast rules. My day to day WOOP-take about a minute but it will no doubt take a bit longer when you are starting out. Most of you would probably agree that tapping does looks pretty weird and it is probably not the sort of thing that you would be seen dead doing in the office. I’m lucky in that I work on my own in my garret so I do not have the ridicule of my colleagues to contend with. But for those of you who share a work environment, there are ways to WOOP-Tap in ‘stealth mode’. You can do it from the comfort of your chair, reciting your WOOP internally and tapping your thumb against each finger of one hand in turn (you have acupuncture points in your fingers). Not too obtrusive and, I think, equally effective.  If even this is too embarrassing, you can WOOP-tap during a toilet break or do a session before you go to work. WOOP-Tapping is likely to work for a variety of conditions but I’ve mainly practiced it to banish procrastination so I am not qualified to comment on its wider applicability.

So, if you suffer from procrastipain try WOOP-Tapping. What have you got to lose? 
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Just get started, feel the satisfaction as the pleasure monkey surrenders control of your brain, and do it; again, and again and again…

References 
David Allen (2002). Getting Things Done: The Art of Stress-Free Productivity. Penguin Group.

Stephen Guise (2015). How to Be an Imperfectionist: The New Way to Self-Acceptance, Fearless Living, and Freedom from Perfectionism. Selective Entertainment LLC.

Gabriele Oettingen (2014). Rethinking Positive Thinking: Inside the New Science of Motivation. Current. 

Timothy A. Pychyl (2013). Solving the Procrastination Puzzle: A Concise Guide to Strategies for Change. Tarcher.

Piers Steel (2012). The Procrastination Equation: How to Stop Putting Things Off and Start Getting Stuff Done. Harper Perennial.