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Book Review: Reverse Parkinson's Disease

Monday June 20, 2016

John Pepper is one of us. Maybe. Diagnosed in 1992, he had had almost twenty years of experience with Parkinson’s by the time he published Reverse Parkinson’s Disease in 2011. He speaks, then, with a certain authority when he describes the success of his treatment program. That program has three branches, one physical (exercise, diet), one mental (attitude, stress management), one chemical (he recommends an MAO-B inhibitor). It is difficult to argue with the first two of those. The third one is problematical. 

In the end, the book does not fulfill the promise of its title. Readers who pick up the Reverse Parkinson’s Disease expecting to find a way to reverse or cure Parkinson’s Disease will probably be disappointed.

Shortly after his diagnosis, Pepper quit his job as director of a South African printing business and began working to defeat Parkinson’s and to share his story with others: “By sharing my experiences with other sufferers, especially those in the early stages of Pd, I hope to help improve their quality of life, by restoring their self-confidence and giving them a better understanding of Pd from a fellow sufferer’s viewpoint” (p. 12). 

Pepper’s advice about the importance of physical exercise is important. It is strongly reinforced by virtually all people with Parkinson’s and by their doctors. He is especially good on the importance of walking and walking correctly. Also useful is his advice about the importance of a positive mental attitude, of embracing optimism, and of exercising the brain.

The weakest part of Reverse Parkinson’s Disease is the section on medications. Pepper is not a doctor: “I don’t pretend to have studied anything about the brain, or how it works” (p. 92). His own physician told him to take one medicine and one only: the MAO-B inhibitor called Eldepryl. He references a research study that seemed do indicate that the drug could help people with Parkinson’s. Here is his somewhat hedged conclusion: “I would personally assume that if taking Eldepryl could possibly slow down the progression of Pd, then Eldepryl must have been one of the reasons why my Pd started to improve” (p. 66).

Particularly questionable is Pepper’s denigration of levodopa, the drug that most neurologists and most people with Parkinson’s see as the gold standard of medications for this disease: “After taking Sinemet [a trade name for one form of levodopa] for three months I did not feel any benefit whatsoever. My movement problems had already been solved and the tremor had already disappeared. Sinemet does not mask all of the symptoms of Pd but, those symptoms, which it does not mask, I was already able to overcome, by using my conscious brain” (pp. 66–67). Pepper goes on to say that “levodopa medication should be a last resort medication, when all other Pd medication has failed. . . . As a Pd patient I personally think that early prescription of levodopa medication is irresponsible. That is just my opinion” (p. 67). We leave Pepper’s personal-experience-based ruminations on Parkinson’s medications right there: they are just his opinion. We all have somewhat unique reactions to specific medications, and we recognize them such. Unlike Pepper, most of us are careful not to generalize.

In telling his story, Pepper himself seems to step away from the promise of his title: “My gift of improved health is an exciting story and it needs to be told to the whole world, so that others will know what can happen, if we don’t give up, when things go wrong. It is not my intention to falsely raise hopes by leading you to believe that my Pd is cured. I still have most of the symptoms, but they are mostly under control and at a much lower level than they were in 1992” (p. 13).

One of the most puzzling features of the book is that at the same time that Pepper wants us to believe that he is far better off after twenty years with Parkinson’s than he was at the start, he also wants us to believe that he still has the symptoms. Indeed, he lists no fewer than thirty-five symptoms of Parkinson’s that he still has: “1. Bad muscle co-ordination. 2. Constipation. 3. Choking and swallowing problems. 4. Rigidity . . . . 34. Confusion with which is the right and left side. 35. My calves become flexed when sitting” (pp. 101–02). That list of symptoms does not sound like the list one would have associated with a man who claims that his methods reduce or reverse the disease.

Halfway through his book Pepper drops a little bombshell: that he may not have had Parkinson’s at all. He reports that he went to a new neurologist, one who had never seen him before. After examining him the neurologist said to him, “You exhibit no symptoms of Pd, and it is quite obvious that you never had it in the first place. You had what is known as Parkinsonism, which could have been caused by medication or by another chemical source, possibly crop spraying chemicals” (p. 103). Pepper rejects that diagnosis: “he never asked me what my existing symptoms were, or what I had had in the past” (p. 103). Pepper even hints that the neurologist in question had self-serving reasons for not wanting investigate the possibility that anyone could reverse the progression of Parkinson’s: “The only conclusion I can come to, is that I present a threat to the medical profession. If all his Pd patients got to a stage, where they no longer need medication, nor need a neurologist any more, then I can understand his fears” (p. 104). Serious charges, those.

In the end, Pepper backs off: “On reflection, I realize that it does not really matter whether I do or don’t have Pd. It is purely academic” (p. 111). But to those who might consider taking his advice about avoiding levodopa and taking an MAO-B inhibitor, it is not purely academic. It might be life or death.

We come away from Reverse Parkinson’s Disease admiring its author’s spirit and determination, but unconvinced that his experience is fully relevant to ours. If he never had Parkinson’s to begin with, there was nothing to reverse. Until we know for sure, it is best to take this Pepper with a grain of salt.

Peter G. BeidlerPeter G. Beidler
Peter G. Beidler

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