How To Spot The Hidden Symptoms Of Early Parkinson’s Disease

April marks Parkinson’s Awareness Month, and one expert is using the opportunity to shed light on some lesser known symptoms of the neurodegenerative condition that affects millions worldwide.

Efrat LaMandre, PhD, FNP-C — a certified family nurse practitioner known to her more than 680,000 TikTok followers as “Dr. E, the NP with the PhD” — says Parkinson’s Disease “often starts quietly.”

“While tremors are the most well-known symptom, theres also stiffness, balance issues, and even mood changes like depression and anxiety,” says LaMandre, author of “Its Not In Your Head,” focused on validating patient concerns and pushing back against medical gaslighting. She also owns a medical practice in New York and chairs the Staten Island Hospital Foundation Board of Trustees.

“It often starts quietly — slower movements, a softer voice, changes in handwriting, even loss of smell,” LaMandre says. “These subtle signs are often missed or dismissed as aging. But early recognition means earlier intervention, which can change the course of the disease.”

Parkinsons Disease is a progressive neurodegenerative condition in which the brain cells that help control movement, coordination, and mood begin to die off.

“Theres no blood test or imaging scan to confirm Parkinsons early on — diagnosis is clinical and often delayed,” LaMandre says. “Our system treats symptoms with medication, but doesnt address contributing root causes like toxin exposure, gut-brain connection, or inflammation that may worsen progression.”

With no cure and often delayed diagnoses, what can loved ones do?

“Support research. Stay informed,” LaMandre says. “If you or a loved one notices early changes, dont wait. Ask better questions and seek providers who look at the full picture. Parkinsons isnt just about shaking — its about quality of life, and the earlier we act, the better.”