The underlying problem with using mannitol as a therapy for Parkinson's disease is its poor absorption in the gut. Hence it produces gas and in some cases, diarrhea. If the absorption of mannitol can be increased than it may be taken at a lower dose and also decrease its associated side effects.
Other nutrients and drugs are poorly absorbed and there are strategies to increase their absorption, here are a few examples.
Curcumin is a component of the herb tumeric. Curcumin has been tested for an array of conditions and has great potential but it is poorly absorbed. Researchers found that when curcumin is combined with piperine, a known bio enhancer, its absorption increases to as much as 2,000%
Natural Compound in Black Pepper Increases Curcumin Absorption Up to 2000% dailyhealthpost.com/piperin...
Piperine is being used to enhance the absorption of antibiotics so lower doses can be used and the most notable example is its combination with the #2 TB antibiotic rifampicin. The following is a video stating how piperine has been combined with rifamipicin to make a drug called risorine:
youtube.com/watch?v=Bk-L1n0...
Given the above knowledge I asked the question if mannitol, when combined with another substance, could be absorbed better (and here is what I found):
Oleic acid and docosahexaenoic acid cause an increase in the paracellular absorption of hydrophilic compounds in an experimental model of human absorptive enterocytes
".... we investigated whether fatty acids such as oleic acid and docosahexaenoic acid (DHA), both commonly present in food, negatively affect the integrity of tight junctions (TJ) in the intestinal epithelium and thereby increase the absorption of poorly absorbed hydrophilic substances."
"Absorption of (14)C-mannitol increased and trans-epithelial electrical resistance (TEER) decreased in cell monolayers exposed to oleic acid and DHA, compared to controls."
"Our results indicate that fatty acids may compromise the integrity of the intestinal epithelium and that certain lipids in food may enhance the paracellular absorption of poorly absorbed hydrophilic substances."
researchgate.net/publicatio...
END OF ABSTRACT -The remaining text from the downloadable PDF document.
"Substances with surface
active properties, such as fatty acids, have been used in pharmaceutical research as absorption enhancers of hydrophilic drugs which normally are poorly absorbed through the intestinal epithelium...."
"In the present study the Caco-2 cell model, which is
an experimental model of human absorptive enterocytes, was used to examine the effect of oleic acid and DHA on the paracellular absorption of the hydrophilic substances mannitol and Cd. Mannitol is exclusively absorbed in the gastrointestinal tract through the paracellular pathway...."
"Thus, in the present study we investigated whether
fatty acids such as oleic acid and DHA, both normally present in food, compromise the integrity of the intestinal epithelium and therefore enhance the paracellular absorption of poorly absorbed hydrophilic substances such as mannitol and Cd."
"Absorption of 14C-mannitol through the cell monolayers
increased with an increasing concentration of fatty acid as well as over time at 30, 60 and 90 min of exposure (Fig. 1a). The increase of 14C-mannitol absorption was more pronounced, at comparable concentrations, for DHA than for oleic acid exposed cell monolayers."
"We have demonstrated that fatty acids common in
food and food supplements may increase the paracellular absorption of hydrophilic substances, such as mannitol and cadmium (Cd), through mono-layers of Caco-2
cells."
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These results are from testing Caco-2 cells: "Caco-2 cells are derived from colon tumours, but
exhibit characteristics of epithelial cells from the small intestine."
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In so many words anyone who is using omega 3 fish oil should use the highest quality, because if there are chemical impurities in the fish oil, the toxins will be absorbed in the small intestine because of DHA. Molecularily distilled fish oil is best because the toxins are removed.
FYI, the most pure fish oil I know of is produced by Supplement Clinic and it is concentrated, purified and given an attractive lemon flavor. I previously had adrenal therapy and had taken this supplement twice a day for approx...8 months - it is pharmaceutical grade fish oil.
One teaspoon contains a huge dose of EPA and DHA omega 3s:
Omega-3 fatty acids2390 mg
EPA1195 mg‡
DHA795 mg‡
supplementclinic.com/Liquid...
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The idea of combining DHA and mannitol should be done cautiously for the obvious reason. Lets, for the sake of argument, say that DHA drastically increases the absorption of mannitol over the projected 90 minute period and as a consequence, the active effects of mannitol are increased in the body.
From wikipedia:
"Common side effects from medical use include electrolyte problems and dehydration. Other serious side effects may include worsening heart failure and kidney problems."
en.wikipedia.org/wiki/Mannitol
In the above article, mannitol is injected for medical reasons and perhaps we need a study of PD patients being injected with mannitol to bypass its poor absorb-ability in the intestines.
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Many people on this site take one tablespoon a day of mannitol and when if they decide to add DHA, the mannitol dose should be greatly reduced as should be the dose of DHA. Taking 795 mg of DHA with 1 tablespoon of mannitol could be very dangerous, so it is obvious that both the doses should be reduced to say, a quarter or 1/8th a dose to start. If negative side effects occur - stop taking the combination.
It is obvious that people melt mannitol in tea then drink it and fish oil with a lemon flavor would be a good compliment - obviously lesser so in coffee.
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Again, this is a untested, experimental protocol and if anyone tries this should be ultra cautious because of possible unpredictable results.
Other concerns: Fish oil is a blood thinning agent and cannot be taken with drugs like warfarin.
Good news: DHA is well known to be neuroprotective agent in Parkinson's disease models.
Impact of omega-3 fatty acids in Parkinson's disease
"We recently demonstrated the efficacy of omega-3 fatty acids to protect against neuronal cell death in an animal model of Parkinson's disease."
sciencedirect.com/science/a...
That's all folks, yea that is from a Bugs Bunny cartoon, and I hope you find this interesting.
Ingredients to prevent or slow progression of PD - Knox Van Dyke - Dept of Biochemistry and Molecular Pharmacology, West Virginia University
Has anyone had success reducing levodopa-induced Dyskinesias after using Dr. Laurie Mischley’s regimen? (High DHA Fish Oil, Citicholine)
If you're trying to follow Dr. Mischley's DHA for dyskinesia protocol, please read this REGARDING DOSING
