Will taking mucuna pruriens (instead of Sinemet) prevent peripheral neuropathy?

[yeramian]

Is the peripheral neuropathy a side effect of Carbidopa, or a reaction to the downtime from Sinemet? My friend had been using Mucuna Pruriens, but I recently discovered it only contained 15% L-dopa and would like to get a higher grade, maybe 98% though I wonder if a 40% powder or capsule would work better? If an extract is 98% will we miss out on the effects of other ingredients of Mucuna? If anyone has experience with these questions, I'd love to hear your thoughts! Thank you!

[Greenday]

Your concerns are valid.

The 98% L-dopa Mucuna extract is simply not the Mucuna powder in its natural form, which may offer additional benefits over the plain or high concentration L-dopa extracts;

For such high L-dopa extract be an effective treatment, you need to accompany with a dopa-decarboxylase inhibitor such as benserazide in order to experience similar effect to Sinemet/Madopar, but probably that way it wouldn't make much difference to the drugs.

I suggest reading the following recent human study:

Mucuna pruriens in Parkinson disease. A double-blind, randomized, controlled, crossover study (2017)

ncbi.nlm.nih.gov/pmc/articl...

"This study demonstrates that the acute intake of MP powder at both high and low dose is noninferior to dispersible levodopa/benserazide in terms of all efficacy and safety outcome measures."

* Objective:

To investigate whether Mucuna pruriens (MP), a levodopa-containing leguminous plant growing in all tropical areas worldwide, may be used as alternative source of levodopa for indigent individuals with Parkinson disease (PD) who cannot afford long-term therapy with marketed levodopa preparations.

* Methods:

We investigated efficacy and safety of single-dose intake of MP powder from roasted seeds obtained without any pharmacologic processing. Eighteen patients with advanced PD received the following treatments, whose sequence was randomized:

(1) dispersible levodopa at 3.5 mg/kg combined with the dopa-decarboxylase inhibitor benserazide (LD+DDCI; the reference treatment);

(2) high-dose MP (MP-Hd; 17.5 mg/kg);

(3) low-dose MP (MP-Ld; 12.5 mg/kg);

(4) pharmaceutical preparation of LD without DDCI (LD−DDCI; 17.5 mg/kg);

(5) MP plus benserazide (MP+DDCI; 3.5 mg/kg);

(6) placebo.

Efficacy outcomes were the change in motor response at 90 and 180 minutes and the duration of on state. Safety measures included any adverse event (AE), changes in blood pressure and heart rate, and the severity of dyskinesias.

.....We measured the content in levodopa of the Bolivian black ecotype (MP used in the present study) and found it to be 5.7%

* Results:

When compared to LD+DDCI, MP-Ld showed similar motor response with fewer dyskinesias and AEs, while MP-Hd induced greater motor improvement at 90 and 180 minutes, longer ON duration, and fewer dyskinesias. MP-Hd induced less AEs than LD+DDCI and LD−DDCI. No differences in cardiovascular response were recorded.

* Conclusion:

Single-dose MP intake met all noninferiority efficacy and safety outcome measures in comparison to dispersible levodopa/benserazide. Clinical effects of high-dose MP were similar to levodopa alone at the same dose, with a more favorable tolerability profile.

--------

"Both low-dose and high-dose MP were superior to placebo. Low-dose MP was associated with a motor response that was equivalent to the response to levodopa/benserazide, while high-dose MP induced a qualitatively better motor response than LD+DDCI along with longer duration of the on state by about 45 minutes and fewer dyskinesias. "

[yeramian in reply to Greenday]

Thank you very much for this information! Its very useful for me and my friend!

[Greenday in reply to yeramian]

Notes regarding Dosages based on the present study:

1) MP-High: Mucuna pruriens powder at high dosage

The dose of MP is calculated to obtain a 5-fold Levodopa dose than LD+DDCI.

2) MP-Low: Mucuna pruriens powder at low dosage.

The dose of MP is calculated to obtain a 3.5-fold Levodopa content than LD+DDCI

3) MP used in the present study found to be 5.7% Levodopa concentration ***

--------------

*Example*

MP = Mucuna Powder

MP-Low = Mucuna Low dose

MP-High = Mucuna High dose

LD = Levodopa

LD+DDCI = Levodopa drug (Levodopa + Benserazide ) / Madopar

-------

*Example with Values: *

LD+DDCI: 100mg (LD)

LD (MP), the LD content in MP : 5.7 % (as in study, actual varies 4-6%)

LD (MP-Low) to LD+DDCI (drug) Ratio: 3.5x

LD (MP-High) to LD+DDCI (drug) Ratio: 5x

---------

The Equivalent of MP-Low with 5.7 % LD content to LD+DDCI drug with 100mg LD content is calculated as:

MP-Low = (350 x 100) / 5.7 = 6,140 mg Mucuna powder

MP-High = (500 x 100) / 5.7 = 8,771 mg Mucuna powder

----

Therefore according to the study:

* 125mg Madopar (100mg Levodopa + 25mg Benserazide ) is equivalent to:

a) MP-Low dose

= 6,140 mg Mucuna pruriens Powder (5.7% Levodopa )

b) MP-High Dose

= 8,771 mg Mucuna pruriens Powder (5.7% Levodopa)

-----

*** Notes ***

The actual values may vary:

When calculating the Mucuna dosage, take account the actual concentration of Levodopa in the Mucuna powder in its natural form and if any other fillers are included in the powder.

Mature Mucuna seeds contain typically 4-6% of Levodopa . The mucuna used in the present study contained 5.7% Levodopa. According to another study the median concentration is 5.3 % Levodopa ncbi.nlm.nih.gov/pubmed/272...

The study results apply to the pure Mucuna powder in its natural form, not the extracts.

Most Mucuna powders on sale are extracts standardized to 15% or more of Levodopa instead of the 4-6% Levodopa concentration in the natural powder. Some manufacturers also add fillers in their mucuna powders. Mucuna extracts may lack certain compounds contained in the natural powder, which make Mucuna to exert its positive effects as shown in the studies.

Recommend starting with the lowest dose of Mucuna to minimize possible side effects or allergies, gradually increase if seeing no effects.

Silvestrov (forum member) suggests EGCG catechines with mucuna as a replacement to the decarboxylase inhibitors such as Cardidoba. healthunlocked.com/parkinso...

**** Always consult with your doctor before starting with mucuna as it may interfere with other drugs. ****

*Mucuna is a poweful supplement with drug-like effect and can lead to serious side effects if not taken properly. Also the levodopa concentration is not standardized in many mucuna products or may differ from batch to batch, or may not agree with the product label, this may lead to undesiderable side effects if the correct dosage is not calculated properly *

[marcet in reply to Greenday]

Thanks for your article but i need your help to understand. How many mg of 99.6% of curease.com l-dopa from mucuna pruriens should i use daily to replace sinemet cr 25/100mg ? Thanks for your help

[Greenday in reply to marcet]

Only the pure Mucuna powder with 4-6% levodopa concentration has been extensively studied and proved to be superior over levodopa alone in multiple human studies. Please understand that the beneficial properties of mucuna don't just lie on its natural levodopa content, but on other beneficial compounds as well, such as decarboxylase and/or MAO inhibitors that mucuna may contain, which yet to be undentified. Mucuna extract with high levodopa concentration may have their mucuna beneficial properties stripped off.

Mucuna with 99.6% levodopa is simply not Mucuna, just levodopa from a natural source with minimal difference to the synthetic version. It is a bad choice of taking levodopa alone, synthetic or natural. You need a decarboxylase inhibitor such as that in Sinemet or Madopar to avoid levodopa breaking down in your body before it reaches the brain. The risk of side effects are much higher taking levodopa alone without a decarboxylase inhibitor, more predominately nausea, sleepiness, reduced "on" time, with no real benefit over mucuna or other PD drugs such as sinement and madopar ncbi.nlm.nih.gov/pmc/articl...

If you want to try mucuna from a reputable company, you may opt for Zandopa mucuna zanduayurveda.com/products/... which proved to be effective for the treatment of PD in a human study ncbi.nlm.nih.gov/pubmed/939.... Alternative you may try at a lower than 15% levodopa concentration extract from a reliable source. But mind only human studies examining the whole mucuna powder proved to be effective as alternative treatment for PD. In any case you need to discuss any replacement therapy with your doctor. Mucuna even though a natural supplement it still acts as a powerful drug and you should be cautious with the dosage.

For better insight about mucuna I suggest you to read the book from DR. RAFAEL GONZÁLEZ MALDONADO . mucunaparkinson.com/PARKINS...

[marcet in reply to Greenday]

Many thanks for the clarification

[marcet in reply to Greenday]

Following your useful clarification, i stopped the 99.6 and did switch to Zandopa, the provided dose 3 times a day. With 99.6 i was full of energy with a kind of flying high feeling. After 3 weeks of Zandopa I am quite surprised to see no benefit, my energy is low and i don’t see much difference with or without Zandopa. What am i doing wrong ? Increase dosage substantially?

[Greenday in reply to marcet]

When comes to mucuna there is not one dosage fit all. How much was your dosage in sinemet or madopar before starting with natural treatment? How much was your dosage with natural levodopa? Where did you buy the mucuna from? Do you take mucuna with empty stomach? Also check and verify your source. I buy directly from the distributor in India and I'm confident I receive the genuine full potency product. Indeed, it is really strange you feel no effect at all. I've yet to experience such no-effect feeling with Zandopa.

Note: I don't advertise Zandopa or other Mucuna product nor suggest any specific dosage or any mucuna brand. Just a personal experience, which it may not be effective for everyone. So far, all human studies on mucuna show that mucuna on the right dosage is superior to levodopa alone and produces much fewer side effects such as nausea, which commonly seen with pure levodopa. I have yet to see any study that claims the opposite.

[Farooqji]

buy beans, roast it in a pan or oven , remove the shells and grind in coffee bean grinder. The powder is ready

[Greenday in reply to Farooqji]

This is how they prepared Mucuna in the study above

[faridaro in reply to Farooqji]

Where do you buy these beans?

[Farooqji in reply to faridaro]

The bean is available at almost all the herbs stores. It's called velvet bean. Here in my country it costs USD 4 per kg

[Iam59 in reply to Farooqji]

What is the Hindi name for velvet beans. I live in KOLKATA. Where can I buy IT. Where do you live.

Can I buy IT online?.

[Farooqji in reply to Iam59]

it's called "konch ka beej" or "kapi kachu"

[Iam59 in reply to Farooqji]

Thanks.

[Boyce3600 in reply to Farooqji]

And this is levodopa and can work to reduce stiffness with no side effects such as hallucinations?

[Farooqji in reply to Boyce3600]

yes , as confirmed by the trial

ncbi.nlm.nih.gov/pmc/articl...

[gurdeep11 in reply to Farooqji]

hi where are you located, my number is 7355674524 it will be nice to chat regarding pd if you too have it

[MMmm7 in reply to Farooqji]

Is this the same as mucuna? Are there already powdered form sold?

[Boyce3600]

As predicted, at PA appt today she said she has never heard of MP and after looking it up poo-pooed the idea of taking it. My hubby is so stiff he can hardly move, cant take carbidopa levodopa and she said there is NOTHING else the neurology tool box to recommend. So done with all these so called medical helpers

[katz2017 in reply to Boyce3600]

I would ignore what she said and take it..start small dose moving up to what is needed to see results.

[katz2017 in reply to katz2017]

P.s our drs.here in Canada never knew of it either...I bought for my husband and it helps him...so we dont care what the drs think.is our or his health.Once they seen how it was helping him they were amazed.

[Farooqji in reply to katz2017]

In case of Parkinson, patients knowledge is better than the doctors. That's why I don't consult doctors specially for PD. They mere know the few drugs and do experiments on patients with different combinations. I will not go to doctors until they discover the root cause and understand the disease. It is really a shame for modern medical community that ancient Indian Hakeem (what they call quacks) were using better treatment that today's modern medicines. They (except few of them) also receive precious gifts from big pharma in reward of prescribing their drugs.

[Greenday in reply to Farooqji]

Unfortunately, a common misconception spread on the Internet and part of the medical community is that the active ingredient in Mucuna is just the Levodopa alone. This is beyond untrue: Most studies performed with pure Mucuna powder (4-6% Levodopa) showed that it outperforms plain Levodopa in terms of efficacy, absorption, bioavailability, duration and number of side effects.

The positive effects of Mucuna over Levodopa are attributed to the natural decarboxylase / MAO inhibitors and other yet-to-be-identified beneficial compounds which Mucuna may contain. Therefore Mucuna Extracts of 12% and above may compromise these innate properties found in the natural Mucuna powder. It is very likely that PD patients experience the full benefits of Mucuna when taken as whole powder instead of extracts.

Yes, it is quite shameful that many PD Patients go through extensive pain and agony and part of the medical community are unwilling to provide them with other alternatives.

Based on the aforementioned human study: ncbi.nlm.nih.gov/pmc/articl...

Video Mucuna vs Levodopa vs Madopar (PD Patient)

ncbi.nlm.nih.gov/pmc/articl...

Frequency and type of adverse events:

ncbi.nlm.nih.gov/pmc/articl...

DDCI = Dopa-Decarboxylase inhibitor

MP = Mucuna Pruriens (5.7% levodopa)

-----

Sleepiness (somnolence) :

- 9, Levodopa

- 6, Levodopa + DDCI

- 1, MP-low dose

- 1, MP-high dose

-----

Nausea :

- 6, Levodopa

- 2, MP-high dose

- 1, MP-low dose

-----

Dizziness :

- 3, Levodopa

- 1, Levodopa + DDCI

----

Prolonged Adverse Events ( >90min) :

- 4, Levodopa

Nausea is reported but more prominent when Levodopa is taken alone. Sleepiness and Dizziness appear more likely with Levodopa / Levodopa + DDCI . Prolonged adverse events are more prominent with Levodopa alone and absent with the other agents.

Bottom line: Levodopa alone appears to have the most adverse reactions (12). The least adverse effects are reported with MP-low dose (1)

[Rosabellazita in reply to Farooqji]

I agree. Im canceling my nx neuro.appt. because all shes going to do is write another prescription cause i wont take the sinemet she presribed. Im taking mucuna instead. I dont like prescription drugs. I told her im waiting for them to legalize marijuana in my state. She thinks im crazy.

[Rosabellazita in reply to Boyce3600]

Me too!

[Greenday]

Another human study showed that 15g Mucuna preparation powder* which contained 500mg natural Levodopa (3.3%), provided comparable results to 200mg/50mg Levodopa/Cardidoba (Sinemet), but Mucuna patients were 20min less "full-on"

ncbi.nlm.nih.gov/pmc/articl...

The actual Mucuna powder in this preparation was approx. 10,300mg (4.86 % levodopa)

The 30g Mucuna preparation was superior over Levodopa/Carbidoba providing an additional 46 min when patients were partially ‘‘on.

Safety: "Apart from one patient who dropped out due to shortlasting vomiting on 30 g mucuna, the other adverse events were: mild and shortlasting nausea occurring in two patients with LD/CD and in two patients with 30 g mucuna; mild gastric pain in one patient with LD/C; and mild dizziness in one patient each with LD/CD and 15 g mucuna."

*The Mucuna preparation in this study included fillers to enhance taste

[jeeves19 in reply to Greenday]

Greenday. In plain English, you're stating that a product with a low amount of levadopa works better than a high one right? If so, I can't grasp it. Surely you need a more powerful amount which would give greater potency? I take MP which declares itself as 98% dopa. Aren't the 15% products just then made up of filler for the remaining 85%?

[Greenday in reply to jeeves19]

Jeeves, I thoroughly answered a similar question made by marcet in this post, you may refer for more details.

Only pure mucuna powder with ~4-6% levodopa concentration proved its efficacy and superiority in multiple human studies over Levodopa alone, whether natural or synthetic. Therefore the beneficial properties of mucuna lie in the rest 94-96% of mucuna powder.

Those additional compounds included in mucuna may act as decarboxylase or /and MAO inhibitors, however they are yet to be unidentified therefore they can’t be standardized in any extract whether 15% or 99%. Specific compounds in mucuna, and not the levodopa alone, allow part of its natural levodopa content to enter the brain and exert is pharmacological properties. Taking high concentration levodopa extracts without a decarboxylase inhibitor, such as the ones in Madopar and Sinemet, and it is very likely to suffer from levodopa side effects such as nausea, dizziness and reduced “on time”, as most of the levodopa is broken down in the body before it reaches the brain ncbi.nlm.nih.gov/pmc/articl... . Except from less dyskinesia, I don’t see any real benefit from taking levodopa alone (natural or synthetic) over mucuna whole powder or the common levodopa drugs.

If you opt for a high concentration (>90%) levodopa extract from a natural source, then you probably need to combine it with a decarboxylase inhibitor such as carbidopa, however that way I don’t see any real benefit over the levodopa drugs. An alternative way is to combine Levodopa with green tea or other extracts with COMT capabilities in order to increase its bioavailability in the brain, again that way increases the complexity of the treatment, it's missing real human studies, and involves a lot of experimentation and risk of side effects.

Taking mucuna as a whole powder is the best way to reap the benefits of the mucuna’s properties as human studies suggest. The most renowned mucuna brand is “Zandopa” (based on HP-200) zanduayurveda.com/products/... , which has a low concentration of levodopa but its efficacy was proven in a human study ncbi.nlm.nih.gov/pubmed/939.... Zandopa includes some fillers such as sugars to give a better taste if you don’t mind.

If you’d like to learn more about mucuna I suggest you read the book of Dr. Rafael González Maldonado, a renowned neurologist with expertise in mucuna mucunaparkinson.com/PARKINS...

You may also refer to the most important human studies with mucuna (whole powder)

* An alternative medicine treatment for Parkinson's disease: results of a multicenter clinical trial. HP-200 in Parkinson's Disease Study Group.

ncbi.nlm.nih.gov/pubmed/939...

* Mucuna pruriens in Parkinson disease. A double-blind, randomized, controlled, crossover study

ncbi.nlm.nih.gov/pmc/articl...

* Mucuna pruriens in Parkinson’s disease: a double blind clinical and pharmacological study

ncbi.nlm.nih.gov/pmc/articl...

* Ayurveda Medicine for the Treatment of Parkinson’s Disease

researchgate.net/profile/Sa...

[jeeves19 in reply to Greenday]

Thanks for taking the time Greenday. Appreciate it😊

[reedboat2]

I’m using a 15% extract from Paradise Herbs and getting excellent results. The company advertises that “the essence of the whole herb is captured”. I buy the Paradise capsules online from iHerb.com. Lately I’ve been switching off with 40% bulk powder from Barlow’s to save money. I take no pharmaceuticals. My main symptoms are tremor and some bradykinesia (sore and stiff muscles). Like John Pepper, I believe that exercise is the key factor in symptom reduction. I credit the mucuna extracts for helping me get decent sleep and to feel good enough to exercise. I’m 71 yo and fortunately in good health overall. Best of luck to each of us on the personal and unique PD journeys we are all on.

[marcet]

I also bought from and received package from India directly. I tried Madopar 62.5mg with Levodopum 50mg and benserasidum 12.5mg. Sinemet cr was 25/100mg, twice a day. I tried first Sinemet and then Madopar but had to stop as i was feeling worse. This is why i really expect Zandopa to work

[Greenday in reply to marcet]

So far, which combination of drugs did make you feel better? You mentioned in a previous post that you felt better with 99.6% levodopa, what was the optimum dosage?

It is strange that such a low dose of madopar and sinemet alone make you feel so bad that you have to stop them. Most PD patients able to tolerate low to medium dosages of common Levodopa drugs such as sinemet and madopar, depending on the severity of the disease. I suggest you refer to an experienced in PD neurologist. Maybe you need an adjustment in dosages and frequency.