It's now 2 months since I posted my article on the inhibition of Cytochrome P450 enzymes by Grapefruit juice and it's likely effect on improving the bio-availability of levodopa. If you tried it for a significant period, say 2 weeks or more, let me know how it worked for you. What dose did you take and when ? With what kind of levodopa ? Did it help you or not and how ? Did you have any adverse effects ?
If I get enough answers I will try to summarise them alongside my own experience, into my next article.
Have a nice day,
Albert
If you have not read previous posts on this subject, start here before making comments,
Hello Albert! My husband has been taking it ever since your first post. I believe it does work! He is on 1 1/2 Sinemet, one in the morning, MP for mid-day, and half Sinemet before he goes to bed, usually around 23:00. He drinks approx. 6-8 oz GJ after breakfast with his vitamins. His last dose of Sinemet (1/2 pill) lasts until 7:30-08:00 am. We also asked our compounding pharmacy pharmacist is it's OK to take his thyroid med having drank GJ, and she said to wait about an hour before or after GJ to take thyroid meds. That was our only concern, but it appears to be no problem as long as he takes thyroid meds an hour before or after GJ. Hope this helps. Thank you for your research and your tireless efforts in improving PwP's lives.
Later this month, we will talk to Dr. Mischley and ask her guidance on taking Azilect (monotherapy) and MP. We found TATTVA'S MUCUNA (15% L-Dopa) and Naturebell Mucuna 30% L-Dopa to be the most effective, maybe even better than Sinemet.
I tried Grapefruit Juice for a month a glass in the morning with initial gain of on period prolonged a little, now I stopped by three weeks and soon I'll start using it again. As I told you, I will make periods of use and not use to evaluate the effectiveness on the basis of observation of the obvious. In my case a dose of two glasses works better. I use madopar. Thanks Albert, a wonderful job yours on the GJ.
In an article I will soon release, I will be writing about 2 new observations :
1) Suddenly stopping GJ after a long period, 2 weeks or more, may cause severe (cold turkey) withdrawal symptoms, such as intolerably painful fatigue which builds up over a few days. If you have already experienced this by accident, I would like to know. This will provide clear evidence that GJ was working for you, but I don't recommend trying it, I'm seeking expert advice about this. In my case these bad symptoms stopped completely in less than 1 hour after drinking a glass of GJ followed by the meds. To avoid this withdrawal effect, if you need to stop GJ, do it progressively by reducing the dose over several days.
2) I believe that it is possible to overdose on GJ by gradually building up CYP inhibition over a long period. When this happens, the Cytochrome enzymes (GJ inhibit 6 types to some extent) are so strongly inhibited that levodopa lasts a very long time, more than 12 hours. But there's a drawback. The Cytochrome enzymes can't do the job they are supposed to and toxins from food metabolites are no longer cleared from the blood. The result can be excessive tiredness and even nausea after meals or certain foods. If you've experienced that let me know. You should immediately cut down the GJ dose, but not stop it, to avoid the withdrawal effect. As a guide, if your levodopa lasts more than 6 hours in the daytime, you may be overinhibiting the Cytochrome enzymes and should progressively cut down on the GJ.
I'm currently on just half a glass, 100 ml per day for that reason.
I'm hoping to get expert pharmacological advice before publishing the details of these results.
Despe, I found that GJ works well with MP, but Green Tea extract also helps in combination with GJ. Green Tea has a mild DDC inhibitor.
The effect of GJ is even better with Sinemet because of the DDC inhibitot, Carbidopa. I now take 1/2 10/100 C/L in combination with MP and it works fine. That's only 5mg of Carbidopa.
I hope you'l let us know what Dr Mischley says. I usually like what she writes.
Albert, thanks a million for all that hard work! You are incredible in your pursue to "tame," as Gio says, the "tiger"!
My husband doesn't always have a full cup of GJ. Many times he has even less than half a cup but he mixes it with water. As the Vanderbilt MDS told us "Less if more" referring to medication. I will make sure he doesn't have a full cup of GJ and keep it at half a cup or less. He usually takes his vitamins with the mixture of GJ and water as well as his mid-day MP, 150mg L-Dopa. In the evening and after meals, he mixes the juice of an organic lemon with water and a little GJ and takes his evening vitamins. He takes his last Sinemet dose (half a pill, 100/25) before bed with plain water. Of course, he has a big cup of green tea every morning after he takes Sinemet, always on an empty stomach. He takes green tea extract only when he doesn't want to drink tea or he is out and about early in the morning.
He never complained about nausea, just an upset stomach, and he hasn't complained about tiredness (nock on wood ) Hope we are on the right path. He would also like to go back to just MP and maybe Azilect. A lot of questions to ask Dr. Mischley, but we have written them all down, and we hope that there will be plenty of time to get all the answers. I will pass on her wisdom.
Looking forward to reading your third post on GJ and its inhibition of CYP enzymes. Hope our experiment with GJ and its results has helped a little.
Hi Wriga, I'm a great believer in the efficacy of foodstuffs as medicine and I love grapefruit, but I feel conscience-bound to tell you that I've read and been told that grapefruit interacts in an unsafe way with many medications. Speak to your doctor or your pharmacist or even Google about your own particular combinations. Many blessings to you all.
Thanks for replying. I should have made a link to my earlier posts on this subject since you don't seem to have read what has already been widely discussed. I'm a research chemist and I've researched this subject intensively, including interactions between Grapefruit and other meds. I know the subject is controversial and I have warned of the serious risks when taking other medications in the post for which the link is given below and the references therein. For PwP I believe there are benefits and for many people, but clearly not for everyone, the risks can be managed.
Hi! My husband does not take grapefruit juice. He has been using statins for years and it is dangerous to combine the two. He does take C/L, B1, and Seligeline. Hope this helps. Going on 5 years for us!
Albert - thanks so much for the research you are doing on GJ. My husband did try it for a very short time - he wasn't enthused with drinking it and I had difficulty finding it in the grocery stores - I was stunned that it wasn't on the shelves. Having said that and reading your article(s), I think this is an interesting avenue to pursue.
I have been having a glass of grapefruit juice with my Thiamine, COQ10 and fish oil, plus rhodiola, ashwaghanda, vinprocetine, L-theanine, folic acid and lithium oratate then waiting half an hour while listening to 40hz and using the infra red helmet before drinking a tea made from mucuna pruriens, green tea and dandelion root.
I have no idea whether it is helping but hope like hell it is.
Hi Getz. I thought B1 should not be taken with citrus juices. Also, grapefruit interacts with statins as well. People taking blood thinning meds like wafferin are also advised not to mix grapefruit with it
Been having a hard time with atrial flutter and atrial fibrillation. My husband was going for ablation because the flutter was on for 4 days then on day of procedure his heart reverted to sinus rhythm so it was cancelled.
🙏🏻
My husband does not take grapefruit in any form because he is on statins and on anti coagulant.
I don't normally get upset by comments from people on this forum, but I would ask you to think 5 minutes before making such a statement. I suspect that you have no idea of the hundreds of hours of work, checking, interrogation, networking with experts and competence needed to establish and substantiate the basic information behind any research hypothesis. A wide ranging soundbite like this has no substance whatsoever without the basic knowledge and consideration of the principles, mechanisms and evidence to back it up. I say this with due reverence to Dr C. for whom I have the highest respect. Any juice ? A juice is a solution of various chemicals, sugars, lipids, proteins and minerals. They are not all the same and therefore don't have the same effects.
Sadly, I think this post needed to be prefaced with something along the lines of, "please read my previous posts - links below - before commenting on this post" or a similar standard reply might save your sanity. People make assumptions rather than asking questions and comment with little to no knowledge of what's gone before. Your research is much appreciated by those of us who have read and followed it.
I have only been on this site for less than 2 months. Thank you for making that suggestion. No one knows my heart. My husband was just diagnosed with PD. I am retired, on disability, trying to take care of my husband. I am not perfect, but if you knew me, you would know I dont have a mean bone in my body. I am not perfect! Sorry I didnt know I had to read everyones previous posts and know their background. I felt very discouraged and unwelcome on this site as a newbie to it all after the comment. Unfortunately, words cant be taken back. Again, I have only been reading on this site for a short time. It is a shocking thing to me to hear the diagnosis that my husband has PD. It would be nice if people wouldnt make assumptions about others and be reprimanded on a public site. I do like this site and I really am thankful to all of the people who make huge contributions.
Thanks for saying what you needed to say. My comments weren't specifically directed at anyone in particular. I was naive to think that forummers would respect the question that was asked. I was hoping to get serious feedback to check whether a hypothesis that I had developed over 6 months of hard research and analysis could be validated by users. Feedback is essential for me to build up a picture of how the protocol works or doesn't work for patients who are all different. My objective is to help all PD patients, but for that I need to know whether or not it helps them. Unfortunately, the thread became an opportunity for those who had not seen the earlier posts and had not tried GJ and therefore could not answer the question, to add their opinions and hearsay. On a controversial subject like this that carries serious health risks, hearsay is dangerous and I don't want to be the cause of anyone taking risks. The earlier posts from me had clearly warned of these risks and presented the best validated references to enable people to avoid them. If you havent read them do so. You joined the thread when it had already deviated from its pupose, and become a general discussion, so you were not to know. I only knew for certain of a few people who had tried GJ, but I suspected more had done so. Some replied to me by private message and I thank them for that. I'm doing further work on this subject which is more complcated than I first thought, but I hesitate to publish it here if people are going to be trivial about it. I post to other, more scientific networks where it is taken very seriously indeed, and the benefits and risks are discussed, but if Parkinson's patients don't participate, it will take much longer to make progress. That would be a pity.
I appreciate your explanation. Thank you. I wish you all the best success in your research and appreciate all of the time and effort and your desire to help all PD patients. The patients need all the help they can get!!
I have used grapefruit juice, both the bottled from condensed and raw fruit varieties, to extend the half-life of the medications I want to help that are processed via cyp450, I have two medications, about 100 ml in the a.m. following my dose, for the last three months, and my subjective perception is that it does seem to help.
Speculation: the degree and duration of the effect may greatly depend on the medication half-life, what is already in your belly, whether the effect is gradual onset gradual offset or contains cliffs, I am not really familiar with the pharmacodynamics of the p450 enzyme system involving GJ, rate limiting factors etc. So some trial and error and patience is in order.
TALK FIRST TO YOUR DOCTOR AND ALSO YOUR PHARMACIST.
Let me repeat that: Talk FIRST to your doctor, AND pharmacist.
So always talk to your doctor and pharmacists. DO NOT ASSUME ONE IS THE SAME AS THE OTHER...BOTH DOCTOR AND PHARMACIST.
Many meds are affected by GJ, but not all, and there are definitely alternatives that are not. So whatever you are on or have as a disorder, study up AND PLEASE TALK TO YOUR DOCTOR. DOCTOR, NOT NUTRITIONIST, NOT NATUROPATH, NOT DIETICIAN. AND AFTER YOU TALK TO YOUR DOCTOR, TALK TO YOUR PHARMACIST. OR VICE VERSA.
You must be wary though of any medications or processes you need that depend on this pathway so that the reverse effect occurs, that GF juice inhibits the main effect you need, and there are such medications which are weakened by GF. So you must do homework, as someone above said, yes, GF is a kind of drug, and has "interactions." In fact it is one of these "interactions" that we seek when taking it for PD and certain anti-depressants.
For example, if you are taking a medication for bi-polar or have bi-polar or schizophrenia, there are possibilities that GF could destabilize you. Some blood pressure medications, antacids, can be adversely affected by GF.
Do your homework against your own various conditions and treatments, and talk to a doctor.
This is a summary of most of what I know. It is not exhaustive and I am no authority, this is just passive FYI. If you are on or need any of the below, you can unintentionally and inadvertently REALLY F*** YOURSELF UP with GJ.
Grapefruit juice will increase the drug effect of these: Carbamazepine, Hypericum perforatum (St. John's wort), phenobarbital, phenytoin, rifampin
Grapefruit juice will decrease the drug effect of these drugs: Alprazolam (Xanax), amlodipine (Norvasc), atorvastatin (Lipitor), cyclosporine (Sandimmune), diazepam (Valium), estradiol (Estrace), simvastatin (Zocor), sildenafil (Viagra), verapamil, zolpidem (Ambien).
If you are taking buspar (buspirone), the effect is to increase the level of buspar, and you could get something very dangerous called "serotonin syndrome."
If you are on a statin, GJ can increase it to the point that it causes muscle damage. MUSCLE DAMAGE.
One study found blood levels of nifedipine increased dramatically when taken with about 2 cups (500 ml) of grapefruit juice, compared to no juice. This resulted in a rapid drop in blood pressure, which could be dangerous if unsupervised.
Losartan is unusual in that its effects decrease — instead of increase — with grapefruit. This may limit its ability to control blood pressure.
Eplerenone works similarly to losartan, but its levels increase when taken with grapefruit. Excessive eplerenone levels can cause too much potassium in the blood, which can interfere with heart rhythm.
Grapefruit influences a few medications that treat abnormal heart rhythms.
These interactions can be particularly dangerous, and include:
Amiodarone
Dronedarone (Multaq)
A study gave a glass of grapefruit juice (about 300 ml) to 11 men taking amiodarone. Drug levels increased by up to 84%, compared to those not drinking the juice.
These two medications play a critical role in managing the health of patients with heart rhythm disorders. Grapefruit-related changes in levels of these drugs have occasionally caused dangerous heart rhythm changes.
Although antimicrobials are one of the most diverse categories of medications, there are only a few medications with known important grapefruit interactions:
Erythromycin
Rilpivirine and related HIV drugs
Primaquine and related antimalarial drugs
Albendazole
Erythromycin is used to treat several types of bacterial infections. A study comparing grapefruit juice to water in patients taking erythromycin showed that the juice increased the drug's blood levels by 84%.
Excess levels of this medication can disrupt heart rhythm.
Levels of the HIV medications rilpivirine and maraviroc, in addition to primaquine-related antimalarial drugs, are also increased by grapefruit. This may affect heart rhythm or function.
Because antimicrobials are generally taken for a limited time, perhaps it's easiest to simply avoid grapefruit while taking these medications.
Some (not all, there are alternatives) mood medications affected by GJ:
Bupropion (Wellbutrin)
Quetiapine (Seroquel)
Lurasidone (Latuda)
Ziprasidone (Geodon)
Buspirone (Buspar)
Diazepam (Valium)
Midazolam (Versed)
Triazolam (Halcion)
In addition to being an antidepressant, bupropion is prescribed to help people quit smoking. Its blood levels increase with grapefruit, which can increase dizziness and sleepiness.
Drugs like quetiapine and lurasidone are used to treat mood and behavioral disorders. Increased levels of these drugs can cause heart rhythm changes or sleepiness.
Furthermore, diazepam, midazolam and triazolam are sedatives that are sometimes used for panic attacks or other forms of anxiety.
One study compared some of these drugs in nine patients with and without grapefruit. It showed that grapefruit can increase these drugs' effects, resulting in excessive drowsiness.
Blood thinners are used to treat or prevent blood clots. Some of them are affected by grapefruit, including:
Apixaban (Eliquis)
Rivaroxaban (Xarelto)
Clopidogrel (Plavix)
Ticagrelor (Brilinta)
Clopidogrel depends on CYPs — the proteins that grapefruit limits — to work. Thus, it becomes less active when mixed with grapefruit.
A study of seven patients taking clopidogrel with 200 ml of either grapefruit juice or water showed lower activation of the drug with the juice. However, its ability to treat blood clots was not affected.
Contrarily, grapefruit increases the blood levels of other medications on this list, which can result in bleeding.
Alternatives: Warfarin (Coumadin) is used for similar purposes as apixaban and rivaroxaban. While warfarin is sensitive to foods containing vitamin K, its activation is not affected by grapefruit.
Multiple pain medications are affected by grapefruit:
Fentanyl
Oxycodone
Colchicine
Fentanyl and oxycodone are narcotic pain relievers. Although their blood levels are only slightly affected by small amounts of grapefruit, it may change the length of time they remain in the body.
Colchicine is an older medication used to treat gout. It is processed by CYPs and could potentially interact with grapefruit. Nevertheless, a 2012 study showed that drinking 240 ml of grapefruit juice only had a minimal effect on its levels.
Alternatives: Morphine and dilaudid are narcotic pain relievers that are not affected by grapefruit.
A few erectile dysfunction and prostate medications deserve attention regarding grapefruit interactions:
Sildenafil (Viagra)
Tadalafil (Cialis)
Tamsulosin (Flomax)
Silodosin (Rapaflo)
Erectile dysfunction medications like sildenafil and tadalafil work by relaxing blood vessels, which increases blood flow to an erection.
Because other blood vessels relax with these medications as well, increased blood levels of these drugs caused by grapefruit can decrease blood pressure.
Moreover, prostate enlargement medications such as tamsulosin can also cause increased dizziness and low blood pressure when taken with grapefruit.
So if you are on any of these erectile meds, just LEAVE OFF the GF. Another class of prostate enlargement medications, which includes finasteride and dutasteride, is not significantly affected by grapefruit. Like I said, there are usually alternatives.
I agree that anyone who takes drugs for conditions other than PD, should do their homework on Drug Interactions. My experience is that Drs don't have the info at hand and don't have time to do the homework, so tend to say don't drink GJ. Pharmacists feel more concerned because they are required to advise you, at least where I live (France) but also may not have the data at hand. I'm teaching my pharmacist because he wants to be better informed.
DON'T TAKE ADVICE FROM NON MEDICAL PROFESSIONALS. That includes me !
I wont be replying to questions about specifiic meds.
MarionP, I dont agree with what you say about statins. GJ creates a big overdose situation with statins. Simvastatin increases by up to 700%, Lovastatin up to 500%, Atorvastatin up to 250%. This causes severe muscle damage and renal failure. These are just examples.
My reference for this is Bailey. It's a must read but is not exhaustive. It covers many drugs and conditions.
I get my basic descriptions from an international family practitioner handbook service. I hope your disagreement with them is similarly well taken, but I haven't called them up to say "prove it to my satisfaction." Personally I believe in taking everything with a grain of salt. AND: no one can do your homework for you. It's the adult critical thinking way to go. Always "consider the source."
I know that this whole subject of inhibiting CYP 450 enzymes is a can of worms. It was clear from your biggest post that you had a lot of knowledge and access to a lot of knowledge. Probably more than I have. My comment above was not about that or your sources. It was about the contradictions in that long post that say in one section that the effective dosing of certain statins is decreased with GJ, This was clearly an error of redaction. In another part you say correctly that the effective dosing of the same statins is increased to the point of causing serious muscle damage. I would kindly ask you to reread your post, and if you agree with me to edit out these contradictions and mark the text as edited. If I've misunderstood, please tell me.
Now I know your credentials and evident motivation, It is clear we have more in common than what separates us. I'm not a MD, I'm a researcher, now retired, with PD, a graduate of the Royal Institute of Chemistry in London, I have a PhD in physical chemistry from Uni Bristol, I did a post doc at Oxford Uni, and worked most of my life doing research at a world leading international research centre in Grenoble.
But all that is past history What remains is that I still know how to do research. Until 6 months ago, I had never heard of Cytochrome P450 enzymes, and I knew nothing about the metabolism of levodopa. But research is a process, based on a method, and I'm very good and thorough at that. It didn't take me long to find the weak point in the use of levodopa. It's half life is appalling, but nobody admits to it. Big Pharma don't want us to know why because to resolve it is easy; they know how to inhibit CYP3A4, even more precisely than GJ, but that then makes a whole range of other drugs dangerous and that will cost them $$$. These are bad toxic drugs that the body normally gets rid of quickly. When there are alternatives, these more toxic ones should be taken off the market. That's the real problem for big pharma, $$$$.
Sometimes there are no alternatives so we have to live with that. Maybe levodopa is a bad drug by this critérium, but we have no alternative. But why should we PwP have to put up with these very short ON states when we can resolve it for many who are not on other drugs. It's an ethical, political and $$$ issue.
All that to say that we should be working together for the common good of PwP. We cannot progress on this issue without getting quantitative pharmacokinetics data on levodopa in relation to CYP3A4 inhibition. We need to know the AUC with and without GJ, so we can get the dosing of both GJ and levodopa optimised. If we were to do that, Big Pharma would then magically produce a CYP3A4 inhibitor better than GJ, which is a very blunt instrument. I have written to a dozen experts in this field, nobody wants to get their hands dirty, it's too controversial. The only people interested are researchers and med people who are also PwP. We have to work together, but we are too few.
Always convinced as the first time I read your work, that it is a great job that everyone should read in full and understand the likely extent of the benefits and risks as well. Thank you Albert.
You seem to be very knowledgeable about GJ and meds interaction. You have listed a lot different meds, however, you didn't mention how GJ interacts with Sinemet and/or Mucuna Pruriens. Are you a medical doctor or a PwP? I might have asked you in the past, but I don't recall.
Are you aware of any medical doctor to be knowledgeable of natural remedies, or any patient who would just pick up the phone and ask the doctor if it's OK to take GJ with prescription meds? It is the ND who WILL ANSWER the question, not the medical doctor. Shouldn't prescription meds have instructions on the specific med and its interactions? My pharmacist always gives me a sheet with instructions, interactions, frequency, etc. I always have a consult with our pharmacist before I even fill the prescription and at times I have turned down meds due to their side effects. My husband (PwP) doesn't take any of the meds you have listed above, just a compounding thyroid med. I asked our compounding pharmacist if it's OK for my husband to take GJ. She said "No problem, as long he takes it an hour away from GJ ingestion."
My perception of your post: You are trying to discredit GJ ingestion as it's not part of medical and pharmaceutical training. I didn't rely only on Albert's hard work and research, I DID MY OWN! I believe everyone should do the same. We are not medical doctors, just doctors of our selves. I take full responsibility for my decisions and actions.
Your perception of my post as discrediting GJ is 100% wrong. You could not be more wrong. That in itself is rather amazing to me. But people always think they know better than anyone else, they even have a name for it now, "Dunning Kruger effect. " why should you differ?
I don't give advice, and with this kind of information I always say to go see a doctor first. That is not good enough for you? Instead, you want to talk about natural therapies, which are nothing more than snake oil. Are you selling something?
Natural therapy is phony from the get-go, and I am an enemy of "natural" everything. It is for victims of PC Barnum, who said "there's one born every minute," and "Never give a sucker an even break." Yet another similar description of the "natural" healer's view is "If God did not want them shorn, he would not have made them sheep."
"Natural" is what someone calls it when they are selling to what they believe are value-less fools because they want to relieve them of their money as fast as possible while they are suffering and dying and vulnerable, because that is what fools are for.
Why don't you take the hint and start doing your own research on a medication not mentioned? Need you be spoon fed to that complete degree? Did you want me to publish the entire hospital and pharmacy formulary handbook for you here, and family practitioner handbooks, the AHFS is about 4500 pages now. What is it about a doctor you can't stomach?
I notice you don't disclose anything about who you are. Why not? In fact, just about no one does. Why don't 99% of us do so? When you get them to do so, so shall I. Start with identifying whoever this "Despe" is, what is in her wallet, where does she come from, what is her background to be legitimately on this site. I wonder if this Despe character has an agenda to judge and qualify people or to sell them something. After all, she does not offer her own definitive identity description and evidence of it. Makes you kind of wonder what her agenda is, doesn't it. Is Despe hiding something?
For God's sake, and your husband's, please remember: Caveat Emptor is the basic premise of this website, published clearly by the website service. That means it assumes you are by default designated as a grown-up who knows to take information and then do their own homework and be responsible for any decisions you take, all liability is on the reader. By definition, by intention, you are told it is a condition of using this website. Act like you know that, your husband deserves a critical thinking approach, don't you think? All the more mature participants say to take everything and verify it for yourself, and I echo that exact thing. Especially for your husband, he is the one who get's it in the neck if you are wrong, so you should have a strongly disciplined standard of expectation that you lay upon yourself.
And: has it occurred to you at all that not every response is tailored exactly and only for you, when there are many many other readers who might harm themselves on their own by making the same assumption?
Thank you for answering my question. I know now that we have more in common so no need to antagonize. I respect your opinion, please respect mine. I don't believe in conventional meds, they have but harmed me and my husband. Eighteen UNNECESSARY operations for me in the name of profit, two serious ones for my husband which could have been avoided if we knew then what we know now. . .
It's best you educate the American people about healthy diets and physical activities rather than trying to educate them what new meds are out, indications, contraindications, and side effects. Prevention is the name of the game.
Please share with us your therapy protocol and how it has helped you in delaying the progression. This is the kind of information I would like you to share with us as a medical doctor.
Hi malayappan - thanks for jumping in and with your response to that awful rant above - you beat me to it. Marion P please do not speak to members of this group this way its disgusting - We are all here to support each other so we don't feel so alone and are free to discuss anything. If you don't agree with what someone has posted you can politely disagree and carry on and find a post that suits you. Or better still go an join another group - there are many out there that are extremely negative and many that post on those sites are 'right fighters' and we know you can never be heard or win an argument with a 'right fighter'. I think Marion P owes Despe an apology. And Despe I apologise that someone from HU spoke to you this way.
PEB, no need to apologize. I appreciate your support, but MarionP's ranting fully describes how some medical doctors feel about natural remedies and CAM, both out of their box.
Can you please just stop, Doctor? If you really are a medical practitioner, then this is totally unbecoming of you. Have a blessed day.
Nice article, it particularly explains how dyskinesia is linked to the dopamine concentration curve in the brain. If inhibiting CYP3A4 with GJ helps to smooth out this curve to eliminate the extreme lows and highs, dyskinesia could be vastly reduced. It gives me more motivation to continue this research.
I'm 25 years into parkinsons(ism) symptoms- have been taking sinemet for 10-though am now done to one half of a 10/100 once per day. Have been taking MP for a few years also. Recently I started mixing MP (1/4 tsp. brown mucuna + 1/4 tsp white powder) with a small bit of grapefruit juice and am finding that it speeds up transition to "on" mode fairly consistently-some mornings I feel the dopamine surge 15 minutes after I take it (a vast improvement from previous hour long wait). I only need about 1/4 cup GJ and it works great when I mix it with the MP powder. Also am sipping a cup of green tea throughout the day. Sure hope this regimen continues to be effective. Just thought you might find it useful to hear from someone who has been "down the road" for a long while and have successfully reduced sinemet almost to zero. I switched brands of mucuna with good result. Thanks !
What brands of MP (brown and white) are you using? Do you take it more than once a day? Do you always take it with grapefruit juice? Do you take any other supplements?
I take Barlowes and Raw Food World MP -doses average every 2 hours from 8 am to 6pm latest. Lately have been consistently mixing in grapefruit juice..... In addition I currently take a few chlorella tablets, magnesium threonate (Life Extension) combined with EPA/DHA oil (Premier Research) then an extended release formula (also Life Extension) of magnesium citrate and oxide. Kind regards to you.
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) Hope we are on the right path. He would also like to go back to just MP and maybe Azilect. A lot of questions to ask Dr. Mischley, but we have written them all down, and we hope that there will be plenty of time to get all the answers. I will pass on her wisdom. 
Citicoline: "patients treated with citicoline experienced a significant worsening 45 days after the medication was discontinued". Updated.
A riddle, wrapped in a mystery, inside an enigma!
Levodopa carbidopa starts to work 2:30 hrs after taking it...
