Timing of meds with food?

[jeeves19]

Be interested in the community’s take on this. I used to believe that it was an hour before food and 2 following. Then for a couple of years I knocked it down to 1/2 hour and 1 hour following. This was because I heard a neurologist state this on YouTube. But recently I’ve been having trouble with meds and am wondering if the latter timings are influencing this. Thanks in advance for your contributions. 😊

[ruff1]

Hi

John tries to wait an hour after taking a tablet before eating a meal that is high in fat and protein . He can eat snacks like humous / rice pudding / banana custard / scones / flapjack, in between meals without it affecting his medication. 😀

[jeeves19 in reply to ruff1]

Thanks Christine 😊

[Hidden in reply to jeeves19]

I agree. Watch protein

[laglag]

I was told the same thing you were told, take meds & wait 1/2 hr to eat &/or wait an hour after you eat to take your meds.

[aspergerian]

When does delayed gastric emptying become an issue?

[pdpatient in reply to aspergerian]

Great question, aspergerian. I have the same question since it does affect me.

[aspergerian in reply to pdpatient]

I'm on a 4 hour meds schedule. I've begun taking slightly more levodopa so as to counter impaird motility.

[jeeves19 in reply to aspergerian]

What is a 4 hour med schedule?

[AaronS]

Chicken or heavy carbs eg. Pizza can destroy my meds effectiveness

[Somic67 in reply to AaronS]

in my experience the worst thing is to mix carbo with proteins (es. pizza with ham) - my digestion takes forever, also vegetables and proteins is slower than proteins only. The more the quantity the worst the time. also do not mix proteins (dairy with meat or meat with eggs or eggs with dairy)

I say in my experience because my meds interval is 1/1,5 hours and eating is always a challenge ... and I eat low carb. I try to dissociate and rotate foods.

Remember that PwP need more proteins than the others, to avoid long term amino acid depletion that brings meds induced dyskinesia, dystonia, etc etc (as per Dr Hinz study)

[Pa-zzi69]

Naturopath Dr. Laurie Mischley recommends taking Sinemet with vitamin C [ascorbic acid] or lemon juice since the drug is better absorbed in an acidic environment.

My neurologist also prescribed 1/2 hour before and 1 hour following a meal.

And yes, protein-rich foods are said to be detrimental to drug absorption.

[ScribblerCLT]

PD nurse confirmed PwPs suffering protein timing issues should eat 1 hour before levodopa and two hours after levodopa. I take levodopa in three-hour intervals (so zero minutes to eat) and was starving myself of protein despite my best efforts because my Sinemet wasn't working. Considered protein shakes.

The nurse also said only a small portion of PwPs are sensitive to protein timing and effects appear right away, so protein is unlikely my problem. I spent first two years after diagnosis eating whatever and whenever while taking up to 5x200mg a day with no problem. Most of us PwPs suffer from constipation, and he figured that constipation interfered with my levodopa absorption . Three weeks and three laxatives later, and one sick leave which may put me into permanent disability, my guts were moving but my symptoms were still dire. I threatened to end all my PD meds. Instead, my nurse convinced to stick with the drugs schedule until MDS sees me next week; he OK'd me starting the 12-week Symprove program as I intended because I think the combination of PD and all the meds I've taken in last two years have killed all my good gut bacteria, and "rebooting" my system involves more than just clearing your guts. Finally, in the last week, my solid wall of symptoms seem to last shorter periods and be less painful.

The point if your levodopa isn't working: it may not be a protein issue at all. And you may be the best person to know what's best for you.

[jeeves19 in reply to ScribblerCLT]

Thanks 😊. Oddly, I’ve never experienced constipation which as usual adds to the mystery of this disease 🤔

[PDGal4 in reply to jeeves19]

I've not experienced constipation either, much to the shock of my neurologist/MDS. I eat lots of veggies; not sure if that's the reason or not.

[Somic67 in reply to jeeves19]

if we consider that this disease may be caused by long term gut inflammation causing dysbiosis causing bad absorption with lack of nutrients, then constiption is a natural remedy put in place by an intelligent nature to increase absorption: the slowest the speed, the more the time to absorb nutrients.

the side consequence is known but is secondary vs nutrition.

Any comments?

[jeeves19 in reply to Somic67]

Makes sense but as I said above, I’ve never been constipated which often puzzles me.

[Somic67 in reply to jeeves19]

i think that inflammation and gut dysbiosis don't necessarily mean constipation.

if s.one doesn't regularly have Type 4 (or even 3 but some disagree) of the Bristol Stool Chart he has some form of dysbiosis

en.wikipedia.org/wiki/Brist...

[maryalice]

HI Jeeves, I was told that I should wait 1/2 an hour to eat after I take the mucuna. Or wait 2 to 3 hours to take the mucuna if I have already eaten. I think k it works better and last longer on an empty stomach. That was what I experienced when I would eat and take it too soon after I ate. It can sometimes make you nauseous, so I usually eat a couple bites of fruit or a cracker before I take it. I was also told noti to eat protein until the evening meal, but I don't always follow that rule. I think that not eating with the mucuna helped me.

Be blessed,

Maryalice

[jeeves19 in reply to maryalice]

Thanks Maryalice, my Irish grandmother’s name 😊🙏

[rescuema]

It probably depends on the speed of your digestion, gastric emptying time, and sensitivity to protein. 1hr before and 2 hrs after basically means you should take your med (any) on an empty stomach, but for some that could be sooner or much later. Also, protein isn’t just meat, but includes cheese/milk/dairy, nuts, seeds, beans/soy, pudding, etc - anything with a heaping amount of amino acids that may compete with l-dopa receptors in the digestive tract.

I’ve posted the below recently on another post but you may find it useful, especially the section that lists what foods to avoid if you’re protein sensitive.

parkinsonquebec.ca/wp-conte...

[jeeves19 in reply to rescuema]

Great response. Useful link. Thanks 🙏

[rescuema in reply to jeeves19]

This webinar by APDA will provide even more detail (starts 20:22), especially on moderating the necessary protein daily intake through using plant-sourced proteins, and controlling/spreading meat portions.

s3.amazonaws.com/canceredcd...

[maryalice in reply to rescuema]

Thanks. I appreciate your sharing . I will look it over .

[rescuema in reply to maryalice]

You were intuitively eating some fruits and crackers with your med, and for some that may indeed help with l-dopa digestion instead of empty stomach, just as the link suggests. Larger doses of b6 naturally contained in certain foods such as banana, peanuts, oats, or vitamin fortified whole grain cereals could also be the culprits.

[maryalice in reply to rescuema]

Thank you.

[Despe in reply to rescuema]

Rescuema,

Hubby and some other PwP take DopaBoost "Designs for Health" to boost Levodopa. It includes B6, Tyrosine, Green Tea and Quercetin. Levodopa 60% (MP 425mg/2 caps). B6 and L-dopa together?

[rescuema in reply to Despe]

B6 supplementation (taken at least 2 hrs away) is recommended to restore/counter the B6 deficiency that occurs with l-dopa, but probably not optimal to take it closely at the same time as l-dopa medication, depending on the amount.

Edit: Looking at the supplement facts, it includes 425mg of Mucuna along with GTE, so I'd say this is a supplemental l-dopa on top of your meds.

[Despe in reply to rescuema]

Yes, supplemental. Still B6 and MP together?

[rescuema in reply to Despe]

Some believe mucuna is best absorbed with b6 to utilize the seed powder more efficiently, which may be the reason why the 5mg b6 was added especially since b6 is actually required to convert l-dopa to dopamine, but most likely as a convenience factor to take account of a deficiency as in many multivitamins that actually compete in absorption when taken together. The evidence is overwhelming that excess b6 cancels out or exhausts l-dopa more quickly so taking concurrently is best avoided.

[Phusson]

I can eat almost anything with no protein anytime except first thing in morning before meds. I try to wait at least an hour before eating protein which can make a big difference in medication being effective.

[jeeves19]

Thanks very much 😊

[PDGal4]

I eat about 1/2 hour after morning meds--Rytary--breakfast is always granola, sliced almonds, coconut, and either fresh fruit or dates. Lunch is generally about 1-1/2 hours after 11.30 Rytary dosage as I tend to exercise or do a yoga class at 12.30. Now that I think of it, most my dosages are well before eating, except last Rytary dose of the day (8.30-ish) is generally right after to 1/2 hour after dinner. Try as I have, just can't seem to get the dinner done earlier.

I have severe issues with protein interfering with levodopa absorption. I limit most proteins during the day. I don't drink milk due to lactose intolerance, but find small amounts of cheese, nuts, and beans are not too bad. Yesterday I ate smoked turkey (which my husband smoked the day before and was amazing) for lunch in a green salad with a side of potato salad which had hard boiled eggs in it and I was pretty much done for the rest of the day as far as meds working goes (which meant I was done for the day too). I swore that was the last time I'd decide to treat myself with amazingly delicious food as it's just not worth it.

Meat, poultry, and fish protein are the worst, with eggs a close second. I love eggs in all their various ways to cook but they are pretty much out of my diet. It may be a percentage thing--bacon seems okay but the amount of bacon to the rest of the meal at lunch is low.

I used to try and wait the hour after dinner and at other times, but I've also found if I let the levodopa level dip too much it's hard to get back to functioning. It's best to take if I feel it wearing off even if with a meal.

My neurologist has suggested taking meds with a full glass of water to speed its movement through the stomach and I squeeze in 1/2 a lemon or orange, ala Dr. Mischley's advice to take with an acid.

[jeeves19 in reply to PDGal4]

Fascinating. Do you find that these foods affect your meds only if eaten in the times straddling Levadopa intake or so they inhibit irrespective of when eaten ?

[jeeves19 in reply to PDGal4]

No need to answer! I just read your post carefully and the answer is there. 😊

[Divii in reply to PDGal4]

Why do we need excess acid to absorb meds? Isn’t stomach environment acidic enough?

[qazwsx11]

I don't think there is a magic interval. The emptier the stomach the better the absorption. Every other variation of intervals is adjusting to your tolerance of how effective the outcome will be. I have been trying to also use acidic drink or fruit in as I take sinemet. Not sure if it works, but it certainly tastes better

[beehive23]

For me it is all a matterr of stomach emptying.....whenn low on dopamine my stomach sometimes doesnt empty for 1-2 hours and depending on what you eat....the stomach emptying allows the meds to get into the intestines and cross the blood brain barrier more or less intact....sinemet also makes me sick ...........cheers.

[PDGal4 in reply to beehive23]

Most interesting and something I hadn't thought of before. I've noticed the longer I wait to take next med dose when previous one has worn off, the harder it is to get them working again; I never thought about low dopamine slowing stomach emptying and delaying med getting to upper intestine. Thank you.

[beehive23 in reply to PDGal4]

ive tracked my stomacch emptying and everything from stress to what i eat effects when my stomach empties, i gauge it by my med off on correlated with what and when i eat....if i eat a salad with a dose im pretty good if i eat pasta my stomach might not empty for 2-3 hrs i get bloated etc. cheers.

[gginto]

I was told by the neurologist who specializes in PD- no protein 2-3 hours before taking Levodopa, then wait 1/2 hour after that to take protein....

[jeeves19 in reply to gginto]

Interesting

[gginto in reply to jeeves19]

I guess the question is- Is there one best way to time the meds with protein?

[ParlePark]

I was advised by my mds no eating (anything) 1 hour before and 1 hour after meds.

[MissRita]

I find that I cannot eat unless I take any supplements before hand. If I eat and then take supplements it takes forever for them to take affect.

[ParlePark]

My last meal is 3-4 pm. Meds at 7, 12 & 5. Eat at 8-830 and no protein. Best effect of med is morning. Virtually no tremor in am . Tremors during day and eve. After that wait at least 1 hour prior and 1 hour after eating. But meds are no where as effective as morning as I’ve fasted 16-17 hours. Also take meds with grapefruit juice. Eat little protein between 10-11 and max protein 3-4.

[Erniediaz1018]

My levodopa from mucuna by nutrivita works like magic in the morning on an empty stomach taken with green tea 500mg capsule. I don’t eat anything for one hour, then I can eat anything including protein but the Proteins shortens my on time. Any dose there after during the day gives me better results on an empty stomach. Thanks everyone, I’ve picked up some good stuff from this post.