Gut dysbiosis seems to be very prevalent in people with PD and many other diseases or health issues and potentially contributes to the disease process based on available studies.
In this 2021 study they showed through fecal DNA of 107 PwP that levodopa and especially Levodopa/Carbidopa Intestinal Gel (LCIG) are associated with an inflammatory microbiome.
>>> ' Our results suggest that LD, and mostly LCIG, might significantly influence the microbiota composition and host/bacteria metabolism, acting as stressors in precipitating a specific inflammatory intestinal microenvironment, potentially related to the PD state and progression. ' <<<
Here are two other relevant quotes from the study :
>>> ' The LD group and LCIG group were associated with a metabolic profile linked to gut inflammation. ' <<<
>>> Compared to the Naïve group, the univariate analysis showed a reduction of Blautia and Lachnospirae in the Levodopa group. <<<
This second quote is important because Blautia and Lachnospirae are bacteria that are known to produce health promoting Short Chain Fatty Acids (SCFAs) in the gut and in studies it has been shown that PwP are low in at least the three predominant SCFAs, Acetate, Propionate and Butyrate.
Given this information, it seems like a reasonable measure to take steps to increase SCFA production as a potential means to offset this deficit associated with Levodopa use as well Levodopa Carbidopa Intestinal Gel which appears to be significantly worse than LD in this respect of gut inflammation and dysbiosis.
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chartist
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Mary, Being aware of the issue gives more reason to try and increase short chain fatty acids (SCFAs) and SCFA producing bacteria in order to try and reduce the problem. Levodopa is needed for most PwP and the increased inflammation and gut dysbiosis seem like they can be dealt with in various ways.
When my husband started on levodopa that was when he started getting highly anxious to the point of being suicidal. I had put it down to his genetic as his analysis shows both his dopamine and seratonin pathways are blocked but maybe it was due to his gut bacteria. Interesting.
One of the recent things he has done which has preceded his “miraculous improvement” has been to take a 3 month course of toxaprevent early in the year. He felt it made no difference to him. He has been slowly improving all year with a rapid improvement a few months ago, well after the toxaprevent treatment. I wonder if the toxaprevent cleared up a bacterial infection which has allowed him to begin to heal? Another interesting observation has been his fungus toenail that he has had forever and which is about 5 mm thick, yellow and crumbly is very slowly looking pinker at the quick.
I noticed the study said Japanese doctors use this probiotic above to clear Helicobacter pylori bacteria. Maybe the toxaprevent did the same thing.
to kill Pylori in my gut. After reading your posts, I decided I needed to go back to my first drink of the day, thinking that if I had continued taking it I may have been able to avoid the pylon infection. Cup of lemon juice, cup of water, tbs. Apple cider vinegar, 1/2 tsp. baking soda. Did it this morning and felt that it was more successful than the prescribed antibiotics.
My umile opinion: dysbiosis is also caused by intermittent effect of levodopa oral. When Off gut mobility is very poor and when On ... we may have to rush to the toilette. This Up & Down done daily in the long term disturbs the microbiota. This is one of the reason why physical activity is important to help and compensate gut mobility.
Levodopa if taken without carbidopa may cause vomit (if too much). I can garante it. This means that levodopa doesn't even reach the gut before vomit.
This job is done by the sensor cells (don't ask me the name, pls) in the stomach that prevent too much of this toxic to reach the gut and the blood (and this happens from day one, no need of learning curve). With this evidence it is not a surprise for me that levodopa forced to reach the gut with carbidopa causes some sort of damage to the gut.
In addition dopamina made by gut neurons (our second ... or may be first, for sure older brain) doesn't pass the BBB nor reaches the brain (this is because it would be too much, where the brain needs only 1/10 of the gut production and with a specific distribution). Therefore the vomit protects
Modern medicine blind to this evidences pushes their "so called" "golden bullet" pure levodopa throu the systems to reach its target ignoring all the rest (damages, side effects, B6 and other substances depletion, etc ) along the way.
Suggest to eat pasta and rice of the day after (one night in the refrigerator) or very old bread with water, oil, salt. You will heat 1/3 in weight of resistant starch that feeds the microbiota producing butyric acid.
I remember a comment of a PwP who said to have avoided the meds adding since the beginning Butyric Acid up to 6 gr /day and completely resolved symptoms (tremor)
The "physical activity", you describe, if it is in the form of exercise, can increase short chain fatty acid (SCFA) production which will produce propionate, acetate and butyrate as 3 predominant SCFAs. Among other important actions, these will produce more melatonin in the gut via the interaction of butyrate with the epithelial cells. Acetate and propionate increase melatonin receptors in the gut. The increased melatonin production causes increased production of the SCFAs in a positive cycle. To stimulate this cycle, PwP who are low in all of these factors would need more bacteria capable of producing SCFAs as well as fiber and fermentable fiber to feed this bacteria. The bacteria and fiber will get the cycle started by increasing SCFAs. The increased SCFAs, melatonin and melatonin receptors will directly and indirectly cause many health promoting actions to occur in the gut and throughout the body. Exercise by itself is insufficient to create enough SCFAs, but it is a start in the right direction.
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Sleep/head position and neurodegenerative diseases 
And the beat goes on, and on
