Over one third of PD patients in treatment with l‐dopa may develop PNP, with a significantly higher prevalence of acute and subacute forms in those receiving LCIG. Pathogenic mechanisms remain unclear, but possibly related to a complex interplay between peripheral neurodegenerative processes and l‐dopa neurotoxic metabolites. Prospective, randomized, clinical trials are required to identify factors associated with the onset and progression of PD‐associated PNP and clarify the protective role of B‐group vitamin supplementation
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"there was an association between PNP and higher l‐dopa doses, as well as with the following biochemical alterations: increased homocysteine; reduced vitamin B12; increased methylmalonic acid; and reduced vitamin B6. "
B6 and B12 essential to dispose of homocysteine and methylmalonic acid.
Even just 100 mg daily of the cheap inactive form, too commonly supplied, can be toxic. It occupies receptors that need the active form, P5P. Details here:
Although certainly too much B6 can cause peripheral neuropathy, the lack of B6 effectiveness does the same. What the authors do not address is that the decarboxylase blocking of Carbidopa is done by blocking the action of B6. So when a higher amount of levodopa-carbidopa is taken, they do not address the likelihood that there is therefore more B6 inhibition - which can then cause more peripheral neuropathy. B6 is used when one takes Isoniazid for TB treatment, because it protects from the peripheral neuropathy effects of Isoniazid. That is why some people use Mucuna puriens for their Levodopa source, since it does not contain Carbidopa. But dosing Mucuna is not easy, and should be done only under the supervision by someone who is trained in using it - by Dr. Marty Hinz
But dosing Mucuna is not easy, and should be done only under the supervision by someone who is trained in using it - by Dr. Marty Hinz
You don't need an advanced degree or Marty Hinz to dose Mucuna. I have been doing it for many years by checking the levadopa % on the capsule bottle, combining it with 1/2 or whole 25/100 IR Sinemet for the Carbidopa and experimenting with 60 mg* 100 mg* 260 mg Mucuna capsule strengths and noted how I felt.
I did not like the taste and time it took with the powder and the travelability (is that a word) was a pain in the butt with the powder as well. Nice effort to make MH relevant again.
The active form of B6, P5P, is not toxic. Nothing wrong with Mucuna, but there are other good ways to deal with the conflict between the B6 and carbidopa:
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