Sluggish digestion and C/L not working

[Dash7412]

I am always super careful about not eating for at least an hour after taking my Rytary C/L ER, but if my digestive system is the least bit sluggish (I usually take Miralax daily, due to sporadic constipation), then I will have 2-3 days of rarely feeling “on”; I will do well to feel anywhere close to 50% “on”. Thoughts?….suggestions?

[Buckholt]

I got myself into a bit of a mess about 12 months ago when my condition dipped and I kept increasing my dose to counter the effects. To make sure the meds worked I spaced out eating more and more and I got to a stage where I became a bit paranoid and began to fast much of the day.

I came to the conclusion that more drugs was not the answer and that by not eating I believed that my meds became more and more sensitive to food. (not scientific but my conclusion). So I bit by bit reintroduced food and over months regained the ground lost. Now I don’t skip meals and I leave reasonable spacing.

[Astronomer90 in reply to Buckholt]

I have same problem. I thought levedopa is not doing anything as I was always taking it with the food. I stopped and gave up thinking it is not going to help my tremors at all until one day I took the medicine and it helped. After trying a few times, I understood that empty stomach it is more effective. But now the problem is that it only works empty stomach and I can't eat if I want to reduce my tremors. I take it mainly when going out. Can you share how do manage the food and med? Do you take small portions of food before med? How long after the food you take med?

[Buckholt in reply to Astronomer90]

Everyone is different, of course. But two things worked for me. Firstly I had low protein meals, dull but things like plain salads, veg soup, toast, and secondly, I took meds first and waited for them to work before eating. (Not eating then taking meds hoping that you’d left enough time for food to go through). Good luck

[park_bear]

I use the controlled release version of C / L. Regarding food, according to the label: dailymed.nlm.nih.gov/dailym... "The extent of availability and peak concentrations of levodopa after a single dose of SINEMET CR 50-200 increased by about 50% and 25%, respectively, when administered with food." Personally, I have found that food does not seem to make much difference one way or the other.

Discussion of constipation remedies: healthunlocked.com/cure-par...

The active ingredient in Miralax is polyethylene glycol which was significantly associated with increased disease severity . See linked post for detail.

[Parkie1]

amazon.co.uk/PACK-Ortis-Fru...

I stopped using miralex years ago and was recommended this instead . A whole cube is just as effective and contains only natural ingredients

[asparagu]

Dash, I too have experienced "slow stomach transit time" about 7 years into my Rytary C/L . This condition is known as Gastroperisis and reported as being caused by the extended release version of C- Dopa, L-Dopa. Slow stomach transit time results in the drug C-Dopa, L-Dopa also moving slowly from the stomach to the small intestine where it is absorbed. That's why people with gastroperisis tend to have more "off times" than those who haven't developed this condition. Constipation is also reported as a side effect of this drug which renders it less effective! My solution to all these annoying side effects is taking a digestive enzyme following the drug to allow increased absorption of food as well as the drug. BTW, eating less fatty foods and no meat about half an hour on either side of your drug will for the majority of people with Parkinson maximize your drug absorption which translates into more "on times". BTW, I have been on the same low dosage of my C/L ER since 5 years ago.

[Dash7412 in reply to asparagu]

Thanks for sharing your experiences. I was diagnosed in 2015; the first 5 years were great…a couple of dosing adjustments, no real issues. But here comes 2021, 6 years in and I experienced freezing issues, This subsided with a slight tweaking of my rytary. Then in February of this year, I started having significant drops in my dopamine (natural & what was created via my rytary…9 months later, this has improved greatly, but I still have the increased “off” time, but not as bad. I am very careful about not eating 45 minutes before and after every dose. It seems like I just have sporadic periods when my system gets sluggish and things aren’t moving like they should. I’ve come a long way since February and I feel like I’m getting better every day.. just trying to keep moving forward. Parkinson’s sucks! In my opinion it should be reserved for the sick and evil people who commit the unthinkable crimes and who deserve to suffer and hurt over an extended amount of time.

[Sydney75]

My HWP takes digestive enzymes if helps.

[RBan]

I started using digestive enzymes when I eat and it absorbs the food and levodopa faster. I make sure I take L/C at least 15 minutes before I eat.

[Hidden]

We have found 500 mg of multi magnesium + 500 mg potassium very useful for sluggish bowels and sleep issues.

[Dash7412 in reply to Hidden]

Multi magnesium??