Newer 2024 RCT Suggests That Caffeine Improves PD Motor Symptoms Based On MDS UPDRS III Testing In People With PD

[chartist]

The following July 2024 human study/randomized controlled trial (RCT) link suggests that oral caffeine at 50 mg after breakfast and 50 mg after dinner, for a total of 100 mg of caffeine per day, can improve motor symptoms as determined by UPDRS III testing :

pmc.ncbi.nlm.nih.gov/articl...

The study also determined that caffeine given over just a 3 week period showed a significant improvement in MDS UPDRS III score compared to pre caffeine testing.

The study also showed that 26% of participants experienced side effects related to the caffeine intervention, but the side effects tended to diminish over the 3 week testing. These side effects were not seen in the placebo group.

Here are some relevant quotes from the RCT :

' Approximately 80.0% of the patients receiving caffeine therapy exhibited motor improvement. Meanwhile, only 16.7% of the participants exhibited motor improvement after the treatment with a placebo. '

' Furthermore, caffeine administration at a dose of 100 mg/day would give a patient 1.5 times likelihood to experience improved motor function instead of undesirable effects (likelihood to be helped or harmed (LHH) 1.5) (Table 5). '

' This study showed a significant improvement in motor function in patients receiving caffeine adjuvant therapy. Caffeine adjuvant therapy for 21 days (2×50 mg/oral daily) was able to reduce the UPDRS III score in 80.0% of the patients in the intervention group, whereas placebo at the same dose failed to improve motor function in more than 83.3% of the patients in the control group. Additionally, patients receiving caffeine treatment had a 20 times higher chance of experiencing motor improvement as compared to those taking a placebo (Table 4). This finding was in line with that reported in a previous study, suggesting that caffeine administration 100 mg/day had reduced the occurrence of freezing of gait [12]. Another study also reported that caffeine therapy 2×100 mg/oral daily had significantly improved motor function after three weeks of treatment [10]. '

" We found that 4 out of 15 (26.6%) patients receiving caffeine therapy experienced adverse effects (i.e., heart palpitation, frequent urination, difficulty sleeping, and anxiety); however, these conditions improved over time during the intervention. A similar finding was reported in a previous study, indicating that 17.0% of the patients undergoing caffeine treatment experienced undesirable effects such as gastrointestinal disturbance, insomnia, anxiety, headache, frequent urination, nausea, and palpitation [10,27]. However, the effects of caffeine are dose-dependent and vary among individuals, in which doses of 400 are often linked to undesirable effects [28]. '

The three week testing period was relatively short in order to show benefit in UPDRS III scoring, so self testing by those who do, won't be a long drawn out process to see if similar results can be obtained and caffeine as a supplement is inexpensive as seen in the following link :

amazon.com/Caffeine-Tablets...

It is a bit challenging finding 50 mg caffeine capsules or pills as most of the the caffeine pills or capsules are 100 mg or higher. The above link is for 100 mg pills and would require also buying an inexpensive pill splitter if you don't already have one. Another consideration is that many of the caffeine supplements are pre combined with other supplements such as L-Theanine which is thought to have a calming effect, but that may be a useful feature when taking caffeine which can have a stimulating effect. Here is a link to a supplement which contains 50 mg of caffeine + 100 mg of L-Theanine :

amazon.com/Caffeine-L-Thean...

L-Theanine has shown benefit in PD animal models for motor function improvement also, but to the best of my knowledge, not in humans as discussed in this new (October 2024) animal study :

sciencedirect.com/science/a....

Here are some relevant study quotes :

' l-theanine, an amino acid primarily found in tea leaves, has garnered attention for its potential neuroprotective properties. '

' l-theanine exhibits the potential to alleviate both the motor impairments and non-motor symptoms linked with Parkinson's disease (PD). '

'L-theanine shields the dopaminergic neurons from degeneration and improves the number of tyrosine hydroxylase-positive cells. '

' The principal mechanism involves reducing neuroinflammation, precisely astrogliosis, and diminishing NOS-positive neurons. '

' This study underscores the importance of nutraceuticals like l-theanine as alternative therapy in PD. '

So perhaps the combination of Caffeine and L-Theanine may be a more useful adjuvant for PD, but apparently based on the first study, caffeine alone is useful for improving motor symptom UPDRS III scoring in three weeks.

Art

[park_bear]

Firstly, Art, big thanks for bringing this to us, and for taking the trouble to quote from the study extensively. This was a small study, 15 patients taking caffeine and 14 taking placebo. That's okay, there's not a lot of money to do these kinds of studies. A glaring omission however, is by how much did their UPDRS scores improve? Since they declined to state this, the likely answer is not much.

Be that as it may, I already know I tolerate 100 milligrams of caffeine daily quite well. I would probably just try taking this as a single dose mid-morning. Taking caffeine before bed does not appeal to me. This is personally a low risk intervention well worth a try.

[park_bear in reply to park_bear]

A previous study, found here: pmc.ncbi.nlm.nih.gov/articl..., did cite improvement in UPDRS score. However, dosage was considerably higher: "Patients with PD with daytime somnolence (Epworth >10) were given caffeine 100 mg twice daily ×3 weeks, then 200 mg twice daily ×3 weeks, or matching placebo."

Results: "Caffeine reduced the total Unified Parkinson's Disease Rating Scale score (−4.69 points ...) and the objective motor component (−3.15 points...) ", which is not bad at all for such a simple intervention.

[chartist in reply to park_bear]

Yes, a very small study. In the study they only described the improvement as significant.

In one of the studies they linked to which used twice the caffeine dose at 200 mg/day, they described a reduction of -3.15 points in motor score. So modest improvement at the higher dose, but an improvement is better than a further increase in UPDRS score. That study also showed improved daytime somnolence as might have been expected at 200 mg/day. The optimal dose for caffeine in PD has not yet been established.

You said

' This is personally a low risk intervention well worth a try. '

That is my sentiment exactly. The very short study testing period (3 weeks) makes it a pretty simple and quick test for those who would consider testing it.

Art

[Likii in reply to park_bear]

Concerning by what amount the scores improved ... from the OP's study:

"A reduction in the UPDRS III score of >4 points after the intervention, as compared to the baseline examinations, indicated a significant motor improvement. On the other hand, no alteration in the UPDRS III score, a reduction of <4 points, or an increase in the UPDRS III score as compared to the early assessment indicated no motor improvement."

[MellowYellowcup in reply to park_bear]

agree 10am x 2 shots coffee + cup tea 3pm works for me

[estubbs79 in reply to park_bear]

Caffeine makes my PD symptoms worse and increases my dystonia

[MarionP in reply to estubbs79]

There are other things to try, such as black tea(s). Black tea has caffeine too, but we tend to brew it so much less that we get us very small dose of it. And there are many varieties of black tea that vary quite a bit in the amount of caffeine you get, and you can control that even more by your brewing time. Tea also has theobromine, which you may find milder on your system.

[Bolt_Upright]

Caffeine is my number one supplement!

Pepsi Throwback

[LindaP50 in reply to Bolt_Upright]

😄makes me think of my Mom, I was made from Pizza and Pepsi through a straw!

[MarionP in reply to Bolt_Upright]

You know you have a really interesting point there... Mountain Dew!!!

[chartist in reply to MarionP]

Mountain Dew is 55 mg per can.

Art

[MarionP in reply to chartist]

I swear there is something about the formulation they use that it interacts with the sugar in such a way as to have more of an effect, at least subjectively other than that would imply. Big corporations have the greatest chemists in the world.

Meanwhile during graduate school I made many trips between St Louis and another Midwest area and Philadelphia, of the kind where you exit the car only to refuel\toilet and then get back in and no stops otherwise. One big Godfather's beef pizza sitting on the front seat at the outset, which would last you the to the w. Pennsylvania border. Like many truckers might do (if they aren't forced into monitoring). I'd get in the car in St Louis or sometimes in Columbia, exit the car in Philadelphia. Always between 1075 and 1150 Miles. Quarts of coffee would not keep me awake, but half a dozen cans of Diet Coke would, and with no jitters. Chemists (I mean in the American applied chemistry sense, not what we refer to as pharmacists) can do amazing things. Chemists know things. Chemists are scary smart.

[chartist in reply to MarionP]

A small 12 0unce coffee at McDonalds has 106 mg of caffeine and Starbucks is even more! No wonder those lines are always so long!

Art

[chartist]

Yes, I remember you and your Pepsi real sugar, Bolt!

How much caffeine is in one can? does the label say?

Art

[Mob0 in reply to chartist]

coca-colacompany.com/about-...!

"People are often surprised when they learn that the amount of caffeine in Coke or Diet Coke is much less than in the same-sized coffee. Coke’s caffeine content is 34mg for a 12-oz can, and Diet Coke caffeine content is 46mg. That’s three to four times less than coffee! The same-sized coffee, in this case a 12-oz cup, has 140mg or more.."

[chartist in reply to Mob0]

You're right, I did think Coke had more caffeine than that! Given all of the sugar content, probably not a good way at all to increase caffeine intake.

Art

[Bolt_Upright in reply to chartist]

Pepsi says 38 mg a can for Pepsi with real sugar. Times 8, that puts me at 304 mg a day. Is that enough?

[chartist in reply to Bolt_Upright]

Wow!!!Are you really drinking 8 of those a day, Bolt?

Art

[Bolt_Upright in reply to chartist]

between 6 and 8. I am doing a long term study on drinking nothing but Pepsi. Surprisingly, I am not fat. The rest of my diet (except for the occasional tub of ice cream with real sugar) is keto.

I am having my morning bowl of pistachios, thanks to your suggestion years ago, right now.

[chartist in reply to Bolt_Upright]

That's a lot of real sugar! I used to do that with Coke when I was much younger and didn't seem to have a problem with it, but the level of sugar intake scared me so I stopped drinking so much Coke. At 39 grams per can, if I drank a 6 pack per day, that would be 234 grams of sugar a day plus the ice cream!!!

Art

[Bolt_Upright in reply to chartist]

The mistake you made was choosing Coke.

Pepsi vs Coke

[chartist in reply to Bolt_Upright]

Hah!

After you talked about how good Pepsi with real sugar is, I bought a 12 pack to compare it to Coke. That 12 pack is just sitting in the fridge and no one has taken any except the two I tested! I guess one man's Pepsi with real sugar is another man's Coke!😜

Art

[Bolt_Upright in reply to chartist]

They have Coke with real sugar too (for the person who appreciates second best).

[MarionP in reply to chartist]

I grew up from about age five to 30 drinking loads and loads of Mountain Dew. I don't know how many cans a day it was but it was several to a few anyway. Young and stupid.

[michelagvolpe]

Why you don't drink a good cup of Italian Espresso instead to take tablets of caffeine? 🤔

If I drink coffe my my tremor is getting worse and I cannot sleep.

I take L-Theanine for many months and it helps me to calm in the evening.

Not all publications on pubmed are reliable: be careful.

[Fumaniron]

caffeine mixed with creatine might cause some issues, though

[Bolt_Upright in reply to Fumaniron]

More than some issues. Study says if you take both your PD will get worse.

[Fumaniron in reply to Bolt_Upright]

Exactly. You’re the one I learned that from, so thank you

[Esperanto]

Let's order our Amazon pills again 🙂 Right now, I'm a month for sun absorption in Spain and Portugal. I start my day with a shot of caffeine, enjoying an unmatched espresso. I repeat this at lunch, totaling 2 x 60mg of caffeine. The Mediterranean diet also proves to be exceptional here. Furthermore, the flavor sensation adds an extra placebo effect!

[chartist in reply to Esperanto]

Plus you're getting the multiple added health benefits of chlorogenic acid that the espresso provides, that caffeine alone can't provide!

Art

[MarionP]

If you can tolerate the caffeine you should make use of it, because it's true about caffeine. For instance it's been known clinically for a long time, since the seventies at least, that caffeine can improve your IQ. In fact once in the early eighties in a psychiatry internship, I asked my supervisor, who was a psychiatrist (I was a psychologist, going to specialize in psychiatry, meaning mental disease) what he thought of caffeine and he said the only thing I can think of caffeine is that it improves IQ. So really, moderate amount, MODERATE, I think are helping because they help you focus. It's when there's too much that other things can happen, like any stimulant. But in moderate amounts, the function is to increase "cortical arousal." And that is just a technical term for describing when you need a little more energy and a lot of allows you to settle down and concentrate, as ironic as that particular unfortunate wording sounds. It's only the excess that begins to cause problems in the other direction, the direction of agitation, which is a machine function, a real chemical cellular function. And, as in most clinical biochemistry, it illustrates a very important function. The "Little Red Riding Hood" functions that talk about functioning within a golden range, not too much, not too little. Not too hot, not too cold. Both sides of the range when you get beyond it is problematic. It's important to remember that. Too much cortical arousal, OR too little cortical arousal is problematic.

[Obiora]

Its known that there is a protective relationship between caffeine and Parkinson

[jujulini]

I can’t drink coffee because it upsets my stomach but I make homemade coffee ice cream and I notice my PD symptoms are better after I have my daily bowl about 10 am. I don’t know how much caffeine is in the instant espresso powder that’s in it. I put 6 heaping teaspoons in each batch. And I get 4 large bowls per batch. Yum!

[MarionP in reply to jujulini]

Nice creative idea, and it obviously works for you!

[HugoRipanykhazov]

Pity I I'm reading this having just come back from the supermarket, where I forgot to buy colored bell peppers.

I wonder how much caffeine there actually is in those things?

AND at the moment òur espresso machine is broken!