PDR (physicians desk reference): Sinemet

I have learned more about using C/L in the past 20 minutes. I just wanted to know what to expect while reducing it if mucuna pruriens makes that possible. Those night sweats that come as it wears off during the night (hyperpyrexia) and I learned that it can make you fall asleep unexpectedly and I thought I was just not getting enough sleep at night. Duugh I should have read the PDR a long time ago. Here's a link to it. pdr.net/full-prescribing-in...

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  • Definition of "AUC" --

    Handy ref--thank you! In reading this, I had to look up the abbreviation "AUC." This stands for "Area Under the Curve" and refers to the plasma concentration versus time of any given dose of a medicine. Since the Concentration first rises and then falls, it is not constant. AUC measures the total effective amount of medicine the patient receives from each dose. It is a "total-effect-over-time" concept analogous, say, to "man-hours" for the amount of work accomplished on a project by a variable number of workers.

  • Great explanation that even I can understand. :)

  • Why reduce C/L to take mucuna pruriens they are the same med just in a differant form they both have the same side effects only mucuna pruriens are produced with out any over sight by any one. You don.t know for sure what or how much you are getting. Who is making it. Most likely being made by some big pharma company or by a sub company of one. It is made to make a profit just like C/L is. It is not natural it is still derived from a plant by using alcohol and is not pure l-dopa.

    Just because it is called natural don't make it safe.

  • Thanks for being concerned. I'll report what happens. The raw product is grown in India and is processed in America. It isn't pure L-dopa according to the co. information provided. It is a nutrient bean that they have powdered and tests at 3-5% depending on the growing season. The co. admits, as much. I believe as I am really "tuned in" to my body I can do this experiment harmlessly.

  • good luck hope it works out

  • If you take mucuna pruriens you are just substituting one source of L-dopa for another except mucuna has no carbidopa and will be less effective.

  • There is a way to replace carbidopa. Carbidopa is a aromatic l amino acid decarboxylase inhibitor, it inhibits an enzyme which prevents the conversion of levodopa into dopamine in the body so (the majority of the l-dopa) will be delivered into the central nervous system.

    Use pure levodopa from the mucuna pruriens plant and combine it with (at least) 94%+ pure EGCG from green tea. EGCG is a decarboxylase inhititor:

    ncbi.nlm.nih.gov/pubmed/113...

    If you are taking a MAO inhibitor some caution must be exercised when taking large doses of EGCG because it is also a MAO B inhibitor (which is good news if you are not on a MAO B inhibitor like azilect or selegiline):

    ncbi.nlm.nih.gov/pubmed/204...

    The problem with taking EGCG is it is not bio-available - readily absorbed, by the body. German researchers noted that 94%+ pure EGCG is better absorbed when taken with 200 mg vitamin C and 1,000 mg of omega three from salmon (salmon oil). Other conditions: EGCG is best absorbed on an empty stomach upon waking and again at 4:00 PM and caffeine, calcium, milk or hard water (heavy in minerals) must not be taken with the EGCG - they will prevent absorption) information source:

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

    Are omega 3s good for Parkinson's (yes):

    articles.mercola.com/sites/...

    What other components of salmon oil are good for PD?:

    Salmon oil and vitamin D:

    livestrong.com/article/2855...

    Is vitamin C good for PD (yes):

    "CONCLUSIONS:

    Whereas vitamin C has a strong link with Parkinsonism..."

    ncbi.nlm.nih.gov/pubmed/250...

    Is EGCG good for Parkinson's (yes): lib.dr.iastate.edu/etd/13626/

    This combination could present itself for the early morning and late afternoon doses of levodopa, but what about the late morning and evening dose?

    Entacapone is a Parkinson's drug used for on/off syndrome. Entacapone inhibits the catechol o methyl transverase enzyme which prevents this enzyme from converting levodopa into dopamine in the body - it has similar action to carbidopa. It just so happens than another catechin from green tea, quercetin, is also a comt inhibitor:

    ncbi.nlm.nih.gov/pubmed/127...

    Is quercetin good for Parkinson's (yes):

    ncbi.nlm.nih.gov/pubmed/217...

    But quercetin is not well absorbed so it has to be taken with bromelain - an enzyme from pineapples:

    "Additionally, as I stated earlier, bromelain assists in increasing your body’s absorption and utilization of quercetin."

    quercetinbromelain.org

    Upon waking - EGCG plus C, Omega 3 + levodopa

    11:30 AM - Quercetin/bromelain + levodopa

    4:00 PM - EGCG plus C, Omega 3 + levodopa

    9:00 PM - Quercetin/bromelain + levodopa (if needed)

    After having tried all of the above the only side effect I encountered was stomach gurgling from the salmon oil. The cheaper the salmon oil, the more gurgling you will experience.

    Carbidopa = 94%+ pure egcg with 200 mg vitamin c and salmon oil

    Entacapone = quercetin and bromelain

    I developed this method over months (years) of research and make the most of it.

    Rich

    PS. Spread the word.

  • I can read an abstract and get confused by it, as always. That language is above my level of knowledge. But I get that drinking green tea with MP is advisable, right? BTW I am getting salmon oil and vit. C every day already. I used to keep pineapple juice n the fridge because I love it. My wife asked me to shop for orange juice as it is her preference. I guess we can have both, thanks as always for for the ideas.

  • What I am saying is EGCG has the same chemical action as carbidopa but is poorly absorbed. Absorption is increased by taking vitamin C, salmon oil with no caffeine, milk, calcium or hard water (with minerals). I drink green tea too but the caffeine in green tea limits the absorption of EGCG (the most studied component of green tea). Basically, what I posted is a method to use dietary supplements as drugs (in place of drugs). Taking the components separately will help your health but will not have the cumulative effect of making levodopa better absorbed into the central nervous system. EGCG = carbidopa and Quercetin (with Bromelain) = Entacapone (both taken with levodopa). I have done both and you can feel the effect in your head with these strategies. The EGCG method made me feel better because it has anxiolitic (anti-anxiety) activity.

  • Okay, I uderstand the warning about caffeine. That figures as I do kow that snce trying to help my sinemet work I have considerably less use for caffeineated coffee. So, how much EGCG do you find advisable for your normal dose?

  • Caffeine does not effect the absorption of sinemet....only EGCG. (I just did an internet search and did not find any contraindication for sinemet and caffeine). As for my EGCG dosage I take just what is on the bottle....and depending on your body you may have a different tolerance than I do. More on this later....I have to go and do daily 'stuff'.

  • Silvestro, do you know the specific mechanism by which EGCG inhibits peripheral metabolism of levodopa? I'm sure you are familiar with Marty Hinz's theories about carbidopa inhibiting peripheral metabolism of levodopa by deactivating Vitamin B6 and that this has a devastating effect upon the body. If this is true, I'm wondering if EGCG might inhibit peripheral metabolism of levodopa in some other, less menacing way. Do you know anything about this? Thanks.

  • silvestrov is this all you take or do you take additional supplements as well?

  • My father has Parkinson's and long before I manifested symptoms I watched standard therapy (slowly fail) and thus rejected it altogether. The only PD supplement I like is the use of Azilect though there alternative MAO inhibitors like polygonum multiflorum:

    dissertationtopic.net/doc/1...

    Alternatively I have used the following (though not at the same time):

    Polygonum multiflorum

    EGCG

    Quercetin

    Ling Zhi mushroom

    Olive leaf extract

    Black tea extract

    Cat's claw

    Vitamin C,D

    nicotinamide, thiamine, riboflavin, methyltetrahydofolic acid, methylcobalamin, biotin, pyridoxyl, 5 phosphate

    Magnesium: glycinate, threonate, sulfate, oxide, malate, chloride

    n-acetyl cysteine

    alpha lipoic acid/acetyl l carnitine

    fish oil, cod liver oil, flax seed oil, salmon oil

    coconut oil

    piperine

    zinc, selenium, iodine (nascent, kelp)

    CoQ10: ubiquinone, ubiquinol, pqq

    resveratrol/pterostilbene

    NADH

    PEAK ATP

    pyruvate

    baicalin

    tyrosine

    theanine

    melatonin

    Like I said, I have used all of the above but not all at once.

  • Silvestrov, did any of these substances work really, really well for you?

  • Here are the supplements I take and why:

    Riboflavin 5 phosphate (vitamin B2)

    The following study shows motor improvement in PD patients with the discontinuation of eating red meat and the addition of 30 mg of riboflavin every 8 hours.

    "Their average motor capacity increased from 44 to 71% after 6 months, increasing significantly every month compared with their own pretreatment status...."

    scielo.br/scielo.php?script...

    This study has been criticized because there is no placebo group but if you give it some thought there could be NO placebo group. What are scientists going to do? Have 1 group eat meat and the other tofurky? Also, the article has PD patients taking 30 mg of riboflavin every 8 hours. Can a person purchase 30 mg of riboflavin? No. The only come in 100 mg or 400 mg doses. Rather, I take a daily supplement of Riboflavin 5 phosphate, the bioavailable form of riboflavin. When you take riboflavin the body has to process it into its reduced form: riboflavin 5 phosphate.

    Methylcobalamin (vitamin B12)

    Methylcobalamin is the coenzyme/reduced form of vitamin B12 and is the most important energy vitamin. For the first 4 days I had a massive energy push from methylcobalamin meaning I was deficient in the vitamin.

    globalhealingcenter.com/new...

    Most DRs and vitamin companies sell cyanocobalamin and it is a cheap form of B12. When PD patients take levodopa (in any form) their B vitamin status, B12, B6, B1 and B9, determines whether they will have high homocysteine levels:

    ncbi.nlm.nih.gov/pubmed/202...

    B vitamin status, PD homocysteine:

    ncbi.nlm.nih.gov/pubmed/145...

    Folic acid (B9) could suppress Parkinson’s – new study

    www2.le.ac.uk/offices/press...

    The best form of folic acid is methyltetrahydrofolic acid, again, the coenzyme or reduced form of folic acid.

    Pyridoxal-5-phosphate (vitamin B6) is a cofactor in the production of levodopa and must be taken by patients taking Sinemet. It's use as a therapy for patients taking mucuna pruriens levodopa alone is thorny. It helps the body convert levodopa into dopamine so it has been recommended to not take it within 1 1/2 hours of taking levodopa. This problem is minimized/solved by using EGCG as therapy because EGCG inhibits the decarboxylase enzyme to prevent the body from converting levodopa into dopamine. Plus, vitamin B6 deficiency is associated with PD:

    viartis.net/parkinsons.dise...

    Thiamine (vitamin B1)

    Long-Term Treatment with High-Dose Thiamine in Parkinson Disease: An Open-Label Pilot Study.

    ncbi.nlm.nih.gov/pubmed/265...

    Again, rather than using the general form of thiamine use the reduced (conenzyme form) of thiamine:

    Thiamine pyrophosphate

    en.wikipedia.org/wiki/Thiam...

    Cerebrospinal fluid levels of thiamine in patients with Parkinson's disease.

    ncbi.nlm.nih.gov/pubmed/104...

    This is the end of part 1 from the list of supplements I listed.....this section is on B vitamins. In other words, to be continued soon.....

    Rich

  • I forgot 2 important B vitamins - nicotinamide and NADH.

    Both are forms of niacin and I will go first with, what I call, the vitamin that could: nicotinamide.

    Nicotinamide/niacinamide (same thing) is a non-flushing form of niacin that does not affect cholesterol levels.

    Niacinamide has been shown to be neuroprotective in multiple models of PD:

    ncbi.nlm.nih.gov/pubmed/224...

    Niacinamide and alzheimer's disease:

    life-enhancement.com/magazi...

    Niacinamide and multiple sclerosis:

    news-medical.net/news/2006/...

    Niacinamide and Fredrick's ataxia:

    www3.imperial.ac.uk/newsand...

    Nicotinamide and Huntington's disease:

    ncbi.nlm.nih.gov/pubmed/207...

    Niacinamide for arthritis:

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

    Niacinamide for anxiety:

    nature.com/nature/journal/v...

    "Dr. Kaufman advocated relatively modest quantities of niacinamide (250 mg) per dose but stressed the importance of the frequency (six or eight times a day) of those doses. "

    orthomolecular.org/resource...

    I have read 250 mg of niacinamide can be taken every 1 1/2 hours (food or no food) and a maximum daily dose is 3,000 mg/day.

    I obviously take niacinamide.

    NADH

    Nicotinamide adenine dinucleotide (NADH) is the active coenzyme form of vitamin B3. It plays an essential role in the energy production of every human cell.

    NADH was found to be beneficial to 78% of PD patients in a study by Dr. Birkmayer:

    nadh.com/pages/parkinsons

    Dr. B had the best results with PD patients who had the shortest history of the disease. PD patients improved their symptoms by 10-60 percent.

    Dr. Birkmayer recommends NADH be taken at 20 mg doses three times a day.

    Nicotinamide/niacinamide is the precursor of NADH and they can be taken together.

    Thus ends the B vitamin section and the combination of above mentioned B vitamins (both posts) would be good therapy for any idiopathic Parkinson's disease patient.

    Next post, antioxidants: CoQ10, acetyl l carnitine with alpha lipoic acid, n-acetyl cysteine and vitamin C.

  • Hello, Silvestrov. My Dad was diagnosed with PD about 2 months ago, he is 80. His neuro told him to hold off medications for now. His symptom is tremor (hand and leg). What supplement would you recommend I start him with? I am thinking green tea extract. What else? The list of supplements one can take is overwhelming. I think it is trial and error way for each individual. Thank you for your reply.

  • One supplement which may help him is NADH. NADH has been tested and shown to have positive benefit for 78% PD patients. And the best results are for patients who are earliest in their diagnosis.

    Dr. Birkmayer recommended 20 mg three times a day.

    nadh.com/pages/parkinsons

    If you were going to accompany high potency 94%+ pure EGCG/green tea extract with 200mg vitamin C and 1,000 mg salmon oil up waking....all the details are earlier in this thread.....that may be enough combined for good benefit with NADH. I take the EGCG therapy + and when swallowed I do not feel any stomach irritation. But do not substitute any other fish oil for salmon oil because they cause stomach upset. I tried highly purified cod liver oil and even it caused stomach upset. Another note of caution is components of green tea/EGCG is a MAO inhibitor so taking it Azilect should be done with caution. One dose and see how he reacts to the therapy. The beauty of EGCG is it is a decarboxylase inhibitor and can be combined with natural levodopa. It is an MAO inhibitor and an iron chelator. Iron concentrations are a known cause of nerve degeneration in PD and EGCG helps remove them. EGCG also has anxiolytic activity - it relieves anxiety and that is a standard symptom of PD. Etc............

    So NADH + EGCG/green tea extract and vitamin C with salmon oil. All of these supplements have been shown to be good for PD.

  • Thank you so much.

  • PS. In order to evaluate whether either supplement (NADH) or combination of supplements (EGCG + Vit. C + salmon oil) work to improve your father's symptoms, make sure to not start them both at the same time. Dr. Birkmayer noted that 2 weeks of NADH therapy should show results for PD patients (from 10 - 60%) and if everything is taken at once and improvement is felt - which one is causing the improvement? So try the NADH solo for 2 weeks then start the EGCG combo, in my opinion. This way your father will can feel the effect and can give positive feedback. PD is a strange disease and everyone reacts differently to various therapies so you want to know what works and what does not. I noted EGCG has anxiolytic (anti anxiety) effect and when combined with Vit. C + fish oil for absorption, it sedates me. So 1 hour after taking EGCG+ I drink a cup of English Breakfast Tea (high in caffeine) or coffee so I do not fall back asleep. Tea and coffee are great for PD but should be taken until about an hour after EGCG.

  • Thank you. The amount of information on supplements people are hoping will help them is overwhelming. We'll try different things and hope that some of them will help.

  • Hi Buzz! I am currently taking Mucuna Pruriens at night so I can sleep. It is the natural approach to L-Dopa, and the Mucuna bean has been used for "thousands of years" in India and that area as medicine. It stops the shaking of Parkinsons and it does stop the jerks and all RLS symptoms for me. I used it at the same time I was slowly getting off the Ropinirole. I now take only MP at night about 45 minutes before I want to sleep. The dosage I take lasts four hours--uninterrupted, deep sleep! :-) But then I have to take more for another four hours sleep. For me this was much better than ropinirole or any prescription meds. I don't like drugs but took the ropinirole when I was desperate for sleep. It soon lost its effectiveness, but it gave me enough "time" to search out natural L-Dopa. There are some good studies out there on MP. It apparently is not for some people, but it has been a life-saver for me, allowing me to function somewhat normally again.

    I am now trying the Relaxis Pad which, if it works, will stop the RLS permanently. No more meds or MP. I've only been using the Pad for a little over a week, so I will report back here on this blog after I see some results. For information, go to myrelaxis.com.

  • SuperMNew, I've been trying to find out if in "those thousands of years" of Mucuna Pruriens being used as medicine in India, if any of those good Indian doctors made notes about Mucuna's long term usage for the symptoms of what we now call Parkinson's. Even though they might not have used our modern scientific methods, surely some of them made patient notes about the effects of taking Mucuna on a long term basis. However, I haven't been able to find reference to any such things on the internet. Do you know anything about this? Thanks.

  • nope. However, my neuro is Pakistani. His grandfather was an herbalist, I'll ask him if we have time left after discussing me, if he ever discussed that with his Grandfather. Next appt is in September. I have every intention to ask but I cannot gaurantee I will remember.

  • This might be a good source of information for you: herbalcureindia.com/herbs/m...

    I have copied several articles on MP. I read all I could find on it before I ordered some myself. A lot of the research done on MP was done in our country, but the above site suggests it is the World's Premier Health Information Site. I didn't search the site because it is late tonight and I wanted to respond to your question. Keep investigating, that's what I have done.

  • I hope for the same benefit that you have experienced. BTW I have restless legs too if I don't medicate but I got a handle on it by adding 1/2 Benadryl to my Sinemet, ??? It was a surprise that it worked but it still is working for about a year now. I was able to get off Mirapex that way. Now if I have to get up during the night (like you after about 4 hours) if the RLS starts or I' feeling hot like the Sinamet is wearing off and the tremor in my body is coming on I repeat that routine and in a matter of half an hour things calm down and I go back to sleep. Really am glad to hear that your dose of MP lasts 4 hours, I was contemplating having to continue to use the Sinemet and benadryl routine forever to get long lasting good sleep cycles. It's a pain to keep medicine at the bedside every night for the rest of your life isn't it? I'd read that the effect of MP was on average an hour. How much MC constitutes a 4 hour dose for you and what do you mix it into? I can't wait for my shipment to arrive and to get started trying it out.

  • Please go slow until you know what dose works for you. I have a combination of problems (sciatic nerve irritation due to a broken back, leg vein stripping that has been completed now, but my nerves are very, very sensitive and jump just by lightly touching my legs.) I think as my legs heal from the vein therapy, I may notice a different level of RL.

    I ordered the 98% MP powder from Powder City. It's cheap but there are no fillers in it, and it's not in gelatin capsules which have to dissolve in the stomach before you get the meds started doing their thing. Currently I take a half teaspoon of the 98% MP EXTRACT (I hope you ordered the extract; the plain bean has been very little help for me, although the bean supplies vitamins and minerals like any other food). The MP extract I take by the tsp full is probably equivalent to what 2 capsules would hold, or maybe 3. I did some math using the mgs that helped me when I was using 40% MP extract and figured I'd start with 1/2 tsp of the 98% powder in water (has virtually no taste). I have also been adding a scoop of Zandopa, but when I run out of that I will using only the MP 98% powder and adjust the powder up to replace the Zandopa if I need to. This combination, once it takes affect (which is about a half hour), lasts me exactly four hours. Then I repeat and get another four hours and sometimes more. This certainly beats walking the floor all night and having to sleep during the day, which I can't do...too busy. I try to take it all on an empty stomach, but if I get a slight upset stomach, I drink some Almond Milk or Flax Milk. Then I settle right down.

  • SuperMNew, do you also take C/L along with the MP? If so, how much do you take? Thanks.

  • I just take the Mucuna Pruriens, and I use the extract, 98%. I take a half teaspoon in water about 30-45 minutes before I want to sleep. Then, four hours later, when the first dose wears off, I take another half teaspoon of the powder, wait a half hour or so and resume the night's sleep. Sometimes I get more than four hours on the back side of the night.

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