Parkinson's Movement
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Liquefy your L-dopa

Liquefy your L-dopa

The following method for liquefying L-dopa has been shown to have faster on time with less dyskinesia. It is perfectly safe and as it will be shown, has been used with children with amblyopia (lazy eye).

Simply put, it is liquifying 5 doses of L-dopa with 1,000 mg of vitamin C/ascorbic acid, is stored in the refrigerator and a dose is extracted when needed.

[Preparation of a levodopa/carbidopa solution in ascorbic acid (citridopa) and chromatographic and electrochemical assessment of its stability over 24 hours].

"Thus, a patient taking 5 tablets of Sinemet Plus a day, would pulverize them in a glass, ceramic or marble mortar and add them to a measuring cup containing a 1 gram tablet of vitamin C (Redoxon) dissolved in 500 cc of cold water. This would be shaken or stirred until the Sinemet powder had dissolved."

ncbi.nlm.nih.gov/pubmed/778...

Redoxon: amazon.com/s/?ie=UTF8&keywo...

Of course there are 1,000 mg capsules of vitamin C available which can be emptied into water. Will they completely dissolve in water like redoxon? Standard 1,000 mg capsules of vitamin c are much less expensive than redoxon:

amazon.com/Swanson-Vitamin-...

Using liquid levodopa in the treatment of Parkinson's disease. A practical guide.

"A solution of levodopa and carbidopa, stabilised using ascorbic acid, offers a means of delivering a titrated amount of levodopa at regular intervals. Solutions pass through the stomach faster than solids, affording more rapid symptomatic relief in some patients with Parkinson's disease."

ncbi.nlm.nih.gov/pubmed/914...

Oral levodopa/carbidopa solution versus tablets in Parkinson's patients with severe fluctuations

"Four patients with Parkinson's disease, optimally treated with levodopa/carbidopa (LD/CD) tablets but experiencing severe motor fluctuations, underwent an open trial of a levodopa/carbidopa/ascorbic acid solution (LCAS) orally at timed intervals. LCAS reduced bradykinesia, decreased dysfunctional dyskinesia, and increased functional “on” time when compared with previous LD/CD tablet therapy. Oral LCAS allowed better titration of levodopa dosage and offered a more predictable response than LD/CD tablets. Preparation and oral consumption of LCAS was easy and inexpensive. LCAS may be a practical alternative for patients whose motor fluctuations fail to respond to optimal therapy with LD/CD tablets."

neurology.org/content/43/5/...

[Gastric acid secretion and absorption of levodopa in patients with Parkinson's disease--the effect of supplement therapy to gastric acid].

"We measured the pH and amount of collected fasting gastric juice. Gastric acid secretion was decreased in 22 patients (58%). In ten of these 22 patients, 30 ml of lemon juice was prescribed in every administration of levodopa as a supplement to gastric acid for two weeks. Increases of L-dopa concentration after 60 min. and 180 min. were observed after lemon juice supplement therapy. Among the Parkinson symptoms, rigidity, akinesia, and small step gait were improved in every case except one patient who showed decrease of L-dopa concentration at 180 minutes."

ncbi.nlm.nih.gov/pubmed/820...

24% of lemon juice is vitamin C and the PH of lemon juice and vitamin C/ascrobic acid is similar: 2.2 - 2.4 PH

Lemon juice: fda.gov/Food/FoodborneIllne...

Vitamin C/ascorbic acid: metabolicmaintenance.com/pr...

I previously mentioned this solution was used for children with amblyopia (wikipedia):

"Amblyopia, also called lazy eye, is a disorder of sight due to the eye and brain not working well together."

Development of two stable oral suspensions of levodopa-carbidopa for children with amblyopia.

" In the suspension containing ascorbic acid, the mean concentrations of levodopa-carbidopa were above 93% and 92% for 14 days at 25 degrees C, and 93% and 92% for 28 days at 4 degrees C. This liquid formulation was administered to 15 children (mean age: 5.6+/-1.4 years) with amblyopia."

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

There are some questions which have to be contemplated. What about people taking slow release levodopa (Sinemet CR/Madopar CR)? Vitamin C does come in slow release tablets but at what dose of vitamin C would need to be taken to maximize the CR dose?

This method of liquefying levodopa would work for those using 99% pure levodopa as derived from mucuna pruriens but how well will mucuna pruriens supplements work which are not 99% pure levodopa? Most range from 15 - 50% and how easily will the rest of the plant dissolve?

Best wishes,

Rich

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I read a response you wrote re how to administer a version of your pure l-dopa protocol to a woman whose husband who had trouble swallowing. Seems like that would apply. I currently take 300-350 C/L daily in 50mg increments. I am planning to try your protocol subbing the morning and late afternoon dose. I had already purchased Vit C powder, so I will now try it in liquid form with quercetin w/bromelain.

Thank you!

Julie

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I tried 99% pure levodopa from mucuna pruriens with quercetin/bromelain, EGCG, vitamin C and salmon oil all dissolved in a liquid form. I can honestly say it was one of the nastiest combination of flavors I have ever swallowed. Though it worked immediately......

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I thought it was Q/B or ECEG (I only read it once). I was juicing marijuana leaves for a while. It was vile tasting. I've also been researching black seed oil which many reviewers liken to motor oil and give up after one or two tries.

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it was the salmon oil, im getting shivers right now

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I don't understand?

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I'm thinking of taste, when I was little they used to give us cod liver oil, gross!

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Ho! I remember that one vividly. A taste you never forget!

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EGCG has chemical action similar to carbidopa/benserazide ; quercetin has chemical activity similar to entacapone; 200 mg of vitamin C aids in the absorption of both 99% levodopa from mucuna pruriens and EGCG. 1,000 mg salmon oil helps the easily methylated and oxidized supplement EGCG to be absorbed better. Yes liquifying it all together made it work immediately and in a robust manner but it tasted ghastly.

A few references:

Green tea polyphenols: novel irreversible inhibitors of dopa decarboxylase.

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

Epigallocatechin-3-gallate (EGCG) for Clinical Trials: More Pitfalls than Promises?

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

Quercetin potentiates L-Dopa reversal of drug-induced catalepsy in rats: possible COMT/MAO inhibition.

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

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Dear Silvestrov,

I have been reading a number of your messages and am grateful for your research and your sharing of it. I wondered if you have finished your documentary because I'd be interested in watching it. My 79-year-old mother has been recently diagnosed with "parkinsonism" by a UCSD movement disorder specialist/neurologist. She has had shortened gait, a few falls (from not lifting foot high enough to step) and some reaching for words in explaining herself. I don't know what to do. I don't trust the Sinemet because of the Carbidopa and how it seems to bind the vitamin B in the body and the supposed increase in Parkinson's death rate since its introduction. Also, the short window of effectiveness of Sinemet and the added dyskinesias people are left with afterwards. The best option seems to use Mucuna Pruriens perhaps supported by amino acid therapy or the Hinz Protocol. Then I find that Dr. Hinz has had his license suspended for a period of years, perhaps spurred by a mental health crisis, but the result was a good number of people who felt they were not properly treated...and something about potentially false supplement claims??? I'm scared for her to go the conventional method. She is scared to go the homeopathic way. My question to you is do you know of the Hinz protocol and if so, what do you think of it? I am researching, reading and trying to figure out the best thing to do, but I'm afraid I'll make a mistake, not being a doctor, and recommend something that will hurt my precious mom, who has been my rock my whole life. Please forgive me, I'm just feeling so unsure of how to advise her. How have you done it? How can I get a medical doctor who will agree to oversee a homeopathic protocol? I found one in the San Diego area, but my mom worries about some questionable reviews. I know that it's a lot to ask, but what would you do if you were me in advising and caring for my mom?

Any guidance would be greatly appreciated,

Sarah

1 like
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Sarah,

First of all, here is the link to my documentary:

vimeopro.com/user60766261/r...

I have come to categorize Parkinson's disease as a 'trial and error' disease because every person with Parkinson's seems to react differently to the various therapies and everyone seems to have a different but similar version of the disease.

In my doc the second video is on Amino Acid Management featuring the Hinz protocol. I have had people on the therapy who have contacted me and it seems to help them but it is expensive and the amount of (mucuna pruriens) levodopa they take is prohibitive. On average, every person takes about 1 bottle every 2 days and this translates into approx. 11 grams of 40% levodopa a day. Cramping and nausea are common side effects of the therapy.

The easiest solution to the levodopa quandary is for her to try Zandopa (HP-200). It has been tested on PD patients and though it is a powder it is mixed with water and thus it too is in a liquid form. Zandopa can be purchased on amazon.com.

amazon.com/zandopa/s?ie=UTF...

An alternative medicine treatment for Parkinson's disease: results of a multicenter clinical trial. HP-200 in Parkinson's Disease Study Group.

ncbi.nlm.nih.gov/pubmed/939...

Regardless of the form of levodopa someone takes it causes a subclinical niacin deficiency and 250 mg of slow release niacin is recommended for this and an additional reason. One man went on 1,000 mg of niacin per day and it improved some of this symptoms but he had to quit taking it because of nightmares and extensive flushing. A later article showed that niacin relieved inflammation from the GPR-109a receptor (Niacin receptor 1):

Low-dose niacin supplementation modulates GPR109A, niacin index and ameliorates Parkinson’s disease symptoms without side effects

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

Since a meat consumption interferes with the absorption and conversion of levodopa into dopamine, a (relatively) meat-free diet is recommended with breakfast and lunch being veggie meals and some form of protein consumed at dinner.

The problem with this diet is the major source of cobalamin (vitamin B12) is from red meat and because any form of levodopa can raise homocysteine levels - a non-protein amino acid associated with vascular disease and dementia, by eating a minimal amount of meat you need to add a B12 supplement. The most potent form of B12 is methylcobalamin and B12 is a co-factor for the conversion of homocysteine to methionine. Studies have shown that oral/sublingual B12 is just as effective as B12 injections in raising cobalamin levels. In a Dutch article they stated that large dose of methylcobalamin, larger than a doctor would prescribe, is perfectly safe. ALS patients were given 50 mg/day of intravenous methylcobalamin per day with no side effects. Normally 1 mg of B12 is considered to be a 'maintenance' dose but larger doses are required to PD patients because of known B12 deficiencies and the use of levodopa. I have taken 5 mg/day sublingual methylcobalamin for years with no side effects. Low B12 levels is associated with poor cognitive function and peripheral neuropathy.

peripheralneuropathycenter....

Treatment with high dose vitamin B12 been shown to be safe for more than 50 years

stichtingb12tekort.nl/weten...

If you either take B12 or folate you should take them both. They are like the dynamic duo of B vitamins because they work synergistically. Methy folate (methyltetrahydrofolic acid) is the bioavailable from of the vitamin and it also helps to lower homocysteine levels associated with levodopa. By itself folate has been shown to be neuroprotective in PD:

Folic Acid Linked to Parkinson's Disease

webmd.com/parkinsons-diseas...

400-800 mcg/day of Methyl folate is sufficient unless the patient is known to have the MTHRFR mutation then large doses of folate are required:

healthunlocked.com/parkinso...

If you take sinemet/madopar you have to take pyridoxine (B6) but if you take Zandopa you do not. Sinemet/madopar causes a deficiency of B6 but taking more than 5 mg of pyridoxine per day causes the immediate conversion of (mucuna pruriens) levodopa into dopamine in the body. Thus it prevents the levodopa from reaching the blood brain barrier to be converted into dopamine in the brain.

So start with Zandopa, 250 mg slow release niacin, 5 mg sublinqual methylcobalamin and Methyl folate. Keep in mind that every person has a uncertain response to levodopa and it may be required to take 4-6 doses a day - it depends on individual response.

This is enough info for you to mull over so after watching the doc and reading the links I sent you let me know how your mother responds.

Rich

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Bless you a million times over. The knowledge you have accumulated is amazing and so incredibly needed with the state of care for Parkinson's at this time. I am so happy to have the link for your documentary and will apply myself to it! Thank you, Rich. I am so grateful for your help.

Sarah

1 like
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Dear Rich,

I am so appreciative of your documentary material. I've been following it for hours and taking notes. I can't believe you have both sides of your brain going with being an artist and understanding this intricate and complex medical information. I like your recommendations above and am researching further with this in mind. I would really like to know your view on Carbidopa. It scares me because of this study:

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

Conclusion

"Between 1960 and 1974, the only prescription form of L-dopa available was the single-ingredient form that was associated with a decreasing death rate.61 In 1975, the original combination L-dopa/carbidopa drug (Sinemet®) was approved by the US FDA. Between 1976 and 2011, the CDC documented a progressive increase of 328.7% in Parkinson’s disease deaths that crossed age, sex, and ethnic boundaries.61,84 In addition, no effective way has been discovered to truly stop what has been described as neurodegeneration.

The mechanism of action for carbidopa and benserazide induces irreversible binding to and permanent deactivation of PLP and PLP-dependent enzyme molecules, potentially inducing a negative impact on over 300 enzymes and proteins."

----------------------------------------

I have a sibling who will only listen to large, double blind studies, which, of course, are not so easy to find with more homeopathic therapies. I've also noted that the large ones for Sinemet and its various different formulations seem to be funded by the large drug companies that sell the product, listed in the conflict of interest statement on the medical journal studies themselves! So how are we supposed to trust that this is an unbiased result that is not skewed to represent the product from which they are making money?

Also, there is a site called Askapatient.com, When you look up Sinemet, there are, yes anecdotal stories of people who have had horrible experiences with hallucinations and paranoia with their loved ones on this medication. And these are written off as "anecdotal," but geez, it's hard not to listen to caregivers discussing their experiences.

Then you go to another site for patients' experience and it's a much cheerier outlook:

patientslikeme.com/treatmen...

but I noticed that they partner with drug companies as well. And maybe that is because it is valuable info for the drug co.s, but it's just strange looking at two very opposing pictures of the same situation.

I know that you said everyone is so different. I want the very best for my mom. The hard part is, family pressure to follow the conventional accepted medical route, confirmed by studies funded by conventional suppliers. I have seen doctors make major mistakes (just last month my friend's husband with brain cancer was put on a chemo drug that made him violently sick. The doctor had left on vacation and not left a backup doctor on duty, something that was confirmed by the shocked hospital staff. They went to another doctor who said he couldn't believe the first doctor had used that chemo agent because it was no longer used in the industry and was considered highly toxic and ineffective).

The other problem is that the amino acid Hinz protocol therapy has so many supplements that they sell and is expensive, as you said. It comes across to a sibling as a marketing ploy.

Do you think there are many doctors willing to work with patients who want to do these homeopathic, less beaten path ways?

I would really value hearing your thoughts,

Sarah

Reply

I will get back at you later because I am working a heavy schedule this week.

Rich

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Many thanks for your kind words about my researching but I have always

had a non-fiction mind - regardless of being an artist. I have read history for decades and by necessity I started to read science and found it is not that much of a change. I just needed to familiarize myself with the vocabulary of science.

Keep in mind that there is no perfect therapy to treat PD whether it be standard practitioner or alternative therapy like Hinz et al. propose. People have contacted me who were taking the Hinz protocol and many had cramping and nausea from taking large doses of MP levodopa (without a decarboxylase inhibitor). The therapy has helped people but like any other therapy for Parkinson's disease, the results are variable. I like their approach because it makes use of various herbs, amino acids.... mucuna, selenium...and considers nutritional deficiences of PD other than dopamine....

I am familiar with the Hinz et al. article (Carbidopa death rate...) and originally included in a semi final version of the Amino Acid Management video. I removed it because it needs independent scrutiny from a statistician. Hinz et al. have the habit of using their own studies as evidence of their own claims - they use previous studies as references for their current article.

This is unusual practice for scientists and I have seen other instances but not

to this extent. Then again, when you make a pioneering attempt at a new therapy you may have to quote yourself if no one has published a study on the particular subject you are writing about.

A little closer to home, my father had PD and lived to be

88 years old. He took 25/250 sinemet 4 times a day and his cause of death was a gall bladder problem. It is one thing to say that there is a relationship between carbidopa and Parkinson's disease death rate but what are the symptoms of carbidopa toxicity and what parts of the body fail (due to carbidopa toxicity/pyridoxine deficiency) and cause death?

Hinz et al. state:

"We hypothesize that if the Parkinson’s disease patient is being evaluated for the signs and symptoms of progressive neurodegenerative disease without considering the potential for, as well as the existence and ramifications of RNDs associated with the disease itself, L-dopa, and/or carbidopa, then nutritional collapse components will erroneously be attributed to progressive neurodegeneration."

Additionally:

"Systemic vitamin B6 concentrations inversely correlate with mortality induced by coronary artery disease, colorectal cancer, stroke, heart failure, and atherosclerosis. We hypothesize that if carbidopa and benserazide significantly deplete PLP, then an increased death rate will be observed."

Atherosclerosis & PD:

"Cerebral atherosclerosis has been previously postulated as a possible etiology for Parkinsonism. Epidemiological studies, however, have suggested a relatively low incidence of ischemic strokes in Parkinsonian patients."

sciencedirect.com/science/a...

"Diminished smoking in PD patients likely plays a role in our finding of decreased stroke in patients with PD."

ncbi.nlm.nih.gov/pubmed/160...

Though mini 'silent strokes' can cause PD their cause is unknown:

Silent Stroke Can Cause Parkinson's Disease medicalnewstoday.com/articl...

Colorectal cancer:

"Conclusion: PD is associated with reduced odds of colorectal cancer. Further research is needed to elucidate the mechanisms underlying our findings."

neurology-asia.org/articles...

Heart failure:

"If you have Parkinson's disease, you have a more than two-fold increased risk of developing heart failure and a 50 percent higher risk of dying from heart failure,"

But the article does not attribute a pyridoxine deficiency as the cause of heart failure. Rather, they note:

"Heart muscle cells and neurons in the brain have huge numbers of mitochondria that must be tightly monitored. If bad mitochondria are allowed to build up, not only do they stop making fuel, they begin consuming it and produce molecules that damage the cell. This damage eventually can lead to Parkinson's or heart failure, depending on the organ affected. Most of the time, quality-control systems in a healthy cell make sure damaged or dysfunctional mitochondria are identified and removed."

sciencedaily.com/releases/2...

What is the #1 cause of Parkinson's disease death rate? Pneumonia:

ncbi.nlm.nih.gov/pubmed/249...

Hinz et al. attribute an enhanced PD death rate to carbidopa and pyridoxine

deficiency and so carbidopa has to be compared with the TB antibiotic isoniazid

(which also causes a depletion of pyridoxine - vitamin B6).

There are many chemical names for carbidopa including Alpha-Methyldopa-hydrazine.

There are many chemical names for the TB antibiotic including isonicotinyl-hydrazine.

"The antituberculosis drug isoniazid can result in a functional vitamin B6 deficiency. Anti-parkinsonian drugs benserazide and carbidopa cause vitamin B6 depletion by forming hydrazones."

altmedrev.com/publications/...

1) Isoniazid binds directly with pyridoxine to form isonicotinylhydrazide.

2) Isoniazid is dehyrised to its hydrazones; which block pyridoxine phosphokinase, thus preventing conversion of pyridoxine to its active form, pyridoxyl 5' phosphate.

Management of acute isoniazid toxicity

"The three mechanisms described above demonstrate how isoniazid can deplete the body of pyridoxine. Pyridoxine is thus an antidote. In acute toxicity, pyridoxine has been shown to halt seizures, correct metabolic cidosis and shorten coma duration."

acmt.net/ijmt/ijmt/page.asp...

Isoniazid Overdose: Recognition and Management

"Given in gram-per-gram amounts of the isoniazid ingested, pyridoxine (vitamin B6) usually eliminates seizure activity and helps to correct the patient's metabolic acidosis."

aafp.org/afp/1998/0215/p749...

Isoniazid Overdose

"This paper presents a series of two cases of isoniazid poisoning presenting to a tertiary referral centre in North Queensland. Isoniazid toxicity produces a triad of coma, metabolic acidosis and seizures. The seizures are often refractory to traditional antiepileptics. A specific antidote is available (pyridoxine [vitamin B6]) and both patients were administered this as part of their treatment. We also surveyed all hospitals in Australia with an accredited adult Emergency Department to assess the availability of pyridoxine."

link.springer.com/article/1...

Malnutritional neuropathy under intestinal levodopa infusion

"Levodopa/Carbidopa intestinal gel infusion (LCIG) for Parkinson’s disease is under debate to provoke polyneuropathy (PNP). In our cohort of 20 thus treated patients, two developed debilitating axonal PNP with deficient pyridoxin and folate levels, and marginal cobalamin. Homocysteine was highly elevated. The neuropathies responded to vitamin replacement. We assume that LCIG can provoke PNP most likely of malnutritional origin. To avoid this side effect, the assessment of predisposing factors before treatment as well as neurophysiological and laboratory screenings appear necessary."

link.springer.com/article/1...

Isoniazid induced motor-dominant neuropathy

"Isoniazid though a very effective treatment for tuberculosis can cause severe motor-dominant neuropathy which can be reversible with pyridoxine supplementation."

jpma.org.pk/full_article_te...

So pyridoxine is the antidote to isoniazid poisoning and Hinz et al. use it as part of their therapy because of a deficiency caused by carbidopa.

To summarize: If you take Madopar or Sinemet you need to take P5P - pyridoxyl 5 phosphate. If you use a natural form of levodopa, you do not need to take P5P - vitamin B6.

Hinz et al: "In 1941, almost 20 years before the dawn of L-dopa,

Baker described a subgroup involving 25% of Parkinson’s disease patients who achieved “definite objective improvement” with vitamin B6 administration."

If you want to read about the historic use of pyridoxine go to document page (this means the introduction, title...pages are included go to page 335 or text page 303 in this book:

healthunlocked.com/parkinso...

----------------------------------------

I understand the need for double blind studies to determine facts but science and scientists have not created a positivistic utopia on earth. Scientific learning is incremental and study is ongoing to explain the unexplained.

Doctors use many drugs which they do not understand their 'mechanism of action'.

For example:

TB antibiotic pyrazinamide: " The mechanism of action for pyrazinamide (PZA) is unknown."

uptodate.com/contents/pyraz...

Leprosy antibiotic Dapsone: "Mechanism of action is unknown;"

Drugs with Unknown Antiparasitic Mechanism of Action

link.springer.com/reference...

Category:Drugs with unknown mechanisms of action

en.wikipedia.org/wiki/Categ...

On the last list there is one Parkinson's drug (Budipine):

en.wikipedia.org/wiki/Budipine

------------------

To only take substances that have been double blind tested eliminates vitamins, minerals, amino acids.....because there is no profit in testing those substances in a double blind trial. Drug testing is expensive and costs between 200 million and 2 billion dollars. Who is going to test a readily available mineral for 250 million dollars and then sell it for 20 dollars a month?

I understand family pressures and you want the best for your mother but you can take standard therapy with vitamins....etc...to make the work better.

I recommend 250 mg slow release niacin, high dose methylcobalamin (B12),

Methyl folate,:

parkinsons.org.uk/news/5-fe...

"Intervention #1. A combination of the following vitamin supplements: 2.5mg of folate, 25mg of vitamin B6 and 2mg of vitamin B12. This combination will be described as "triple therapy with folate."

clinicaltrials.gov/ct2/show...

And P5P if you take carbidopa/benserizide.

______________

I recently found an additional article which shows the safety of high dose B12. A 22 yo woman tried to commit suicide by taking huge doses of isoniazid and doctors reversed the condition by infusing 65 ampules of Optineuron over a 31 hour period. Each ampule contains 1,000 mg of cyanocobalamin hence the patient took 65,000 mg over the therapeutic period.

medind.nic.in/jac/t04/i1/ja...

Optineuron: dawabazar.in/optineuron/lup...

On the subject of B vitamins both riboflavin (B2) and thiamine have been

shown to have some therapeutic benefit in PD.

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

Thiamine (injected): bioportfolio.com/resources/...

treatment-for-Parkinsons-disease.html

Other supplements that have been shown to be good for PD are

NAC:

N-acetyl cysteine:

news-medical.net/news/20160...

Standard doses of NAC are from 600 - 1,800 mg per day in divided doses.

I take NAC with food because on an empty stomach it can cause upset.

If your mother has anxiety I highly recommed the amino acid from tea called L-theanine. Theanine can be taken up to 1,200 mg per day at 200 mg doses. 400 mg is the maximum dose and any more will not be any more effective - diminishing returns sets in.

Some theanine studies

Theanine & PD: ncbi.nlm.nih.gov/pubmed/184...

Theanine & anxiety:

ihpmagazine.com/l-theanine-...

lifeextension.com/magazine/...

I will stop here because there is enough info here to sift through.

Rich

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Thank you, Rich. I am and will further absorb these things and appreciate the references to study. Do you know if the mucuna is known to cause dyskinesias like the Sinemet does? Also, do you know if Mucuna can be taken with an SSRI like Zoloft? Though I am researching myself, I know that you have covered far more ground and understand it at a deeper level. I'll try not to ask too many questions!

Many, many thanks,

Sarah

Reply

Sarah,

Summation of my 2 posts:

Any form of levodopa causes a subclinical deficiency of niacin. Niacin relieves inflammtion through binding with Niacin Receptor 1 - GPR-109a, and 250 mg niacin per day has been shown to reduce inflammation and decrease rigidity in PD. To avoid excessive flushing the niacin can be taken in a time released form.

Carbidopa or benserazide cause a pyridoxine deficiency and supplementation with pyridoxyl 5 phosphate, P5P, is recommended. If you have never taken Sinemet or Madopar (and taken only Mucuna pruriens levodopa) P5P is not required. If you are taking Mucuna pruriens levodopa with 5 + miligrams of P5P, P5P will cause a loss of effectiveness because it speeds the conversion of levodopa in the body prior to reaching the blood brain barrier.

Any form of levodopa raises homocysteine levels which are associated with vascular disease and dementia. Vitamin B12 is a cofactor for the conversion of homocysteine into methionine. Eating a protein rich diet (with lots of red meat) decreases the efficiency of any form of levodopa because meat/protein competes with the levodopa for conversion.

For breakfast and lunch a no-protein meal is recommended with protein being eaten at dinner. The major source of B12 in the human diet is form meat/animal products so when B12 is needed most it is almost absent from the diet. So B12 supplementation is recommended in its most potent form: methylcobalamin. B12 is a safe vitamin and larger than standard doses can be used. In people poisoned with cyanide a form of B12 called hydroxocobalamin is used to detox/chelate the cyanide and 10 grams - 10 thousand milligrams is used over a 2 hour period. Many doctors are reluctant to give more than 1 mg/day of B12 but because of increased needs this is inadequate more than 1 mg should be taken. B12 injections are common in PD in the form of cyanocobalamin - a less potent form of B12.

It has been shown that oral/sublingual B12 is just as effective in raising

B12 levels as injections.

Vitamin B12 Intramuscular Injections Versus Oral Supplements

"The clinical evidence-based analysis has found that oral supplementation is as effective as intramuscular injections."

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

Methylcobalamin comes in 5 mg sublingual doses. I have taken 5 mg for 5 years with no negative consequence.

B12 and folate (B9) are like the dynamic duo of B vitamins: they work in synergy so they should be taken together. Methyl folate = methyltetrahydrofolic acid, is the bioavailable form of folic acid and it has been associated MTHRFR mutations and PD:

healthunlocked.com/parkinso...

Also:

"We tested the hypothesis that mood, clinical manifestations and cognitive impairment of levodopa-treated Parkinson's disease (PD) patients are associated with vitamin B12 and folate deficiency. To this end, we performed this cross-sectional study by measuring serum folate and vitamin B12 blood levels in 111 consecutive PD patients. Levodopa-treated PD patients showed significantly lower serum levels of folate and vitamin B12 than neurological controls, while depressed patients had significantly lower serum folate levels as compared to non-depressed."

"Cognitively impaired PD patients exhibited significantly lower serum vitamin B12 levels as compared to cognitively non-impaired. In conclusion, lower folate levels were associated with depression, while lower vitamin B12 levels were associated with cognitive impairment. The effects of vitamin supplementation merit further attention and investigation."

sciencedirect.com/science/a...

Carbidopa/benserazide was added to levodopa because 2 - 6 grams of levodopa was the old dosage for Parkinson's disease and it caused nausea and vomitting. Carbidopa/benserazide was added to decrease the size of levodopa to minimize nausea. Natural mucuna pruriens does not cause dyskinesia but you should consider the following article:

Liquid levodopa/carbidopa produces significant improvement in motor function without dyskinesia exacerbation

neurology.org/content/47/6/...

SSRI's raise serotonin levels and any form of levodopa only effects dopamine levels so Mucuna and Zoloft (Sertraline) is safe to take with it. The danger of taking a SSRI is taking another substance which also raises serotonin levels thus causing Serotonin Syndrome:

webmd.com/depression/guide/...

Here are several studies about the effectiveness of Zoloft in PD:

Parkinson's Patients Get No Benefit From Antidepressants Sertraline Or Mirtazapine, But Have More Side Effects

nwpf.org/stay-informed/news...

Comparative study of efficacy for bupropion vs. sertraline (SSRI) in depression with Parkinson's disease

"Results: Comparison of the changes from base line to end point revealed

significantly greater improvement in both depressive as well as motor symptoms of PD with bupropion then with the sertaline on all three efficacy measures. Side effect profile with both the drugs was approximately equal."

asm.confex.com/ipa/11congre...

Drugs contraindicated for use with bupropion:

reference.medscape.com/drug...

S-adenosyl-methionine improves depression in patients

with Parkinson's disease in an open-label clinical trial

deepdyve.com/lp/wiley/s-ade...

There is another SAM PD depression trial and the results have not been published.

SAM-e for the Treatment of Depression in Patients With Parkinson's Disease

clinicaltrials.gov/ct2/show...

Further reading about the ambiguous relationship between SAM-e and PD:

Levodopa Intake Increases Plasma Levels of

S-Adenosylmethionine in Treated Patients With Parkinson Disease

researchgate.net/publicatio...

Increases_Plasma_Levels_of_S-Adenosylmethionine_in_Treated_Patients_With_

Parkinson_Disease

Secondly a B12/PD study notes that:

Vitamin B12-Impaired Metabolism Produces Apoptosis and Parkinson Phenotype in Rats Expressing theTranscobalamin-Oleosin Chimera in Substantia Nigra

"Background:

Vitamin B12 is indispensable for proper brain functioning and cytosolic

synthesis of S-adenosylmethionine. Whether its deficiency produces effects on viability and apoptosis of neurons remains unknown. There is a particular interest in investigating these effects in Parkinson disease where Levodopa treatment is known to increase the consumption of S-adenosylmethionine."

academia.edu/11709393/Vitam...

Apoptosis_and_Parkinson_Phenotype_in_Rats_Expressing_the_Transcobalamin-

Oleosin_Chimera_in_Substantia_Nigra

Rich

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Thank you, Rich!!! Thank you very much for all your helpful information. I am putting together a chart of conclusions, supplements and things to further research.

I will definitely make sure she has these appropriate supplements.

Interesting about the Zoloft for PD patients. My mom has found it so incredibly helpful. She was waking up with these runs of night-time anxiety and not sleeping well. She was very skeptical of taking Zoloft, but after several weeks, she realized she no longer had the anxiety runs in the night and now says she sleeps incredibly well. She says she hopes she doesn't have to get off of it, as it's like a friend :)

Thank you again, and I hope that all the help you have provided by sharing your research/knowledge comes back to you multiplied.

Sarah

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Thank you silvestrov ,

Two years back I was having difficulties for my medication to kick off in early morning so my neurologist advised me to dissolve half a tablet of sinemet 100/25 in a small cup of soda (7 up or sprit o mountain dew) it was working quickly but Soda in general is full of sugar and not good for general health .

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Yes soda is a very unhealthy product and I have not drank it in years. I probably had 1 mouthful in 10 years before spitting it out. The ph of soda is acidic though slightly less than lemon juice and ascorbic acid:

google.com/search?q=ph+of+s...

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I used vinegars mixed with warm water.to up digestive juices (hydrochloric acid) older stomachs can benefit,

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just learned that couple years ago, university of Virginia found lymphatics in the brain....that excreted three pounds of toxins and PLACK.....during sleep. From dr mercola's article on revised stance on wheat and barley allergies.

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I am using half lime with Sinemet plus and half Entaphone tablet for every dose but having slight dyskinesia. Practicing for last six months. I don't have tremors.

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Has this "sinemet juice" been speed-tested against the ODT (orally disintegrating tablet) which when chewed and swallowed with a glass of liquid would seem to offer the same tendency to take effect quickly. The ODT sinemet has a mint taste and is a cheap generic (my copay is $20 for my 1080 pill 90-day supply. I formerly chewed the regular sinemet tablets, which are bitter and made life just a little more miserable by their awful taste. Taste problem solved with ODT, and I can't imagine why they should be any slower than your sinemet solution, if they are washed down with your liquid of choice after thorough chewing and swallowing with a beverage. Rytary was tested head-to-head against regular sinemet but not against sinemet CR or very-tiny-but-super-frequent doses of ODT (to simulate continuous infusion into the stomach.) Rytari added about an hour of on time per day without dyskinesia, which isn't bad. A few more improvements like that and life might seem a lot better!

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Thanks Silverstrov

It is very useful info, and pleased to have this formula and supporting info.

Those i know of who dissolve their Sinemet have done it because of wearing off and dyskenesia. They do not take a dose at set times but sip the liquid all day. The aim is to keep a constant level of levadopa in the body.

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What to say. It's mostly above my head I'm afraid.

Now, I'm to have a Duodopa procedure for the same reason........keeping a constant level of the 'stuff' in my poor old body.

The 2 specialists, Gastro Enterologist and Neurologist have to 'gang up' together and work out the time both can do the procedure. I'm still waiting to hear.

Dyskinesia is wearing me out....I jerk all day...hate it.....also have NUMB TOES, BURNING HEELS, AND I HAVE LOST 2 TOENAILS FOR NO REASON. Is this Parkinson's or do I have Diabetes aaas weeel.

This condition is beating me at the moment......hard to laugh but easy to cry.

'Keep on the sunny side of life' Where is it?

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advancedPDguy

Hi. You mentioned the ODT type of Sinemet in your post 8 mths ago. Are you still able to get it? Express Scripts cancelled my prescription & I am not able to find it now. I called the Mylan, the manufacturer, & they said it would be September, but I still haven't heard anything.

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I take Parcopa. It's blue & minty & dissolves on my tongue. It works well. I do have some off times but not real bad. I've been takng it approximately 9 years & still only take 3--5 per day.

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What strength do you take laglag?

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25/100. The manufacturer is Mylan. The pharmacy gave me some made by Sunxxx? one time and it did not work as well. It took a lot of talking but I talked them into changing it back. Funny thing is, Mylan makes the generic.

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You said too mix five tablets pulverized levodopa with one gram citric acid in 500 cc's. That sounds like a lot of water did you mean 5 cc's 500 milliliters?

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The following link ataes 1000 cc of water is 2.2 pounds....so 500 cc is 1.1 pounds.

google.com/search?q=how+muc...

And I just noticed the additional links on the search page give handy dandy information about the weight of breast implants. More info than was required....lol

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Okay thank you okay thank you I guess it's just over a pint not as much as I thought.

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Today has been great. Except for one episode of paraesthesias it has been smooth like whisky

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Hi

My husband

Has takes dopamine in capsule form

2 different size doses

Throughout the day..

I don't see how I could apply this to him

Although the idea sounds good

As his down time is very significant and so his the Dyskinesia

??

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What sizes and forms does his levodopa come in?

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Dear s,

I tried it today. So far onset of on time is very fast and the duration of on time MODESTLY raised.i shall continue for a week and report back to you.

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Hi Rich, I tried to private message you, but for some reason, it wouldn't acknowledge silverstrov as a recipient. I wondered if I could bounce something off of you. I know your protocol and if it was for me, I would just start it. Instead, being for my 79 year old mom, she wants a doctor who can monitor and instruct her on what to do. I have an appointment for her with an MD in San Diego, CA, who works with the Hinz protocol..it's expensive (and the dr. is loved by some, but claimed by others to only want money), but she likes that he's an MD. She is nervous about it, though. The doctor uses CPK supplements, this company was reprimanded by the FDA for false claims of cures. And the Mucuna is only forty percent. I guess I am just struggling for what to do. She has mild cognitive impairment, and has a hard time absorbing all the med stuff. I keep researching, but wish I could just know the perfect thing. I asked the doctor if he would do a modified version using mucuna. He said "No. I treat patients based on 3 million patient-days of published research and 22 published studies. I will not reinvent a wheel once it has been already invented." I know that you are not a dr., that it's a personal decision, etc., but I just wondered what you would do in this situation. I know your father dealt with this too.

Warm Regards,

Sarah

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Sarah,

Sorry for the delay in responding but I have been over run with work.

Regardless of what protocol your mother goes on if she is having cognitive impairment she should be on a high dose of B12/methylcobalamin (say 5 mg per day) sublingual. B12 deficiency is associated with CI and higher than normal B12 will be needed because levodopa raises homocysteine levels in the body (which is associated with vascular diseases and dementia.

Folate and vitamin B12 levels in levodopa-treated Parkinson's disease patients: their relationship to clinical manifestations, mood and cognition.

ncbi.nlm.nih.gov/pubmed/180...

Secondly, if everyone used your logic to avoid Hinz, et al. because of past malfeasance then you should not purchase any drugs from Merck (and others):

Merck & Vioxx:

theamericanconservative.com...

Valeant: A timeline of the big Pharma scandal

fortune.com/2015/10/31/vale...

The Latest Big Pharma Scandal

ideas.time.com/2012/01/30/t...

Using 40% levodopa was derived from the following study:

Mucuna pruriens in Parkinson's disease: a double blind clinical and pharmacological study.

ncbi.nlm.nih.gov/pubmed/155...

In addition to levodopa the Mucuna pruriens plant contains many alkaloids and so it has additional anti-PD action. Some of the alkaloids include:

"The leaves, seeds, stems and roots contain L-Dopa, Serotonin, 5-HTP, and Nicotine, as well as N,N-DMT, Bufotenine, and 5-MeO-DMT. - Wikipedia

en.wikipedia.org/wiki/Mucun...

So it has a different effect than pure levodopa.

The first study on the following search compares the action of Mucuna p. with standard PD therapy (it is a PDF so it will be downloaded):

search.yahoo.com/yhs/search...

Off to work.

Rich

PS. (Additional edit)... Like any other form of PD therapy the 'Hinz' protocol has variable results. I have conversed with people it greatly helped, moderately helped, helped temporarily then its effectiveness diminished.....sounds familiar does it not? Yes it is expensive and a therapy for senior citizens with is expensive is an additional burden for those with limited income. The main side effects of the therapy are cramping and nausea (caused by large doses of levodopa). -

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Dear Silverstrov,

Sorry, I've read over all of your previous information, and realize I am spinning, and sort of asking the same questions in the above post. Just dealing with the pressure of such responsibility for someone I love.

Sarah

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