Two important studies Re: Sinemet

[MBAnderson]

parkie13 and park_bear posted two important studies yesterday and the day before. Because none of us read every comment in every thread, I feel these are important enough to make them a new subject. They may impact your decision(s) regarding Sinemet.

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

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

[park_bear]

It's not just Sinemet - this concern applies to any levodopa formulation that contains either carbidopa or benzaseride, which is to say, any prescription form of levodopa. The concern is these substances bind with and deactivate the active form of vitamin B6 inside the body. I had been resistant to this information because of Marty Hinz' personal problems, but it appears this phenomenon is generally acknowledged within the medical community.

One way to mitigate this issue, is to take B6 2 hours separate from C/L. P-5-P is the nontoxic form of B6. [edited 12/2/2020]

[Hidden in reply to park_bear]

And please be careful if you decide to take a larger dose of vitamin B6 (between 10-100 mg/day).

journeywithparkinsons.com/t...

[park_bear in reply to Hidden]

At the link he reports taking B6 in the morning at the same time as C/L clobbered the C/L. This makes sense - they will bind together before even getting out of the GI tract. He then claims that high plasma levels of B6 are problematic but he has not actually demonstrated that.

[M-o-ggy in reply to park_bear]

How do I know when the Sinemit is out of my system

[MBAnderson in reply to M-o-ggy]

Here's some good info regarding Sinemet

rxlist.com/sinemet-drug.htm

[park_bear in reply to M-o-ggy]

Here is a chart of dopamine levels over time for both immediate (IR) and controlled release (CR) versions: google.com/imgres?imgurl=ht...

Upon further reflection, I think it is sufficient just to wait until the C/L has been fully absorbed by the GI tract. On the chart that would correspond to the places where the curves start to turn down, which is 2 hours for the IR version and 5 hours for the CR version. Then wait couple of hours after taking B6 before taking another dose of C/L.

[park_bear in reply to park_bear]

This also explains why a morning dose of C/L has not worked for me - I take a multivitamin in the morning and it turns out that it has 40 mg of vitamin B6. I was taking this at the same time as the C/L so they neutralized each other. The evening dose of C/L always worked.

I have been doing this forever, so this demonstrates one can take vitamin B6 at a different time of day than the C/L and the C/L will still work.

[Juliegrace]

I'm getting the same study from both links.

[Hidden in reply to Juliegrace]

Links to close together. The HU link was a result of a search for "sinemet"

[MBAnderson in reply to Juliegrace]

Whoops. Thank you for pointing that out. I'll find the other link, post haste.

[MBAnderson in reply to Juliegrace]

Here is the right one originally posted by park_bear.

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

[wifeofparky]

Sinemet should be taken on an empty stomach for best absorption. Taking a B complex is the best way to utilize the vitamin since vitamins work in combination not just singularly. Take the B complex with your meal and it should have minimal effect.

The study cited seems to be a retrospective observational one with little or no controls to determine the actual problem

[MBAnderson in reply to wifeofparky]

Good points. Thank you for proffering a probable solution.

[Islandhappy]

Seems to argue for getting the levodopa via mucuna

[MBAnderson]

In the title of this thread, I put up two links of the same study. As Rick Perry once famously said, "Oops." Here is the correct link.

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

[Ratzkywatzky]

Hmm, more evidence for my case against starting on Madopar even though I barely have any symptoms yet. Shame as now I am going to be a lot less positive about starting on drugs when I have no choice. Up the exercise and investigate Mucuna further I guess and put it off as long as possible. Thanks MBAnderson for posting as I might not ever have seen that info otherwise. Might summon up the courage to show to PD nurse/ Neurologist at next apppointment.

[Ratzkywatzky]

Hmm again, research of this theory keeps leading back to dr marty hinz who charges $240 for 2 weeks mucuna supply and sells a $900 a month vitamin regime.

startribune.com/fda-acts-ag...