Now that I am finally recovering from the flu I am going to post what the daily regimen of supplements I am taking. Prior to listing the vitamins, minerals, amino acids....I am taking, I need to relate a little history. I have a degree in sculpture and was exposed to many chemicals including toluene. Years later I was a greens keeper and was further exposed to insecticides, herbicides, algaecides and for 1 day, large doses of Monsanto's Roundup.
“The research found that being exposed to bug or weed killers and solvents increased the risk of developing Parkinson's disease by 33 to 80 per cent.”
Parkinson's disease has a heavy association with chemicals and after my exposure I had a pre-parkinsonian symdrome which included: lost sense of smell, depression, anxiety, ED, chest tremors, back stiffness, muscular weakness, fatigue and mental confusion. Upon examining the possible causes of PD the elephant in the corner was toxic chemicals and at the time I thought I had PD as caused by pesticides, herbicides, fungacides, rotenone, MPTP, maneb, etc....so I searched for studies featuring supplements which attenuated the effects of chemicals/PD models so I started to take every supplement with affects mitochondria.
The first supplement I took was DHA/EPA omega 3 and I am currently taking 910 mg (448 EPA + 308 DHA + other omega 3s + 154 mg) x 3 meals (2,730 mg total) . Up to 7,100 mg/day of fish oil can be taken but at that high level a blood test is required. Fish oil is a blood thinning agent and can be dangerous if taken with other blood thinning agents like Warfarin.
DHA omega 3, Parkinson's disease & MPTP:
Omega-3 fatty acids protect against Parkinson's, study says
The second supplement I took was Coenzyme Q10. I read a study that stated 1,200 mg/day of ubiquinone slowed the progression of PD by 44% so I started taking 1,200 of coq10.
Interestingly, when I started taking 1,200 mg/day of ubiquinone it had a profound effect on me but at the time I was already taking large doses of fish oil and did not consider that the 2 supplements were working together for the positive effect I was experiencing. Years later I ran out of fish oil and was unconcerned about replacing the supplement. Hey I was taking CoQ10 right? After about 7-10 days of not taking fish oil my chest fasciculations (not a PD symptom) started to come back and there was some pain associated with the twitching. So I once again started taking the combo together and I felt fine (again). What might have possibly happened is the high DHA/EPA content helped to absorb the CoQ10. Most Coq10 is fat soluble and required a major source of fat to ensure its absorption.
The MJFF tested ubiquinone and abandoned it for other supplements. Considering that ubiquinone is one of three types of CoQ10, ubiquinone, ubiquinol and PQQ, I think this is rather short sighted but hey, it is the MJFF, right?
Finally, coq10 has been tested against various chemicals which have been implicated in PD and has worked well in animal modes or the lab dish. So why do most PD patients not respond to CoQ10? Perhaps the cause of the disease is not chemicals as is the generally accepted wisdom and the cause is something else. Or chemicals are a causal co-factor.
The following study features water soluble CoQ10 mitigating the effects of rotenone in a 'in vitro' model of PD:
Just to be sure I understand the part you say I used, does that mean you once used but no longer find useful? Also do you find the supplements to greatly reduce your symptoms or mainly slowing progression? Always appreciate your comments and insight!
First, I only had symptoms prior to being treated with supplements. And after supplementation the symptoms went into remission. This is one of the main points of my posting: why am I doing so well since I was exposed to massive amounts of chemicals/fertilizers/herbicides/algaecides/insecticides which have been linked to causing PD? Most people only get trace amounts of pesticides through foods but I had direct exposure with near clinically-sized doses (and fully recovered). In the second part of my documentary I seemingly obsessed over PD being caused by microbes: bacteria + viruses. I compared by experience with my father who had PD and our symptoms, symptom progression, problems etc.....where like we had 2 different diseases. That is why I concluded PD was caused by something other than chemicals and they may only be a cofactor to PD development.
I rotate various dopamine producing supplements to gauge their effect on my body and I seem to do best with a mix of 50/50 levodopa/Mucuna pruriens and tyrosine. I rotate supplements in and out to feel them anew to see how I gauge their effects on my body. I went without magnesium threonate for a month and felt my memory deteriorate and I started using it again and am more mentally coherent. I am due to purchase some EGCG and take it with my levodopa/tyrosine concoction.
Rich thanks so much for your post. Couple questions: when you say 50/50 L-Dopa Mucuna I am reading that as 50% L-Dopa MP extract. I am assuming you are not taking pharmaceutical L-Dopa, is that correct?
Second, I take a similar supplement regimen but am hesitant to add L-Tyrosine because I am also on Selegiline and am concerned about the “cheese effect”. Any thoughts on that?
One more- I just started taking Allithiamine daily 50mg, have you researched that and is there any danger of over dosing at that level?
I don't take Sinemet. I could have taken my father's stash after he died, he had PD, but I just let my mother recycle them.
Good move by not using tyrosine with selegiline because it may trigger a blood pressure shift.
Even though Allithiamine is fat soluble you should be fine. Just monitor your body and if you feel side effects cut back on it. Benfotiamine is also a fat soluble form of thiamine and at large doses it has been shown to be safe.
Rich - what is your total L-Dopa (from Mucuna) intake per day? I’ve seen recommended max = 1 gram. I’ve been using only Mucuna as l-Dopa source for about a year using 1000mg per day as a guide. mostly that’s been good but sometimes seems like not enough. Any thoughts?
Fortunately I do not need as much/frequent levodopa as others do on this site. The damage to my dopamine producing neurons (I am L-dopa responsive) is less than most people here and my condition is non-progressive, thus the lower dose. I have taken in the range of 400 - 1,000 mg/day of levodopa from mucuna pruriens either alone or in conjunction with other supplements like EGCG, quercetin, quercetin/bromelain, L-tyrosine, phenylalanine, vitamin C and fish/salmon oil. I only need to take levodopa twice a day: upon waking and at 4PM. The concentrations of
M. pruriens I have taken range from 15% levodopa, 50% levodopa and 100% levodopa. Of all the concentrations
I like 50% levodopa the best because it contains various alkaloids from the plant and thus has multiple physical applications.
"Its seeds contain the alkaloids, mucunine, mucunadine, mucunadinine, prurienidine and nicotine, besides β-sitosterol, glutathione, lecithin, vernolic acid and gallic acid.
They posses a number of other bioactive substances, including tryptamine, alkylamines, steroids, flavonoids, coumarins, cardenolides and metals like magnesium, copper, zinc, manganese and iron."
"Its different preparations (from the seeds) are used for the management of several free radical-mediated diseases, such as rheumatoid arthritis, diabetes, atherosclerosis, nervous
Everyone on HU has different levodopa requirements and it takes a lot of experimentation to find the 'sweet spot'. One easy way to improve how effective any form of levodopa is is
by adding 200 mg of vitamin C every time you take levodopa. Apparently it improves the absorption of levodopa:
The Effect of Ascorbic Acid on the Pharmacokinetics of Levodopa in Elderly.
"In conclusion, AsA can improve LD absorption in elderly PD patients with poor LD bioavailability. LD therapy in combination with AsA may be one of the strategies for
[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."
If mucuna is working for you in a dry form there is no need to liquify it though you can drink Zandopa. And the above formula can be used with natural or synthetic levodopa.
Another possible way to improve levodopa absorption is to add some quercetin to the mucuna + vitamin C. Quercetin has COMT activity like Entacapone but Quercetin has not been tested to see its inhibitory strength is compared to
Entacapone so optimal dose strength is unknown. Experimentation is needed again.
Quercetin may serve as an effective adjunct to L-dopa therapy in Parkinson's disease.
"Quercetin, a flavonoid present in many plants, is reported to inhibit COMT and MAO activities, the key enzymes involved in the metabolism of dopamine."
Let's just say that you did use M. puriens levodopa with EGCG, quercetin, vitamin C and salmon/fish oil, how do you know EGCG is working? Obviously if it helps you move properly and it should make you feel less anxiety. EGCG has chemical action similar to the anti-anxiety med Librium:
Rich - thank you for your detailed reply. Your posts, and your extensive research, have been an invaluable help to me, and I am sure many others on this forum. The path to treating PD naturopathically is fraught with difficulty, uncertainty, and, one might say, potential danger. You are a guiding light to many of us who are attempting to navigate the uncharted waters. Please keep up the good work, and keep sharing.
I buy supplements in bulk so they are not really that expensive. One month of CoQ10 costs me about 20 dollars. That is affordable....I buy coq10 when it is buy one get one free....
Who are your preferred suppliers and are any of these taken in combination? How does the pill taking regimen work? Spread out during day? Should some be taken at the same time for better absorption or avoided because they conflict with other?. I read your threads with awe. Thanks
Nutrabio, a weightlifting supply company, only makes pharmaceutical grade products. I have had good results with Swanson, Vitacost and Dr. Lam's Supplement Clinic. There are other good suppliers but I have little money and have to buy supplements in bulk.
After breakfast I take:
400 mg coq10 (+ 400 mcg piperine)
910 mg fish oil (EPA, DHA contents listed in the original post)
100 mg niacin
500 mg niacinamide/nicotinamide
After Lunch:
400 mg coq10 (+ 400 mcg piperine)
910 mg fish oil (EPA, DHA contents listed in the original post)
100 mg niacin
500 mg niacinamide/nicotinamide
10 mg piperine (to potentiate all the other supplements)
200 mcg selenomethionine
22 mg zinc piccolinate
100 mg thiamine
100 mg riboflavin
5 mg methylcobalamin
1,000 mg Milk thistle
3,000 mg vitamin C
400 mcg methyltetrahydrofolic acid
600 mg n-acetyl l cysteine
Think of it this way. I have divided a multivitamin into its most important parts and take what is only best for me. Some B vitamins like pantothenic acid are like chicken soup - they can't hurt but have little evidence associating PA with any disease. Even celery is a good source of pantothenic acid.
910 mg fish oil (EPA, DHA contents listed in the original post)
100 mg niacin
500 mg niacinamide/nicotinamide
Before bedtime.
500 mg magnesium threonate
200 mg L-theanine
250 mg baicalin
400 mg Full Spectrum Skullcap
In my opinion Scutellaria Baicalensis (Skullcap) and its components, is the best medicinal herb available. I think it is much better than tumeric/curcumin.
First study:
Baicalin may have a therapeutic effect in attention deficit hyperactivity disorder.
"Animal experiments showed that it protects dopaminergic neurons in the striatum, hippocampus and substantia nigra. It also has effects such as anti-depressive and anti-epileptic and offers resistance to Parkinson's disease. Attention deficit hyperactivity disorder (ADHD) pathogenesis is closely related to dopamine deficiency. However, the therapeutic effect of baicalin in ADHD has not been studied. We hypothesize that baicalin may protect dopaminergic neurons and increase brain dopamine levels, thus serving as an effective novel treatment for ADHD."
In another study I read it stated that tumeric has only 5% curcumin in it. Considering that curcumin is not well absorbed and has to be paired with large doses of piperine or has to be made in a liposomal form to ensure some absorption, I will stick with S. baicalensis because it is cheap and effective. Recently I had the flu and guess what? Baicalin/S. baicalensis has been used in China to fight the flu for centuries.
Hi rick, I just looked again at your supplements and I wondered what is the difference between the after lunch lot and then the between lunch and dinner? Do you take the R lipoid acid mid afternoon or at a different time to the main after lunch ones? Thanks Deb
If you look at the list of supplements I take at lunch it could be categorized as a multi vitamin on steroids. Multi vitamins usually have small doses of various vitamins, minerals and amino acids in a pill. Rather I take large doses of the supplements (multiple pills) in conjunction with 10 mg of piperine. Piperine is a bio-enhancer which has been used by pharmaceutical companies to enhance many different antibiotics and an Indian company uses piperine with the TB antibiotic rifampicin. By using piperine with rifampicin the antibiotic dose can be lowered so there are less side effects with better effectiveness.
Dietary supplements like curcumin/tumeric and resveratrol have also been augmented by piperine because they both are poorly absorbed in the gut.
Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. "
Concomitant administration of piperine 20 mg produced much higher concentrations from 0.25 to 1 h post drug (P < 0.01 at 0.25 and 0.5 h; P < 0.001 at 1 h), the increase in bioavailability was 2000%."
The study which featured using 20 mg of piperine with curcumin actually go over the daily recommended limit of piperine. The company which produced Bioperine recommends 15 mg/day divided into 3 doses of 5 mg per day. And there is a danger in using piperine/Bioperine. If you take it with a drug which, say, lowers your blood pressure you could experience a massive blood pressure drop which could hospitalize or kill you. Taking piperine/Bioperine with a dopamine agonist is dangerous because those drugs are dangerous enough and can cause impulse disorders and orthostatic hypotention - your blood pressure rapidly drops. I take it without any worries because I am not taking any drugs so it has no side effects. I take the largest dose of supplement at lunch because it is the biggest meal of the day.
As for alpha lipoic acid I have been using it in conjunction with acetyl l carnitine because they potentiate each other's chemical actions and can be used in lower doses. Here is a Parkinson's disease ALA/ALCAR study:
Combined R-alpha-lipoic acid and acetyl-L-carnitine exerts efficient preventative effects in a cellular model of Parkinson's disease.
"Most notably, we found that when combined, LA and ALC worked at 100–1000-fold lower concentrations than they did individually."
Acetyl-L-carnitine and α-lipoic acid affect rotenone-induced damage in nigral dopaminergic neurons of rat brain, implication for Parkinson's disease therapy.
"Treatment with acetyl-L-carnitine or α-lipoic acid improved the motor performance and reduced the level of lipid peroxides in rat brains as compared to rotenone group. Further, ATP production was enhanced along with acetyl-L-carnitine treatments (p≤0.05). Taken together, our study reinforces the view that acetyl-L-carnitine and α-lipoic acid are promising candidates for neuroprotection in Parkinson's disease."
I take larger doses of them together for use as a nootropic - a supplement which enhances learning and memory. I have tried taking the supplements all at once, 600 MG ALA, 1,000 mg ALCAR or at smaller divided doses, 300 mg ALA + 500 mg ALCAR twice a day, and prefer the twice a day regimen. I take them about 30-45 minutes before I eat a meal because when taken on an empty stomach ALA will lower blood sugar levels and make me want to eat sweets - something which I avoid. So I take the combination then eat to satiate my enhanced hunger.
ALCAR + ALA for diabetes and cognitive enhancement:
There is some evidence that the amino acid L-theanine also modulates BDNF.
"Furthermore, pretreatment with L-theanine significantly attenuated the down-regulation of brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) production in SH-SY5Y cells."
Thank you Richard for sharing your supplements' list with us. Could you please tell which one (or the combination) of the 3 forms of CoQ10 did you use? And also, have you ever considered propolis as MAO inhibitor? I didn't do well on Rasagiline and now am searching for natural MAOI.
I respond to every form of CoQ10 the same way so I buy standard ubiquinone (+ 400 mcg of piperine) from the local supermarket. PQQ, ubiquinol or ubiquinone? It is all the same to me so I take the cheapest brand.
A good natural MAO-b inhibitor is Polygonum multiflorum and outside of purchasing pharmaceutical grade PM from China, this is the best brand available.
Thanks Richie, So appreciate your time to post all these things. Can you pls let us know the suppliers you use and could you also possibly just give your top 10! I don't think I ll be able to convince my hubby to take all that!! Thanks again
There are many good suppliers I know of but am broke and have to purchase my supplements at the local grocery store. Fortunately their brand of CoQ10 combines CoQ10 + piperine. Same story about my fish oil.....the supermarket.
Piperine makes other supplements more bioavailable to the body. The following is a video about an antibiotic called Risorine. Risorine is a combination of rifampicin and piperine.
You message is hard to follow, but by my calculation you are taking 32 suppliments a day?
How can you possibly tell which are helping, which are harming and which are doing nothing?
I suggest anyone thinking of emulating you should take one supplement at a time, for at least two weeks, then assess any improvement, before trying another.
You can definitely disregard this post and not take any supplements for pd and just resign to your fate quietly. But don't start making ad hominem attacks against the poster. If you just click on silvestrov and check his previous posts, you generally can tell he's not really doing any of the things you accuse him of.
It's funny you would rather argue with me than simply clicking through all his previous posts, to check if he's doing any of the things you accuse him of.
And i could ask the same of you too. Feel free to provide actual proof that he owns a business in Swanson, Nutrabio, Vitacost, Dr. Lam's supplement clinic or his local supermarket peddling his wares here
First Rich let me say thanks for sharing and congrats on getting yourself symptom free! I don't have PD but rather SCA1, but I, too, have made myself symptom free.
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Comment and question: I feel like you are taking a lot of unimportant supps. Have you ever considered stripping one out at a time to see if you notice anything? I'm a huge believer in "all things in moderation" although my list of supps is getting longer by the day as well since I want to be sure I keep my symptoms at bay forever.
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Also, have you examined the studies on NR versus NAM. Taking Niacin and NAM are a) duplicating the same chemical reaction in your body and b) could be accomplished in a safer fashion with just NR which is a SIRT1 activator instead of an inhibitor?
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Anyways, just curious, and again thanks for sharing!!
In the following article, if you can get the complete article, it states the niacin and niacinamide/nicotimamide have different methods of neuroprotection. I quoted this information in my documentary.
Parkinson's disease: The first common neurological disease due to auto-intoxication?
Niacin and nicotinamide are very different supplements with different treatment profiles. Niacin effects cholesterol and nicotinamide does not. Niacin causes flushing and nicotinamide does not.
I take supplements which have been tested and shown to relieve my specific medical needs. I fought off osteoarthritis and one of my tools is niacinamide/nicotinamide:
The effect of niacinamide on osteoarthritis: A pilot study
"This study indicates that niacinamide may have a role in the treatment of osteoarthritis. Niacinamide improved the global impact of osteoarthritis, improved joint flexibility, reduced inflammation, and allowed for reduction in standard anti-inflammatory medications when compared to placebo."
I discovered these supplements individually and took them one at a time. Some I felt immediate improvement and others were to compliment each other and have been shown to fight chemically-induced parkinsonism.
I previously looked into NR and don't need to use costly NR because my current regimen costs me 1,300 a year and do not need to add anything else. How much would you pay to be perfectly healthy and able to work?
As for nicotinamide being a Sirt1 inhibitor I tried taking resveratrol/pterstilbene (Sirt 1 activator) for about 4 months - 3 years ago, and perceived no improvement - nothing, on any level, so I stopped using it. I do not have HIV or TB but nicotinamide is a possible therapy for these diseases.
Nicotinamide: An Oral Antimicrobial Agent with Activity against Both Mycobacterium tuberculosis and Human Immunodeficiency Virus
If you buy niacin then you should feel flushing as caused by vasodilation.
If you are taking riboflavin does your urine should be
orange/yellow.
I use nicotinamide for several reasons one of which is to keep my joints flexible. I fought off osteoarthritis and this is what nicotinamide does for your joints:
"Niacinamide improved the global impact of osteoarthritis, improved joint flexibility, reduced inflammation, and allowed for reduction
in standard anti-inflammatory medications when compared to placebo."
Baicalin and S. baicalensis have a sedative effect and I have taken them in the day time and I had to fight off sleep. At night they help me sleep and baicalin/S. baicalensis should be taken before bed.
I take magnesium threonate as part of my sleep time 'stack' and it helps me sleep and sharpens my mind. I went off of it for a month and found myself going into a room forgetting why I went there. Once back on it I mind was sharp again.
Acetyl l carnitine (ALCAR)/alpha lipoic acid (ALA) - along with magnesium threonate, are considered nootropics - supplements which enhance memory and learning, and after I take ALCAR/ALA I can feel it in my brain.
Due to bioavailablity issues and the cost it takes to
enhance the bioavailabilty of curcumin/tumeric I have never tried tumeric.
After much searching I concluded S. baicalensis is the
best medicinal herb due to its flexibility, effectiveness in treating a number of conditions and it has been clinically studied thousands of times. The components of S. baicalensis, with baicalin as its
major component, does nearly everything.
Plus it is cheap and when you add up
the cost of baicalin + S. baicalensis
it comes to 0.12 US cents per day. For a month
that comes to 3.60 USD. Compare that to the price
of curcumin + piperine and this price ranges
from 14.99 to 45.00 a month. So S. baicalensis
is a big cost savings.
Why S. baicalensis/baicalin? It's anti-inflammatory effect is the same as ibuprofen:
"Pre-or post treatment with the same dose (30 mg/kg IP) of baicalin or ibuprofen, a nonsteroidal antiinflammatory drug (NSAID), had a similar analgesic effect."
Baicalin may have a therapeutic effect in attention deficit hyperactivity disorder
"Animal experiments showed that it protects dopaminergic neurons in the striatum,
hippocampus and substantia nigra. It also has effects such as anti-depressive and anti-epileptic and offers resistance to Parkinson’s disease. Attention deficit
hyperactivity disorder (ADHD) pathogenesis is closely related to dopamine deficiency."
"The results indicate that baicalin may induce apoptosis and inhibit proliferation of prostate cancer cells, and has direct anti-tumor effects on human prostate cancer cells."
Rich, thanks so much for taking the time to list all the supplements . I am taking Rasagaline -would tyrosine be the only supplement that could cause a problem with this drug? Thanks
You need to be careful when taking herbs because many have MAO activity - either MAO a or b. Polygonum multiflorum/foti/He shou Wu has MAO-b activity and has been shown to be neuroprotective in PD, and it should be avoided when taking Azilect. St. John's Wart is another herb to skip....if you are thinking about taking a herb just research it first. Sometimes only a component of an herb has MAO activity and the other components do not. So taking a solitary fraction of a herb may be fine, but not the whole herb.
"AZILECT is contraindicated for use with meperidine, tramadol, methadone, propoxyphene and MAO inhibitors (MAOIs), including
other selective MAO-B ihibitors, because of risk of serotonin syndrome [See Warnings and Precautions (5.2 )]. At least 14 days should elapse between discontinuation of AZILECT and initiation of treatment with these medications."
The article above lists many drugs including the cough medicine dextromethorphan. Such a benign drug could cause you major problems.
Anti-depressants need to be avoided whether it be a SSRI, tricyclic anti-depressants or drugs like Wellbutrin/buproion which have noradrenaline reuptake activity. Considering these drugs are prescription your Dr. would not give them to you.
Both Wellbutrin and the tricyclic anti-depressant nortriptyline have been benefited PD patients or has been shown to be neuroprotective in PD studies.
Supplements like 5-HTP and tryptophan which raise serotonin levels should be avoided also.
5-HTP:
"Side-Effects/Warnings: Side effects are uncommon and may include headache, upset stomach, and heartburn. NOTE: Should not be used by those taking antidepressants, especially MAOIs."
PS. Do not take piperine/Bioperine with Razilect because it causes other drugs/supplements to work more effectively and it may induce high blood pressure.
What do you recommend to increase effectiveness of mucuna ? I used to take mucuna every 4 to 6 hours between doses but lately I need it more frequently 2 to 3 hours I’m wondering how to extend the mucuna effect on my symptoms ? Thanks!!!
There are a number of adjuvant supplements which can be added to (any form of) levodopa to make it more effective.
The simplest supplement to add to levodopa is 200 mg of vitamin C. Apparently vitamin C aids in the absorption of levodopa: researchgate.net/publicatio...
Though they do not mention the amount of vitamin C it is 200 mg because in another study, 200 mg per dose (1,000 mg/5 doses) is used: ncbi.nlm.nih.gov/m/pubmed/7...
Secondly, adding EGCG and/or quercetin with the vitamin C may help. The following is a product from the Swiss Herbal Institute which combines EGCG, (600 mg = 300 mg green tea polyphenols + 300 mg EGCG) with 300 mg levodopa. This site is in Polish and if you have a cell it will translate the page. If you are sitting in front of a desktop which will not translate the page the bottle's label is in English:
I am not suggesting you replace your brand of mucuna for this brand, but EGCG can be added to what ever brand you are using. Which brand are you using?
The above supplement is a great idea but does the included EGCG confirm to the following article entitled: Epigallocatechin-3-gallate (EGCG) for Clinical Trials: More Pitfalls than Promises? ncbi.nlm.nih.gov/pmc/articl...
To summarize the article: The EGCG must be at least 94% pure. To increase the absorption of EGCG 200 mg of vitamin C and 1,000 mg of salmon/fish oil are taken with the polyphenol.
The first dose of EGCG must be taken after an overnight fast - upon waking and at least 1/2 hour before breakfast. The second (and final) dose of EGCG (vitamin C, salmon/fish oil) is to be taken at least 4 hours after lunch and at least 1/2 hour before dinner. These times coincide with taking levodopa as a part of PD therapy. In the above study people were given 400 mg of EGCG in the morning and afternoon for 800 mg all day.
How do you know if the EGCG is being absorbed? EGCG has anxiolytic effect and it will relax you. The first time I took it I felt a feeling of warmth in my head and a sense of well being. Sounds hippy dippy but there is a scientific basis for this observation. EGCG effects the human brain in the same way as the anti-anxiety medication Librium/chlordiazepoxide:
"Moreover, EGCG and chlordiazepoxide fully generalized in substitution studies, indicating that they induced indistinguishable chemical states for the brain."
EGCG has both COMT activity and MAO-b activity so if you are on an MAO inhibitor like Azilect or Selegiline, you may need to be careful.
In addition to having poor bio-availablity, EGCG is prone to methylate and quercetin, another component of green tea, reduces EGCG methylation.
Quercetin increased bioavailability and decreased methylation of green tea polyphenols in vitro and in vivo. ncbi.nlm.nih.gov/pmc/articl...
Quercetin can be taken up to 4 times a day and let's just say you go on EGCG, Vit C, Mucuna/levodopa twice a day and you take levodopa 2 more times a day, quercetin + vitamin C can accompany those doses.
Quercetin's COMT activity has been tested in a drug-induced PD model and,
"In conclusion, the findings of the present study strongly suggest that quercetin can be screened as a potential drug candidate or as an adjuvant for the treatment of neuroleptic-induced extrapyramidal side effects."
As in any perceived garden of eden there is a snake, and for EGCG, it is possible liver complications. EGCG has been associated with liver damage and this has happened to (mostly) dieters. Athletes use EGCG and I have never heard of a case of liver damage occurring. I wrote about the Dangers of EGCG on HU:
If you feel squeamish in using EGCG at high doses, you can counter balance it (and protect your liver) with N-acetyl cysteine, Silymarin/Milk thistle, alpha lipoic acid or theanine.
thanks for the very informative post. Just one additional information required on the following combinations(whether they are safe, if not what side effects are possible )
Back in the era (prior to the addition of carbidopa/benserazide to levodopa), there was a multivitamin called Larobec which lacked pyridoxine. Carbidopa binds to pyridoxine related enzymes to prevent the conversion of levodopa to dopamine in the body. Being chaperoned by carbidopa/benserazide, levodopa can reach the blood brain barrier then pass through it and then converted into dopamine in the brain and central nervous system. The dose of levodopa was lowered from 2 - 6 grams, to, at most, 1.5 grams a day. My father had PD and he took (high dose) 4 × 25/250 Sinemet every day. Since you are (or are willing to experiment with) taking M. Puriens/levodopa you should not take pyridoxine/pyridoxyl 5 phosphate because it will increase the conversion of levodopa in the body and worsen your condition. Here is a Larobec link:
Your major concern is if any of the herbs listed, quercetin/EGCG, could interact with Selegiline and cause a hypertensive crisis (which could hospitalize or kill you.) As for using EGCG with Selegiline I consulted a EGCG/Multi System Atrophy trial - a Parkinson's+ syndrome, and here are the in/exclusion criteria:
Progression Rate of MSA Under EGCG Supplementation as Anti-Aggregation-Approach (PROMESA)
Inclusion Criteria:
"clinical possible" or "clinical probable" MSA (Gilman et al., Neurology, 2008 26;71:670-6)
Hoehn & Yahr stage I – III
A stable regimen for at least 1 month prior to V1 and willingness / no fore-seeable need to change the regimen throughout the 52 week follow-up period for drugs acting against Parkinsonism (e.g. Levodopa, Dopamine-Agonists, Amantadine and MAO-B-Inhibitors)
drugs acting against autonomic dysfunction (e.g. ephedrin, midodrin, fludrucortison, octreotide, desmopresin, oxybutinine) antidepressant and antidementive drugs.
No regular consumption of EGCG, green tea, or more than two cups of black tea per day
Capability and willingness to give written informed consent indicating that the subject has been informed of and understood all aspects pertinent to the study
Capability and willingness to comply with the procedures of the study
Contraception by adequate contraceptive methods (oral, injected or im-planted hormonal contraceptive methods, intrauterine pessar, sterilisation or real abstinence) in all female patients with childbearing potential
Absence of liver disease documented by transaminases and bilirubin below 2-folds of the upper normal level.
Exclusion Criteria:
Hoehn & Yahr stage > III (loss of postural reflexes, no independent walking possible, inability to stand unassisted, wheelchair-bound).
Neurodegenerative diseases other than MSA
Severe liver disease with elevation of transaminases and bilirubin above 2-folds of the upper normal level or regular intake of hepatotoxic drugs
Known hypersensitivity to EGCG or to drugs with similar chemical structure
Participation in another clinical trial involving administration of an investigational medicinal product within 1 month prior to V1
A physical or psychiatric condition, which at the investigator's discretion may put the subject at risk, may confound the trial results, or may interfere with the subject's participation in this clinical trial
Persistent abuse of medication, drugs or alcohol
Consumption of > 500 ml grapefruit juice per day (leading to inhibition of cytochrome P-450 isoenzyme 3A4, which may be involved in degradation of EGCG).
Current or planned pregnancy or breast feeding in females
Females of childbearing potential, who are not using medically reliable methods of contraception for the entire study duration (such as oral, inject-able, or implantable contraceptives, or intrauterine contraceptive devices).
Intake of COMT-inhibitors (e.g. Entacapone, Tolcapone)
Current or planned therapy with Bortezomib and/ or history of plasmocytoma.
Anemia at Screening (Hb < 10g/dl)
Other severe medical conditions upon discretion of the LKP
According to the the above info it is safe to take EGCG with Selegiline.
Inclusion:
“A stable regimen for at least 1 month prior to V1 and willingness / no fore-seeable need to change the regimen throughout the 52 week follow-up period for drugs acting against Parkinsonism (e.g. Levodopa, Dopamine-Agonists, Amantadine and MAO-B-Inhibitors)”
“No regular consumption of EGCG, green tea, or more than two cups of black tea per day”
Exclusion:
Consumption of > 500 ml grapefruit juice per day (leading to inhibition of cytochrome P-450 isoenzyme 3A4, which may be involved in degradation of EGCG).
In MSA/EGCG study the researchers used pure EGCG without any other components of green tea. Most GT supplements have a large component of, say, 50% EGCG and 50% of the entire green tea herb (which contains other components of GT). So in the whole herbal fraction it contains unspecified quantities of quercetin, kaempferol, luteolin and apigenin, all with MAO-B activity (and were tested in the article below). So there is still a chance the 50% tea fraction could cause a hypertensive crisis when taken with Selegiline. Caution is the name of the game and if you want to try a part EGCG with part total herb, you should go slow and take a low dose of EGCG/total herb to see how you react and then try higher doses later.
Otherwise, Buzz on HU used Swanson's brand and it is nearly all EGCG and he felt the warm, subjective feeling in his head after taking the cocktail. Also, when ever trying something new it is best to just take it slow and try a 'trial dose' once and gauge how your body reacts.
The EGCG/GTE I used was the following: supplements.relentlessimpro... And I consider this supplement to be a drug. It has 409 mg of EGCG but also has an additional green tea component.
When taking supplements of this strength and quality supplements such as Milk thistle/silymarin, theanine, alpha lipoic acid and NAC can be taken for dual reasons: each has been shown to protect the live, be neuroprotective in PD models and have other therapeutic effects. For example L-theanine is great for anxiety: ihpmagazine.com/l-theanine-...
Exclusion:
“Severe liver disease with elevation of transaminases and bilirubin above 2-folds of the upper normal level or regular intake of hepatotoxic drug”
I used the full dose of EGCG twice a day but I eventually only used ½ half a capsule with my mucuna pruriens levodopa in the morning and evening. I am not in the need to a large double dose of an anti-anxiety med as strong as Librium. The first time I took it felt like a was taking a prescription medicine – it was a strong yet pleasant experience. One woman tried a 1,000 mg EGCG/Green tea dose with her levodopa and it 'demotivated' and 'zoned' her out.
My first time dose: 500 mg pure levodopa from mucuna pruriens + 200 mg vitamin C + Relentless Improvement EGCG + 1,000 mg of molecular distilled fish oil. Again, the article specifies salmon oil but high quality fish oil is easier to find that high quality salmon oil.
In the the following study, which compares natural MAO inhibitors to Rasagiline & Selegiline, many herbal MAO-b (s) tested and the 3 best are:
“Out of all compounds screened for MAO-B inhibition potential the lead
Curcumin ranks first with the largest interaction surface of about 1223.91 followed by this
Chlorogenic acid ranks second with 1006.37 and Quercetin ranks third with interaction of
This is a must read for everyone thinking of taking herbal supplements because many herbs have powerful MAO activity and should be avoided by those already taking pharmaceutical MAO inhibitors like Rasagiline/Selegiline. Obviously you cannot use quercetin (with EGCG, levodopa and vitamin C, aslmon/fish oil) or curcumin and chlorogenic acid. Quercetin would cause a hypertensive crisis.
If you drink coffee you may be getting enough of quercetin in your diet. In the article the authors noted that quercetin and not caffeine is the major neuroprotective component in coffee. isoquercetin.net/coffee/
I tinkered with a natural MAOi, Polygonum multiflorum, and decided to abandon its use because I was taking L-tyrosine at the time (and the combo might have caused a hypertensive crisis). Also, some herbs have more or less MAO activity and by not taking a MAOi I can experiement with various herbs and found my favorite - Scutellaria baicalensis. One of its fraction is wogonin and it is a powerful MAOi:
Potent inhibition of monoamine oxidase A by decursin from Angelica gigas Nakai and by wogonin from Scutellaria baicalensis Georgi
Wogonin is only 0.7% of the whole S. baicalensis root. So there is only 3 mg of wogonin in a 400 mg S. baicalensis supplement. The main component of S. baicalensis is baicalin, 10 – 17% of the root, and...
“The antidepressant activity of baicalin may be mediated in part through MAO A and B inhibition in rat brain.” tandfonline.com/doi/full/10...
When consumed baicalin is converted into baicalein and when methylated, baicalein is converted into oroyxlin A which, like the antidepressant bupropion/Wellbutrin, oroxylin A has dopamine reuptake inhibitor activity.
Wellbutrin in contraindicated for use with MAO inhibitors.
So 3 components of S. baicalensis have (2) MAO activity/ (1) dopamine reuptake activity and that is why it is good to be cautious when taking herbs with Rasagiline/Selegiline. Scutellaria baicalensis is not as well known for its MAO activity as herbs like St. John's Wort europeanreview.org/wp/wp-co... or Banisteriopsis caapi sciencedirect.com/science/a...
Many thanks for you’re posts which have been extremely helpful to me. Just a quick question, the supplements you use on a rotational basis, how often to you rotate them, what do you replace them with? Many thanks again for all you’ve time and helpful posts.
Hi, Hope you are doing well. I know you command a lot of respect on this site and it would be great if you could update your list three years on. Any chance? I have been watching your excellent videos and you mention L Carnosine, but this doesn't appear in your supplement list and I wonder why? Regards
Sorry for the late response but we live in strange times and I, like everyone else, have been preoccupied with recent events.
When I wrote this list I was recovering from a sickness after being exposed to a variety of chemicals while being a greenskeeper.
Since recovering from an early Parkinson's-like syndrome, I still take the midday/lunchtime dose and the evening/pre-bedtime supplements.
What changed with my list of supplements was COVID-19. I went online to discover which supplements were best and discovered the following.
Supplements Reviewed (which are available over the counter).
In my opinion the best herbal supplement to take is #1.
1) Olive leaf extract/oleuropein (OLE) - I started taking it due to COVID-19.
2) Quercetin - I am not taking.
3) Zinc - I continue taking.
4) Theanine - I continue taking.
5) NAC - N acetylcysteine - I continue taking.
6) Vitamin D - I continue taking.
In the following article OLE extract is identified as a potential therapy/preventative measure for COVID-19:
Potential Inhibitor of COVID-19 Main Protease (Mpro) from Several Medicinal Plant Compounds by Molecular Docking Study
Preprints (preprints.org) | NOT PEER-REVIEWED | Posted: 13 March 2020 doi:10.20944/preprints202003.0226.v1
Abstract: "COVID-19, a new strain of coronavirus (CoV), was identified in Wuhan, China, in 2019. No specific therapies are available and investigations regarding COVID-19 treatment are lacking. Liu et al. (2020) successfully crystallized the COVID-19 main protease (Mpro), which is a potential drug target. The present study aimed to assess bioactive compounds found in medicinal plants as potential COVID-19 Mpro inhibitors, using a molecular docking study."
"Therefore, nelfinavir and lopinavir may represent potential treatment options, and luteolin-7-glucoside, demethoxycurcumin, apigenin-7-glucoside, oleuropein, curcumin, catechin, and epicatechin-gallate appeared to have the best potential to act as COVID-19 Mpro inhibitors."
Of the listed chemicals 'luteolin-7-glucoside, demethoxycurcumin, apigenin-7-glucoside' are not available for retail sale. Of the remaining I think (again) oleuropein (from olive leaf extract) is the best and I decided to take olive leaf extract.
"Oleuropein is a glycosylated seco-iridoid, a type of phenolic bitter compound found in green olive skin, flesh and seeds, leaves, and argan oil."
Plus, oleuropein is a well-known anti-viral agent..
Antiviral Effect of Oleuropein
"Oleuropein exhibits antiinflammatory, antimicrobial, and antiviral effects. Oleuropein is patented for antiviral activity against various viral diseases,
such as herpes mononucleosis, hepatitis virus, rotavirus, bovine rhinovirus, canine parvovirus, and feline leukemia virus, in the United States.89
Oleuropein also exhibits antiviral activity against parainfluenza type 3 virus and respiratory syncytial virus."
In addition to olive leaf extract being a possible COVID-19 drug therapy because of “COVID-19 it is also and ACE inhibitor...
“Olive Leaf Extract: A Natural ACE Inhibitor", plus it: "Natural Extracts Lower Blood Pressure"…so do not take it if you are taking medication which lowers your BP. lifeextension.com/Magazine/...
“Of 178 patients with data on underlying conditions, 49.7% had hypertension, 48.3% had obesity, about 35% reported chronic lung conditions such as
asthma, and diabetes mellitus and cardiovascular disease were seen in 28% each, reported Shikha Garg, MD, of the CDC, and colleagues in an early
Hypertensive patients on ACE inhibitors and angiotensin receptor blockers may have improved COVID-19 prognosis - Apr 9, 2020
“As explained in the article, all the current evidence points to the conclusion that RAAS inhibitors substantially reduce mortality rates in cardiovascular disease and are actually fundamental for dealing not only with hypertension but also heart failure. Therefore, treatment with ACEIs or ARBs should be initiated or maintained in patients, regardless of COVID-19 status.”
The effect of angiotensin converting enzyme inhibitors and angiotensin receptor blockers on death and severity of disease in patients with coronavirus disease 2019 (COVID-19): A meta-analysis
“Compared to patients with COVID-19 not on ACEi/ARB, there was a statistically significant 43% reduction (OR 0.57, CI: 0.37-0.88, I2: 0.000) in the odds of death in those on ACEi/ARB.”
Discussion: “It is safe to use ACEi/ARB in patients with COVID-19 requiring these medications for associated comorbidities. Although limited by confounding factors typical of a meta-analysis of retrospective observational studies, our data suggests that use of these medications may reduce the odds of death. Conclusion: Our meta-analysis of the updated studies on SARS-CoV-2 reassures the medical fraternity on the use of and continuation of ACEi/ARB, supporting all recent recommendations.”
Theanine is a non-protein forming amino acid derived from the Camillia Sinensis plant - the tea plant which white, green, black, oolong and Pureh tea (s) are derived. And all contain theanine and this amino acid boosts the immune system to produce gamma delta T cells.
Scottish firm to trial T cells as possible COVID-19 treatment
"TC BioPharm (TCB) said it would conduct the trial at the Edinburgh Royal Infirmary, using gamma-delta T cells in a technique it has previously used on cancer patients."
"We know from other studies that these gamma-delta T cells in the blood are the first line of defense against many types of bacteria, viral, fungal and parasitic infections," he said. "They even have some anti-tumor activity."
Local doctor says COVID-19 patients noticed results with glutathione
“The scientific literature has shown that there are three nutritional supplements, something that is very easy, not expensive, and easy to find. They’re
called NAC, alpha lipoic acid, and glutathione,” said Dr. Horowitz."
Everyone has their favorite herbal supplement and many here take curcumin. Compared to OLE I did not think it was as good for COVID-19 but there are studies regarding curcumin and covid:
Curcumin (a constituent of turmeric): New treatment option against COVID-19
Curcumin is a component of tumeric but it should be noted that the curcumin component of tumeric constitutes 3.14 to 5 percent of the herb. So if you are going to take curcumin take a tumeric supplement with a higher percentage of curcumin (plus the added component of piperine - it increases curcumins bioavailability).
If you forget about the dosage of the individual supplements I am taking (and if you just combine them), you would have a multi-vitamin, multi-mineral combination (with larger doses than a standard multi-whatever).
Minerals = Magnesium, Selenium, Zinc (and I cannot remember if it is listed, Iron, because I have the 'trait' of Type 2/Mediterranean anemia - only 1 parent: medicinenet.com/mediterrane.... I did not choose all the minerals available, only the ones which I felt were essential.
B complex: B1/thiamine, B2/riboflavin, B3/niacin, B6/(P5P)pyridoxine, B9/(methyl)folate, B12/(methyl)cobalamin.
There are many multi-vitamin/mineral supplements which have vitamins and minerals in them.
Other amino acids/enzymes like NAC, .... are added to the mix along with piperine (at lunch) because it makes the rest of the supplements more bioavailable: easihealth.co.za/wordpress/...
Most CoQ10 is fat soluable hence combining it with DHA/EPA omega fatty acids (and they are commonly combined in the same supplement): duckduckgo.com/?q=coenzyme+...
I do not think calcium is that important of a supplement for me because I consume enough calcium-rich foods in my daily diet. Though a calcium supplement may be appropriate if you do not eat dairy, especially cottage cheese, because it interferes with absorption of L-dopa:
"If I notice an absorption problem relating to protein, what foods should I avoid when I am taking my scheduled dose of levodopa?"
"Foods that are high in protein and should be avoided in large servings include:High protein milk products (including yogurt, ice cream, butter, cheese, and cottage cheese) a little in coffee or tea, or on cereal is usually OK"
If you are taking a magnesium/calcium supplement it is best to take it furthest away (a meal) from your dose of L-dopa (synthetic or natural) as you can:
Effects of magnesium oxide on pharmacokinetics of L-dopa/carbidopa and assessment of pharmacodynamic changes by a model-based simulation
That is a question which requires investigation. I will look into it... After I answered your supplement query I finished my painting, had phone problems (resolved) and now the computer geeks who upgrade website programs (and then let you figure out the problem), have upgraded a PHP file loader on my website so all the image gallery is unavailable (so I have to figure out how to upgrade it). Oh well..... here is the painting: richardmelvin.com/galleries...
Really appreciate all the details - especially the olive leaf extract, as I hadn't heard that one in relation to Covid (and am taking it already, like quercetin). Your painting is stunning, thank you. I am desperate to get to the sea, and that has calmed my need. I can imagine walking in that.
Hot off the press: Post-COVID lockdown I started working in an art gallery and, unfortunately, 18 people at a recent opening tested COVID-positive (4 of the people I had close contact with), so I got tested....and the results are, I tested negative! Now I know I was not an asymptomatic carrier..... The question is did my anti-covid supplement list have anything to do with the result or did I just get lucky?? Either way the test result is good stuff!!
I, on the other hand, took covid in April, working in a flower shop, symptomatic of a slight fever for two days. We share some vitamins, a great desire to live and a love of beauty.
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If you're trying to follow Dr. Mischley's DHA for dyskinesia protocol, please read this REGARDING DOSING
URIDINE: Why LD/CD Users Should Consider It
Laurie Mischley on Using High DHA Fish Oil to Reduce Levodopa-Induced Dyskinesia (Updated) 
