This is a question that I have heard different answers for in different places on the web, but never was quite sure what the exact reason was, but I have noticed that there is a group who believes that Carbidopa itself can be a problem and would prefer alternatives to Carbidopa while some people use an active component from green tea called EGCG as a substitute for the Carbidopa and especially if they are already using Mucuna Pruriens in one form or another.
I found one short answer to the above question that is the title of this post and here is a link to that very brief answer :
This is just one answer and may not be the only reason, but it is clearly one reason for the addition of Carbidopa to Levodopa that I am hoping to clarify for those who are wondering.
To add further to the general topic of L-Dopa / Sinemet/ Sinemet CR / Rytary, etc. here is another link to that subject which expands on that specific topic and answers some important questions that I have seen about the use of Sinemet on this forum :
It is such a common question, I thought it deserved a post of its own, plus I am interested in the second link because it answers questions about CL I have heard so many times on this forum regarding some of the ins and outs of CL/Sinemet, so if that helps any forum members to get a better understanding of reasonable expectations with the common usage of CL in its many forms, then that is a very good thing!
Husband has lost a lot of weight (45 lbs), and that is a huge problem! When he was diagnosed (18 months ago) he went on a keto diet and lost about 30 lbs. We were both very happy, but when he continued losing weight, we got very worried. . . I know there could be a number of reasons for his losing more weight. Dr. Mischley says some (all?) PwP don't produce enough gastric acid and that is the reason for weight loss. IOW, Gastroparesis. She recommended soft foods. On the other hand, taking MP with 1/2 t carbidopa could also cause weight loss. To top it all, his recent stent and near fatal complications (face and neck hematoma/ edema) most likely contributed to more weight loss, as he could not eat (no appetite) during his 5-day hospital stay, most of the time in the critical care unit! Of course, when I picked copies of records, the procedure report listed: COMPLICATIONS: NONE!
I am sorry to hear that your husband has run into a wall of medical complications. Hopefully he can get back on the track to better health soon!
If Dr. Mischley is correct about your husband and lower hydrochloric acid production, she should probably go ahead and test him for that issue as it is a relatively easy non-invasive test and the fix is relatively simple also. It is not just PWPs that have low HCL production as it is quite common in us seniors as we age and the fix is not too complicated if insufficient acid is actually the case. That acid does more than help the digestion process, it also kills some bad bacteria, so having inadequate production is not something to discuss and leave unchecked, it should be dealt with appropriately and sooner than later!
The right type of Medical Marijuana can have a positive effect on appetite, but if I remember correctly it may not be an option in your location? There must be a way around that problem if it is one for you.
Thanks, Art! Your advice and wisdom have been so helpful and certainly missed for a while. . .
She never recommended that test and I will email her to ask about the specific test. If you know exactly what to ask for, I can ask/have our GP order it.
You remember correctly, MM is still illegal in my state. I certainly will try to find a way to have him try it. . . he wants that, too.
Despe, I have described that test before on this forum, but finding that post now would be like looking for a needle in a haystack.
Briefly, it entails taking increasing amounts of hydrochloric acid (Betaine HCL with Pepsin) "with each meal" until heartburn or heat discomfort is first felt and then you use baking soda water to neutralize the excess acid. At your next meal, you take one capsule less of the hydrochloric acid and this is your dose until the heartburn or heat discomfort returns and once it returns you neutralize the excess acid with baking soda water again. At your next meal, you once again take one less HCL capsule and this is your new dose. Repeat the process until no more Betaine HCL capsules are needed. I do not understand the science, but proponents of this method claim that this is one way to help retrain your body to produce enough hydrochloric acid for proper digestion, ameliorate GERD and also help repair the valve that is often leaking from too little acid production of which I do not remember the name right now. When I did this experiment, it worked just as outlined above and I was able to stop the Betaine HCL supplementing fairly quickly. These Betaine HCL capsules are available in varying doses and I chose to use a low dose capsule. It takes a little longer with the low dose capsules, but I felt it would offer me a bit more versatility in finding a more precise way of adjusting the Betaine HCL dose.
Oddly this is the opposite of what doctor's often do with their prescriptions of proton pump inhibitors like Prilosec that I believe actually reduce acid production
and can cause other health problems.
If heartburn develops at the first dose, then low acid is probably not the issue and it should be neutralized immediately with baking soda water and the test discontinued. One thing that I noticed is that meals with high red meat content were digested much easier once I had gotten to no more Betaine HCL capsules needed or during the test period itself while supplementing with the Betaine HCL.
Check with Dr. Mischley to be sure first and then proceed under her guidance or your regular doctor's guidance. You should also be able to find more exact directions on the web, I'm just giving a general outline of what I did for myself to do this test. I have repeated this process a couple of times when I felt I may be having heartburn issues and it worked about the same way each time. The effect is lasting,
well at least it is for me and others I have read about. The capsules I used were inexpensive and only had 325 mg of Betaine HCL with Pepsin 1:3000 at 82 mg.
Notice that the capsules at the link below have 650 mg of Betaine HCL or double what I used per capsule :
Thanks, Art! Cleveland FM doc prescribed Betaine HCI with Pepsin (PURE) and asked him to take two capsules after each meal. He has been doing that with short brakes. Dr. Mischley also asked him if he takes it but said nothing further. I will look into the test you mentioned and have him do it. He hates to take vitamins, says he takes too many.
Well, if the method I mentioned works for him, then the capsules will only be needed temporarily so no need to fret about too many supplements for long. The supposed idea is to retrain the body to do something it normally should be able to do on its own. The doctor seems to be only adding enough betaine hcl indefinitely instead of trying to get the body to do what it should be able to do on its own and then discontinue the betaine hcl. I would look at that method as giving a crutch to a person who has balance issues. They will need that crutch forever, but that is just my opinion .
Art, I also have been diagnosed with GERD. Protein is not my problem but green vegetables and legumes cause me excruciating chest pain. I had upper endoscopy tests but negative for H. Pylori. I was prescribed PPIs but I didn't stay too long due to side effects. I attribute my GERD to several years' use of almost daily Ibuprofen, often 1,600mg! I have found "Acid Soothe" by Enzymedica to help me. amazon.com/Enzymedica-Occas... However, I have been thinking of starting Betaine HCl myself and find out if this will alleviate my problem.
None, Art! I do take Dr. Dean's ReMag and it really helps me, but even before I started it, I had no sleep problems, THANK GOD, as I need a good night's sleep to care for my husband. . .
Thank you for that link, it is good information to know plus it is short and to the point! I see Dr. Marty Hinz is a coauthor.
It seems odd that neurologists seem to rarely mention this to their patients.
I know this relationship between carbidopa and B-6/PLP/P5P has been discussed previously, but is taking the B-6 between carbidopa doses any type of solution or is there a solution that continues to use carbidopa?
To my knowledge, Dr. Hinz suggests a complex protocol in which the essential nutrients depleted by Sinemet are replaced by exogenous supplementation, but his therapy must be individualized and doses carefully titrated for every patient. Hence, no single solution for all ! He sees it necessary to eliminate carbidopa entirely.
Dr. Hinz's protocol can be found in his published papers, which are freely available on the internet.
I think forum member, bassofspades may be on that protocol or was on that protocol. I'll have to check with him to see if he has any up to date comments on the protocol and how hard or how easy it is to use.
Park_Bear and Silvestrov posted extensively on the subject. Bottom line: safe to take B6 (inactive form P5P) as long as one takes it at least two hours away from carbidopa. If you search on the subject here on HU, you will find a lot of useful information.
Thank you Art for that information.I haveread that the carbidopa is used to combat nausea. However it took a long time to combat my nausea. Now that I am taking cl longer, the nausea isn't too bad. I guess my system is getting used to it. BTW, welcome back. You were sorely missed by everyone.
Hi Art, I would like to have your opinion and guidance about the following. I'm a PWP for 13 years. I want to quit Sinemet completely. I think I am having ups and downs while my body is trying to recover and to respond to the natural supplements and healthy steps I have taken trying to heal but Sinemet seems to be interfering. I take mucuna since various years ago in combination with Sinemet but I want to go completely on mucuna (I'm aware I have to quit gradually from C/L). The issue is that mucuna needs carbidopa too to reach my brain. I get use to take C/L the control release and then the mucuna pills in a timeframe of 1 1/2hr to 2 hrs after the c/l. In my case I get the full benefits of the mucuna pills (last for about three hours) that way.
I would like to know if there is a supplement may act and to be like effective as the carbidopa (Lodosyn) or any other drug or agonist to be used on that purpose..... I have been wondering if a family doctor that I'm visiting (functional medicine) may be able to prescribe me Lodosyn to be prepared in a compound pharmacy in my neighborhood, like for example just a pill of carbidopa 25mg . It makes sense to you? What's your thoughts? Thanks, hope to hear from you soon......
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I do take Dr. Dean's ReMag and it really helps me, but even before I started it, I had no sleep problems, THANK GOD, as I need a good night's sleep to care for my husband. . .
Immediate-Release Versus Controlled-Released Carbidopa-Levodopa 
? Carbidopa and levodopa can be taken with or without food - Rxlist.com ?
Switching from generic Carbidopa/Levodopa to Rytary
