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Wednesday, May 18, 2016

Parkinson's: How Food Affects Medication Efficiency

If you have Parkinson's disease, what and when you eat may affect how well your Parkinson's medications work. 

Here's an overview of how our digestive system works. From the moment food enters your mouth and you start chewing, the process starts. Saliva containing enzymes is secreted and starts to break down the carbohydrates.

From there it heads to your stomach, where it combines with acids and pepsin and churns until it's a soft fluid goop called chyme. 

Then it goes into the first part of your small intestine, which is called the duodenum. There it mixes with enzymes from the pancreas and bile duct to break it down further. From there it slowly travels through the rest of your small intestine, which is about 20 feet long, and this is where many of the nutrients are absorbed into your bloodstream via "carriers." 

Think of this as a huge crowded train station and all these nutrients are trying to catch their particular trains: the F trains for fats, C trains for carbohydrates and P trains for proteins. The problem is the carbi/levodopa pill you swallowed also needs to catch a P train and the proteins are bigger and more pushy, so your meds get shoved to the back of the line.

Catching the right train.
Once they are on a train and on their way to your brain, they encounter the same problem. Those pushy proteins fight to get in first. This is why you may want to take your carbi/levodopa before you eat. So it doesn't have to compete with the others.    

The rest of the goop then enters the large intestine, where most of the water and vitamins are absorbed. Bacteria completes the digestion process and the rest, well, it ends up as poop! (bowel movements) 

Sometimes due to Parkinson's, the normal rhythmic motions of our digestive tract get slowed down and then constipation can be a big problem. Constipation may also be caused by dehydration, lack of physical activity and not enough fiber. So drink plenty of fluids, keep moving and add some extra fiber (bran, beans, berries, peas, greens, nuts, squash or fruit) to your diet. Just add it SLOWLY to avoid gas.   
Bran muffin
In my case, because I take so little carbi/levodopa since having DBS surgery, I do better if I take my pills right after eating. Which is best for you? You need to figure out that answer yourself. 

Who says I can't make this humorous? 

First you add a scoop
Of veggies to your soup
Then your tummy does a loop
And mixes it into a goop
From there it travels in a group
Like a tumbling acrobatic troupe
Until it exits as your poop! 

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  1. My husband was diagnosed with PD 12 years ago. Since then we discovered that animal protein (including dairy) interferes with the absorption of his PD meds, so he avoids it all day until after his last dose of the day. Plant proteins don't seem to cause him a problem. Since he became practically vegan (he never eats meat or eggs, and dairy only occasionally late evening), he has longer 'on' periods and experiences far less discomfort from dystonias. This article explains very well how proteins push the L-dopa medication to the back of the queue, which means you may not get a chance to absorb any of it so may find yourself experiencing long 'off' periods. We have also discovered that a big drink of water can sometimes get the medication into his system when it otherwise seems delayed. It is well worth experimenting with your diet when you have Parkinson's Disease. You may be able to improve your quality of life dramatically.

  2. Nice article YumaBev!
    PD for 6-7yrs diag 2013,L.O.Set, (Mine non genetic, exposure to agent orange in V.N.). Eating less and less often really does help getting more of the C/L to the substantia nigra. I'm finally getting some mental control, not over eating and eating less often. Being mostly (90%?) vegetarian, heavy calciferous vegi health NUT, I have/had (hard to break) an almost continuous snacking habit which (even not being a heavy meat/protein consumer) conflicts w meds as Bev explains so well with the P train etc analogy. Lots of H2o really helps also. For me; food of any kind, dilutes, slows down or stops "on" time substantially or immediately :-( Besides being very active, actual exercise has huge "on" time benefit.
    Really rooting for the "advancing" new therapy of creating a small access point through the blood-brain barrier via somewhere in the nasal passage to get pharma-dopamine for now, (someday our own gene modified cells producing dopamine) almost directly to the brain, maybe via handy nasal spray? This would certainly be helpful 4 when all your Leva 2 dopamine converting cells R dormant. Wouldn't that be a kick in the pants :-)? It's many yrs off still, but I'm a dreamer/believer.
    Santa Cruz,Ca.

  3. Excellent explanation! Another diet issue is sugar for me. I have to avoid all sugar or symptoms are unaffected by meds and progression is faster.

  4. Thanks for this! I know for me the main enemies have been dairy, sugar, and sadly full strength caffeine. (I can do mocha.) These throw me over the edge with tremors and stiffness. Which I learned before getting diagnosed. Also learned that I am now celiac. So yes, food matters! Arrica

  5. I found out from my specialist/neurologist at the Movement Disorder Clinic that eating a lot of protein 30 minutes before or an hour after taking levodopa/carbidopa can reduce it's effectiveness significantly. This includes dairy products,, so, cheese as a snack for the bedtime dose is out for me now, I do toast and al bit o jam or fruit instead of the cinnamon raisin toast with butter, homemade apricot jam and 9 year old cheddar I love. Scott

  6. I've noticed my meds work less when I have a large serving of red steak. Brie