John,

I have often thought this to be the case. Surely, like any other drug, weight affects metabolism or pharmacodynamics, yet I have seen maybe two articles at most that even ask this question let alone ask the bigger questions you do.

In my experiences, not one doctor has ever broached weight. It seems like once I started levodopa I called the shots in my dosage. This, to me, underscores how little is by doctors other than trial and error in the treating our PD. Not their fault; that is just how it is.

I have started two clinical trials and not surprisingly, weiight is not all considered.

This, of course, begs the question...how can the amount of levodopa we take be at all be a measure of disease severity? It cannot, yet study after study uses it as a yardstick because it is all they have. Any research using dosage as a measure seems fundamentally flawed to me. My current MDS who has managed clinical research for over 20 years told me that when levodopa doses have been tracked for studies; there is absolutely no pattern or relation to disease severity or longevity. He says the data is all over the place and one would be surprised that it even works at all from a research control perspective.

This is why we are in dire need of bio-markers and imaging to not only better treat patients but to also give the research the validity and reliability it so sorely needs.

Laura