Engsec, as I remember from talking to you previously on here, you were self-treating your father who suffers from PD yourself correct? I think based on what Tryguy has stated so far is that he doesn't suffer from being fatigued or sleepy rather that he has not received or felt any relief of parkinsons symptoms other than sleep assistance if he takes it before bed. Regardless, even if he has fatigue or sleepiness, there is nothing that I have read based on everything produced by Dr. Hinz on the internet to suggest that decreasing the 5-htp is the proper way to manage this either. If the patient is having nausea then that means there is either too high or too low of administration of 5-htp, but 5-htp itself is not adjusted based on sleepiness.

I think all the things you are suggesting are probably based on your personal experience with your father. From what I remember when we talked you were unable to work with a doctor trained in how to properly do this because you live in Iran and already purchased the amino acids. If these things like changing the 5-htp in this fashion, changing the Tyrosine based on patient observation, and judging catecholamine balance or optimization based on blood pressure status work for you that is great. But it needs to be clear that none of these things are discussed or recommended by Dr. Hinz or in any of his papers so I just want to make sure this is understood by others. If these things are working for you that is awesome and I wish you the best. I can't imagine how hard this must be to do on your own, so i'm glad you have found something that works. But to others, I just want to stress that all of these things of making decisions based of this information is not recommended to achieve optimal results. If you don't have access to a doctor though it is probably worth thought.

To expand a little more on how the 5-htp dosage is determined for each patient as well as Tyrosine and overall optimization of symptoms. For 5-htp the dosage for a parkinsons or "dopamine dominant" patient is determined based initially on observing the side effect of nausea. If nausea is present then the 5-htp dosing value needs to be changed. Too high or too low of 5-htp administration will cause nausea. Dr. Hinz's recommendation is to go from 2 to 1 to 3 to 4 to 8 of NeuroReplete which contains 37.5 mg of 5-htp per capsule. I think it is around 40% have no nausea on 2 and then another 30% don't have nausea on 1 then smaller percentages on the other values. There is a small percentage of patients who still will not achieve nausea relief and will either need 5, 6, or 7 NeuroReplete or they will need to start adding RepleteExtra which basically contains 75 mg of 5 htp on top of the NeuroReplete to achieve higher 5-htp dosage values. There are three levels of L-dopa induced side effects. The initial stage is nausea which is controlled based on what I just stated. The 2nd stage is having other side effects most predominantly headaches and anxiety. When the 2nd stage of side effects present often the patient will already have control of the nausea. The current recommendation based on what I have read is to increase the 5-htp value by 37.5 mg a day and that usually takes care of the 2nd stage side effects while keeping stage 1 at bay as well. 3rd stage is psychosis and depression. 3rd stage very rarely happens but if it does it usually signifies mass serotonin depletion since the patient is usually on very high amounts of L-dopa. By increasing the 5-htp value usually into the 300-900 mg a day range these side effects also are eliminated. As you can see, this research project seems to still be fluid with its protocols. Eventually I see them having a way to be able to initially prevent any of the increase in side effects from occurring at all. But for right now just staying aware of their presence and implications and how to get rid of them is the best course of action.

For the Tyrosine they state this quite clearly in that they absolutely do not suggest adding Tyrosine without getting a lab test. The lab test is used to identify dopamine fluctuations where the L-Tyrosine and L-dopa are being preferentially turned into dopaquinone and then to melanin. You can see this here: KEGG PATHWAY: Tyrosine metabolism - Reference pathway . With this stealing of the precursors you get inconsistent Dopamine production leading to fluctuations in the synapse leading to fluctuating symptoms. By giving ample Tyrosine based on lab results (anything over 40,000 ug p/g creatinine is considered a fluctuation) you are able to have enough Tyrosine in the system for when this preferential siphoning occurs it won't affect the production of L-Dopa. L-Tyrosine is rate-limited so increased amounts past a certain point does not increase dopamine production either. It basically protects the L-dopa from being converted into dopaquinone->Melanin which would fluctuate the dopamine production

So I just want to state one last time that if you have access to a doctor who knows what they are doing and work with Dr. Hinz then I would highly suggest doing so. I commend Engsec for making do with what he has but it needs to be clear that making decisions based on these things if you don't have too is not wise.