Think back to the last year, and think of the day that you felt healthiest. If you are a PwP like me, you probably felt pretty good: that's both relatively good as compared to the rubbish days either side of it, but even absolutely good as compared to a non-PwP of your age and with the same other illnesses.

So, where does that leave us?

1. If we can get to our high water mark once, we can, if optimally dosed, get even better days.

2. If we can get to our high water mark using existing drugs, we don't need new drugs to get to this level again.

3. The challenge is to get the most out of existing drugs. For most PwP that means getting the most out of levodopa.

With most systems, if you put the same inputs in, you expect to get the same outputs out. This raises the question of why you can put in 600mg, split between four doses of levodopa one day, say, and the same amount and at the same times the next day, but get two different responses?

In short, we need to track down where the levodopa is being lost: is it deficiencies in the pills not coming up to spec? is it delayed gastric emptying? is it competition with protein in the diet? and this is a recent one, is it due to the wrong kinds of bacteria in the intestines?

Simon Stott has written an excellent article describing research into the effect of bacteria in the intestines on the amount of levodopa that gets usefully absorbed. See his 9th February blog at:

The Science of Parkinson's | Plain English information about the research being conducted on Parkinson's

John