As a continuation of thought on my previous post regarding the value of integrating neurotransmitter testing in PD treatment, this post is to solicit feedback/insight/experience with testing further up the biosynthesis chain by testing amino acid levels ... specifically those involved in the dopamine biosynthesis chain (l-phenylalanine and l-tyrosine).

Here are my amateur thoughts, I'd love to hear your ideas/feedback:

- My Mom is only taking 2 x 25/100 sinemet per day, so I think she's relatively early in her dependence on sinemet. I would like for her to start a complimentary treatment that would, hopefully, energize her own internal dopamine production by supplementing with precursors (l-tyrosine, NADH, etc.).

- So, my idea is to have her amino acid levels tested to find out where in the dopamine biosynthesis chain we need to focus on with supplements.

protein --> l-phenylalanine --> l-tyrosine --> l-dopa --> dopamine

I think/hope that if you specifically know your levels of l-phenylalanine and l-tyrosine you can choose your choice of amino acid supplement(s) more selectively, and on top of that, be able to measure if your supplements are increasing your body's supply of these amino acids effectively over time.

Another random but related thought is that my mother has gastro intestinal problems including GERD, and I suspect as with many aging people, low levels of hydrochloric acid. I am wondering if because of her lower acid levels she is not able to properly digest and extract amino acids from the protein she eats, since protein requires higher acidity to digest. Maybe this test will help answer that question as well (if she is low in l-phenylalanine) ... stricly a hypothesis of course, and I'm sure there are many more variables involved.

Finally, another potential benefit is that we can get a measure on her l-tryptophan levels. She is currently taking an SSRI for mild depression. It would be interesting to see if she has abnormally low levels of tryptophan, which may also lead to choices about how to treat her low(er) seratonin levels ... and perhaps that is also related to poor digestion of proteins (very hypothetical again).

Besides any feedback on this approach, has anyone ever gotten their amino acid levels checked and did it reveal anything of interest regarding your condition?

It is very possible... protein is not broken down properly in people using acid blocking drugs.

In fact vitamin B12 is not utilized normally either and these patients may develop low B12 levels leading to neurological problems. It would be a good idea to get her tested.

Anything lower than 400 should be supplemented. This is a general recommendation for all people over 50 in this country!

Don't accept "normal" from the doctor because low ranges are still reported here as "normal". Ask for the numbers.

Parkinson's affects the gut. See the following overview by Tadross at Imperial College:

http://www.cureparkinsons.org.uk/cli...%20in%20PD.pdf

John

Nickvalo,

I think your attention to amino acids is a good strategy. I have never had my levels checked but since shortly after dx in 2003 I have been taking a supplement called Dopavite that is an amino acid formula specifically designed with PWPs in mind, although the manufacturers cannot state this claim on packaging. I was on the usual PD drugs, up to and including l-dopa, until I quit them 1.5 yrs ago. I now rely on Dopavite and a range of complementary therapies to maintain my health. I have the usual symptoms of PD but with a slow progression, a lot of pain, but a much better quality of life than when I was on PD meds, which were only hastening my decline.

At the time of dx I was also extremely B12 deficient and have an ongoing problem with this, which I deal with successfully by taking Solgar Methylcobalamin, 5,000 mcgs daily in sublingual form, available from iherb. Note I do not take Cyanocobalamin. The body would still have to convert it to methyl form and I would be loading my system with excess cyanide which is potentially toxic.

I think you are taking a very good approach to this problem. Do not underestimate the contribution of a B12 deficiency to neurological difficulties. Severe and prolonged deficiency can lead to subacute combined degeneration of the spinal cord leading to paralysis and dementia at worst, and to peripheral neuropathy at the very least. I also feel that in an indirect fashion it could be a contributor to PD. B12 deficiency makes you extremely anxious and you find it difficult to handle stressors; you feel like you are burning adrenaline all the time and this is very dangerous for anyone inclined to PD.

Best of luck to you.