[rainbow676]

Many PDers find that protein interferes with levodopa absorption. Can any members comment on which proteins interfere most, and which interfere less?

My mom has lost a good bit of weight and would really like to eat some protein during the day (she currently only eats it at night).

Are there any recommendations on which proteins (if any) might be better to eat at lunchtime? We would be so appreciative of any tips.

Many, many thanks in advance, and best wishes to all. (And apologies for those who see this twice -- I'm posting on another forum as well.)

[soccertese]

after 12 years since my diagnosis and taking only sinemet, i'm embarrassed to say i haven't mastered the protein problem and i too limit my protein intake during the day.

there are certain amino acids that interfere with l-dopa and some that don't, i wouldn't attempt to advise you on which protein containing foods might interfere more than others.

here's a website that might be a good starting point.

http://forum.parkinson.org/index.php...out-nutrition/

you can search the site using "protein".

you should consult a dietician too, protein intake isn't the only factor in weight loss.

[rainbow676]

Originally Posted by soccertese

after 12 years since my diagnosis and taking only sinemet, i'm embarrassed to say i haven't mastered the protein problem and i too limit my protein intake during the day.

there are certain amino acids that interfere with l-dopa and some that don't, i wouldn't attempt to advise you on which protein containing foods might interfere more than others.

here's a website that might be a good starting point.

you can search the site using "protein".

you should consult a dietician too, protein intake isn't the only factor in weight loss.

Thanks very much, soccertese. Will take a good look at this site. Good point on the dietician....will look into that as well. Best wishes.

[RLSmi]

Originally Posted by rainbow676

Thanks very much, soccertese. Will take a good look at this site. Good point on the dietician....will look into that as well. Best wishes.

Rainbow,
I have studied gelatin, hot water denatured collagen, in the past in research. Although it may not be a "balanced" protein in terms of containing all of the dietary essential amino acids, it is pretty low in the aromatic amino acids with large, bulky side chains which interfere with DOPA absorption like tryptophan, tyrosine and phenylalanine. Supplementing dietary gelatin-containing dishes with a little bit of more complete protein such as egg or egg white might be one approach to a solution.
Gelatin is very high in the amino acids glycine, proline, and hydroxy proline, with lesser amounts of other important amino acids like lysine, arginine, etc.
I'm fortunate to have little trouble with protein interference with my DOPA absorption. This could be because I take such large amounts of the drug and still have essentially no dyskinesia.
Robert

[rainbow676]

Originally Posted by RLSmi

Rainbow,
I have studied gelatin, hot water denatured collagen, in the past in research. Although it may not be a "balanced" protein in terms of containing all of the dietary essential amino acids, it is pretty low in the aromatic amino acids with large, bulky side chains which interfere with DOPA absorption like tryptophan, tyrosine and phenylalanine. Supplementing dietary gelatin-containing dishes with a little bit of more complete protein such as egg or egg white might be one approach to a solution.
Gelatin is very high in the amino acids glycine, proline, and hydroxy proline, with lesser amounts of other important amino acids like lysine, arginine, etc.
I'm fortunate to have little trouble with protein interference with my DOPA absorption. This could be because I take such large amounts of the drug and still have essentially no dyskinesia.
Robert

Thanks, Robert -- these are very interesting tips. I do have a question, though, if you wouldn't mind answering. You say that gelatin is low in the aromatic amino acids that interfere with dopamine absorption, like tryptophan, tyrosine, and phenylalanine.

But don't some people actually NEED more of these amino acids to help the absorb l-dopa? (I know some PWP take amino acids.) Or maybe it's just that the amino acids aren't inherently bad -- and some people may need them -- but it's best not to take them with l-dopa.....?

Sorry, I don't have much of a science brain!! In any event, thank you so much for the message --- will definitely look in to gelatin.

[RLSmi]

Originally Posted by rainbow676

Thanks, Robert -- these are very interesting tips. I do have a question, though, if you wouldn't mind answering. You say that gelatin is low in the aromatic amino acids that interfere with dopamine absorption, like tryptophan, tyrosine, and phenylalanine.

But don't some people actually NEED more of these amino acids to help the absorb l-dopa? (I know some PWP take amino acids.) Or maybe it's just that the amino acids aren't inherently bad -- and some people may need them -- but it's best not to take them with l-dopa.....?

Sorry, I don't have much of a science brain!! In any event, thank you so much for the message --- will definitely look in to gelatin.

Rainbow, I apologize for confusing you with too much chemistry!

Even though my DW also majored in chemistry, her eyes glaze over when I start holding forth on the latest research in protein structure-function relationships!

The best answer to your questions about possible interference of dietary protein with l-dopa absorption is to keep protein-rich meals or snacks well-separated in time (30 min. to an hour) from taking the drug. The reason for this is that the body uses the same uptake "channels" for those amino acids with large bulky side chain I mentioned earlier that are required for uptake of l-dopa. Those amino acids crowd out l-dopa and slow down its uptake. The result is that the drug gets converted to dopamine which can't get into the brain. Carbidopa helps with this, but not completely.

Hope this helps.

Robert

[johnt]

The effect of dietary protein on the amount of levodopa getting in to the brain is likely to vary from person to person. (It seems to have little impact on me if I eat cheese at lunch, for instance.) So, theory is only going to take you so far. In this case, where - provided protein is added in small quantities and, in total, only ever reaches moderate amounts - the dangers of experimentation are likely to be low, we do not have to rely on theory.

Why not discuss with your mum's doctors whether a try and see approach is reasonable? It would be easy to keep a food diary and to keep track of symptoms - my measure of choice is the side-to-side tap test. I think within a week you'd have a good idea as to what to do.

John

[soccertese]

my plan of attack would be to work with 1 variable at a time. try to figure out what dose of sinemet gives the best relief. try a different generic, maybe a different one works better, i like teva. maybe she does better on taking 1/2 of a 50/250 tablet which is blue instead of yellow, i've read the coloring agents sometimes affect people - just throwing stuff out here.
see how well she does without any food food in the morning if possible. get her feeling the best she can and then add back in food, 1 supp at a time. gastric emptying can be a problem and constipation definately slows down stomach emptying. drinking enough fluids is definately a must.
afternoons are tough for me, have to up my dose and sometimes sinemet just doesn't work. that's the upside of agonists if one can tolerate them, long duration and i assume unaffected by diet. i assume l-dopa and agonists are 1:1 at the molecule level in affecting dopamine receptors or close in effectiveness yet you can get by with 18mg of requip and might need 1000mg of l-dopa, which means very little l-dopa gets to where it's needed and then gets broken down rapidly in advanced pd'ers. evolution has resulted in our body designed to get rid of excess dopamine.

doing this is tough for someone savvy about pd, very tough if you're just helping. that's why finding the best MDS you can and/or support groups is important.

her dyskinesias might make it so you'll have too much of a challenge.

[rainbow676]

Belated thanks for these very helpful messages. We are trying a little more protein during the day, keeping it 30 mins away from Sinemet, and using a food diary. Also very interesting that different brands of Sinemet can work differently for different people -- will look into that.

I do appreciate the assistance. My mom has put on a few pounds, so she's making some progress.

[Nan Cyclist]

I just started Sinemet a couple of weeks ago after six plus years. I immediately ran into the protein problem and got this advice from my MDS: don't eat protein 1/2 hour before taking pill and/or wait two hours after eating protein to take pill. I take a 25/100 at 7am, eat lunch before 1pm, second pill at 3 pm and skip third pill. So far , so good.