Increasing literature points to a significant connection between the bowel land PD- for instance constipation often precedes PD by years--and bowel bacterial flora are often "different" in Parkinson's patients

In PD -there is an increased prevalence of
SIBO-small bowel bacterial overgrowth--this can lead to lactose intolerance as well as impair medication absorption from the gut----- there is no question that based on the color of my urine (entacapone)-- I am not absorbing as much stalevo as before

Since I took a course of antibiotics- I seem to have developed lactose intolerance- when I eat ice cream/cheese late--next day motor-wise is definitely worse- and overall i am worse since the antibiotics

I definitely do better- on a predominantly fruit-veg diet

There is some evidence that probiotics- can both help treat SIBO as well as have some impact on PD motor fluctuations

I know that when I am constipated or if i have more flatulance in the am ( TMI) - i will have a worse day


Th question is what-to-do--for now--

I will check for and treat (will try without antibiotics) H. Pyelori-- the bacteria that is responsible for a significant percentage of stomach inflammation and ulcer-- broccoli seems to be the best single non-antibiotic agent-- usually takjes 3 antibiotics



Eat mostly fruits/vegatables



Research more-ask about the ideal probiotic in PD--one that will help CIBO as well as restore flora that is often deficient in PD==e.g PD patients have less Prevotella Species and more lactobacillus--



Does anyone have similar experiences or knowledge--especially in terms of which probiotic to take?

We did the stool test you overnight to the lab and sat down with the analyst....

no pylori (which can mess with your sinemet absorption-search this forum for articles about that), and SOME critters in there that were questionable, but we never got a really clear answer on why they were bad, plus the amount in there was very very low....

we purchased the recommended very expensive oil of oregano, a probiotic, and some other supplements I can't remember

One visit, the test, and recommended supplements were over a thousand dollars, so this is a very pricey undertaking and not covered by insurance.

Results? Could not tell a difference. But that's just one person, and I really don't think we had that big of an intestinal imbalance to make a huge difference. We eat so healthy to begin with, which is where it all starts, I believe.

Having said that, however, the constipation needs to be kept under control if possible, because it can ruin your day (or week, as the case may be). Here are things we have read about over the years for constipation and that we do (sorry for the pun, there, ha):

-lots of water
-exercise (especially walking, it moves those innards around!)
-fiber, so fruits and veggies
-oatmeal (NOT instant, steel cut or the rough flakes, and yes, it does take longer to cook but it's worth it)
-there are recipes out there for prune juice and stewed fruit you can make, and many people swear they can work wonders, but we have not tried those

We found that taking a probiotic seemed to cause upset stomach, so we don't take that anymore. Maybe we didn't take the right ones, but we tried several, one was Digest Gold, another was FortiFlora I think, it's been awhile and we've thrown them away, so I'm not sure. Plus, what didn't work for us may work for someone else, this is just our experience.

I hope you get some relief, constipation is miserable.

For GI concerns, ConsumerLab approved 21st Century High potency or Ultra Potency Advanced Probiotic. Also, if you are not taking Azilect, and if you don't mind making it regularly, kefir has a wide range of both bacteria and yeasts that are very favorable to gut concerns. You might not tolerate milk kefir, but water kefir should be alright.

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To add to my previous reply:

Milk kefir is said to have a wider variety of organisms than water kefir, though both have a wider variety than yogurt. But water kefir is recommended if/since dairy protein is a problem for you. Homemade kefir is interesting/tricky-one batch will be silky smooth and luscious and the next one will be lumpy and tart-to-sour (if milk kefir). This is because the kefir grains are living organisms and respond to many factors (e.g., temperature of room/milk/water, changes in atmosphere...). Store bought kefir can be good as long as bottle says it contains living organisms.

My wife was diagnosed about 2 years ago. Her movement disorder specialist told us she encourages all of her PD patients to try probiotics because it seems like they can’t hurt and might help even though evidence is not super strong. She doesn't have any recommendations but found that a lot of her patients like Activia yogurt, which is pretty high in probiotics and also seems to help with constipation, especially if they make a breakfast parfait/sundae out of the Activia (particularly the prune flavor if you can find it!), bran flakes, and fresh berries. She told us that's been her recommendation to all of her PD patients so far. She also said it’s much easier to get the benefits when the probiotics are actually in whole foods rather than just in a supplement.

fbollaci123, you said:
I would like to toss this question out there for you and everyone else to weigh in on: Should people on Azilect not take kefir?

My husband has taken a half glass of organic bio-active kefir every morning for the last 1-1/2 years. After starting the kefir, he was on Azilect for several months and didn't do well on it (side effects / no therapeutic effect). He then went on to start on levodopa treatment. Would the Azilect therapy have had a better chance at success if we had stopped his kefir?

Hi Bergamotte,

I will try my best to explain what I know. Azilect is an MAO-B inhibitor. Ordinarily there are no dietary restrictions required when one takes Azilect at the recommended dose. However, certain foods such as aged cheeses contain very high amounts of a substance called tyramine. MAO inhibitors can potentially cause tyramine to accumulate in the body and lead to a dramatic rise in blood pressure. For this reason, one should avoid foods with very high amounts of tyramine. Yogurt, which is fermented, is considered to be low in tyramine, and can be eaten without restriction. Nuts and also peanut butter are also considered to be safe to eat.

As for kefir, there is little information available. In one study, tyramine concentrations of kefir samples changed from non detachable values to 12.8 mg/liter. Under 6 mg of tyramine is considered to be safe so it appears that one could take about 1/4 liter (approx. 8 oz) of kefir without concern.

The thing is there are some people who are unusually sensitive to medications such as Azilect. In terms of taking kefir while on Azilect, I would proceed with caution and discuss matter with the doctor(s) who may wish to monitor blood pressure. Hope this helps.