Three of the most popular Parkinson’s medications prescribed are Levodopa medications, such as Sinemet®, Carbidopa/levodopa extended-release capsules (Rytary®), Carbidopa/levodopa/entacapone (Stalevo®) These medications are often prescribed to help control the symptoms associated with Parkinson’s Disease such as slow movements, stiffness, and or rigid body parts.
Let’s talk a bit about Dopamine. Dopamine is a chemical produced in your brain that functions as type of neurotransmitter. Your nervous system uses it to send messages between nerve cells. Dopamine affects so many different behavior and physical components of our body. It affects our learning, motivation, heart rate, blood vessel function, kidney function, lactation, sleep, mood, attention, control of nausea and vomiting, pain processing, and movement. When 80 percent of dopamine is lost, PD symptoms such as tremor, slowness of movement, stiffness, and balance problems occur.
So now we know what dopamine is and how lack of production of dopamine affects Parkinson’s disease, lets see how the medications prescribed work exactly.
Let’s look at the most common used medication called Carbidopa/levodopa. This medication is two different medications in one. Levodopa changes into dopamine in the brain, therefore helping to control movement. While Carbidopa prevents the breakdown of levodopa in the bloodstream so more levodopa can enter the brain. Carbidopa can also reduce some of side effects associated with levodopa’s such as nausea and vomiting.
Most people will eat some sort of protein with each meal. But did you know that protein when eaten close to or at the same time as Carbidopa/levodopa can decrease the effectiveness of the medication. When any kind of protein is being digested, it is broken down into amino acids. The lining of the digestive tract contains many receptors designed to absorb the amino acids and to transfer them into the blood stream to then be carried to the brain. There are only so many receptors in the digestive tract and for some people the proteins they consumed in food may be absorbed first over the medication they just took, resulting in less medication being absorbed and re-distributed back to the brain. This can cause some people to feel like it’s taking a very long time for your medication to “kick in” or you may be spending more time than you usually do in an “off” state. You may even feel like the medication did not work at all.
So, what is Protein rich foods? These can be lean chicken, lean pork, fish, lean beef, tofu, beans, lentils, low-fat yogurt, milk, cheese, seeds, nuts, and eggs.
The medication levodopa (Sinemet) is a protein building block, so it competes for absorption with other proteins. For that reason, these medications often work best when taken on an empty stomach. But this can also mean having side effects of the medication. Your doctor may recommend taking medication on an empty stomach — 30 minutes before or 60 minutes after a meal. Another option is to save higher amounts of protein for the end of the day, when controlling symptoms may not be as critical. If taking your medication on an empty stomach does not work for you. You can try taking it with Apple sauce, a small snack, or crackers to curb nausea. Always talk to your doctor about the right option for you regarding your medication before making any adjustments or changes, talk to a dietitian to craft a diet that helps you manage your Parkinson's symptoms and feel energized and healthy. This is simply for education and suggestive purposes, this in no way should be considered medical advice or used without consulting your physician before.
Nicole Muriel MOT OTR/L