Well, thank you! It's really a sad thing, though, isn't it? People need to know about their medicines, diagnosis, etc., and doctors should be good at explaining and partnering with people. Best of health to you!

Agree 100%. My 'very busy' neurologist basically just said "Take 3." You are indeed a God-Send, Andrew. You have no idea how valuable this has been to me.

Physical exercise should be ur lifestyles and cbd oil hemp

​@@rickypastille pll l Leo

See a neurologist movement specialist not just a Neurologist

DRD...now there's a not-so-common disorder. I hope yours if the form that stays sensitive to levodopa long term!

So far so good. We can definitely tell when I'm in need of my next dose. Extending the sinemet out via comtan has done wonders. The symptoms never fully rectify, but we receive enough correction that I'm able to function much better than before. May I ask if any contraindications between levodopa and melatonin exist? I read an NIH study showing that melatonin acts as a dopamine antagonist and can negatively increase the physical aspects of PD. I was curious if the same can be said regarding DRD, and if melatonin might inhibit sinemet's effectiveness.

@@AndrewReevesNeurology njuuhhh. 6:24

Glad you found it helpful, Tyrone! You're right, dosing and regimen is a constant issue in PD management. Even when they're spot on, day-to-day fluctuations still cause issues. Best of luck in your new job!

Thank you for the info. I didn’t even understand the make up of the medicine until now. I stopped taking mymed when it made me sleep around the clock. I smoked marijuana now during the day instead of taking the medicine. Usually during the course of a day now I consume one pill and two doses, and at night I take a whole pill, mainly to keep it in my system and help a little bit with the shaking. the marijuana is a particular brand which leaves no desire for food and doesn’t put me to sleep. And best of all helps with the tremors. Lymphatic massage has also been very helpful. I go for an hour once every 10 or 15 days​. 6:24 @@AndrewReevesNeurology

Glad I could help, and I wish you the best of health!

Same as me, but I find taking them at 8-9am, noon-1pm & 5pm better as I can cope with off period better in the evening/overnight

​

Same thing with my dad. Have you tried taking her off meds? Just curious...

@@EnlightenYourself206 Of her own doing she has been off all medications for about a month. She is better but still not quite back to normal. Maybe she won’t ever return to normal but she is better not taking the medication. Thanks for asking.

Interesting, my husband has been prescribed the meds but we have not taken them yet. We are trying to stimulate his dopamine levels through walking exercises and anything we can think of. If the meds won’t help slow down the disease, why take it? They have enough problems as it.

@@videomanic411you can do both. Go on Mediterranean diet. Eat plenty of vegetables and some fruit esp blueberries and fish. Salmon is best. Lots of Omega 3 and lots of flax seed. Take your medicine also. Remember to exercise daily.

Thanks for your comment. Perhaps I should do a "non-motor PD problems" video some day.... Hmmm....

@@AndrewReevesNeurology That would be very much appreciated. Kind Regards Colin

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Glad you found it useful! God bless you and stay healthy.

I'm caring for mine. How can I complain...2 hours max sleep per night because she needs help to potty and had retention problems. ..but she can't sleep either plus is suffering with the progressing disease.

Try lots and lots of water in case he is dehydrated along with the other symptoms. I hope this helps. May have to keep increasing meds slowly to see how they respond to it but the extended release at bed time helped my husband along with the other meds in the day time but if he doesn't drink alot if water he has memory problems bad in the evening. I hope this helps.

@@teresakelley4463 Thank you!

I have had a few patients who sip Sinemet water. The pills dissolve fairly easily and the people kind of sip their way through the day sometimes. Other times they use Sinemet water as a way to take 1/4 or 1/3 of a pill, or some other fraction that isn't 1/2. Just an idea I've seen.

Many drugs can cause a feeling of shortness of breath. There are several medications besides Sinemet, such as ropinirole and pramipexole. There are few others which are not used quite as commonly.

I read that she is having these symptoms because the medicine is wearing off on her. I hope this helps. My husband takes Carbidopa levodopa 4 times a day and Carbidopa levodopa extended release at bedtime. I'm not saying she needs that amount but I read that she's having these symptoms because her medicine wore off. I hope this helps.

My wife's neurologist suggested meds for anxiety, but that just adds another pill and side effects. Try and get yours to learn the Wim Hof deep breathing technique. Might help...

Yes, they don't slow down the underlying processes of degeneration. They are to reduce the symptoms. No one has come up with anything that actually slows down the process yet. We are waiting for something like that!!

Glad to hear you've got an answer with the glass of water. And glad I'm officially a "young man" still! That's the best thing I've heard in a fair bit!

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before taking any levodopa drug, pls be warned that it gives addiction as prescribed today (same as eroine with eavy if not lethal withdrawal syndrome). Too much drug since the beginning gives rapid saturation and resistance and need to increase dosage with rapid addiction. Levodopa consumption in brain is minimal (mcg) and the missing quota is even lower. A drug (like levodopa) can take weeks to reach the center of the brain and be effective; starting with mg of current drugs (pure levodopa with a concentrator) may be immediately effective because of the huge quantity of drug - this is the main mistake. it will shock the entire brain tha will defend itself increasing resistance (i.e. reducing sensibility to the drug and developping methods to protect itself from or get rid faster of the toxic drug). As the result a disease that took 20 years to manifest will acellerate progression and will require more and more drug that will cause more and more brain damage in a negative loop - but the cause will the drug (and the concentrator, that will cause a cronic vit B6 deficiency) not the disease. Alternatively mucuna pruriens powder can be much better in the long term. Only take care to start at very low dosage (easier because levodopa in mucuna is approx 5% and without the concentrator only 1/10 or 1/20 reaches the brain; in addition taken with food compete with other aminoacids thus with 1 gr of powder x day you can have 1 mg or less of levodopa reaching the brain and be sufficient to control symptoms for th rest of your life without side effects - not 100/300 mg flooding your brain daily giving in 5 years the known probems). if no effect, increase it every 2 months until desired terapeutic effect is reached. Then you will likely stay on this level for all your life without addiction or end of honey moon or wearing off effect. if you want to try to heal, consider alternatively Sodium Ascorbate (SA) IV or orally at high doses (up to 250 gr/day for 5+10+5 days) to get rid of the yeast that may be causing PD and heal your gut from any kind of disbiosys. SA also boosts dopamine production and nutrient absorbtion from food. Than stay on 50/100 gr/day until symptoms decrease or disappear. In addition add vit B6 (from a B complex) at high doses (50/100 mg/day orally or IM every 3 days) to promote dopamine production and neurotransmitters balance. Add also vit D and mineralize your body duly and remove all the carbs and sugars that you can. If in real difficulty at the beginning of the disease, consider talking with your doctor to take deprenyl up to 10mg/day and add fermented foods in right quantity (you have to test what works best for you). fermented foods brings more tyramin (a descendant of tyrosine, that is well neutralized by the liver if not blocked by deprenyl) it stimulates the production of noradrenaline that helps you to move and lasts longer than levodopa. Deprenyl has side effects on blood pressure and heart rate, so pls do not exagerate with fermented foods. Obviosly you can believe it or not, but I'm ready to provide supporting docs/links

I start them when symptoms get to the point that the person wants to take medicine for them. There used to be a belief that starting levodopa early in the disease accelerates the course of the disease. That turned out not to really be the case.

There are several alternatives. An experienced neurologist might be helpful in selecting other meds. Of course, every single medicine has potential issues. I often remind my patients that aspirin kills thousands every year. Of course, it saves many, many more people from strokes, heart attacks, and blood clots. But there is ALWAYS a risk. Just like every time you get behind the wheel of a car, there's a risk.

Hm sinemet

Glad it was useful, Maria.

maria1707 QAseeparkinsons

maria1707 / ;

maria1707 hhhhhh.

I don't have strength to walk and I urinate often 11 times a day

Glad it was helpful. Stay healthy and active!

Doctor,can stroke cause parkinsons?

Some large studies have looked at this, as I recall, and there seems to be a pretty minor difference in the rate or severity of dyskinesias. That comes at the cost of foregoing the motor improvements for the preceding years. There are always tradeoffs.

From a neurologist in Spain. It seems like MP is a better choice and it’s natural!! What is your research on MP? Mucuna does not produce dyskinesia. A different study, this time in monkeys (with unilateral parkinsonism induced experimentally), produced very interesting results on the possibility of dyskinesias. One group was treated with Sinemet (levodopa and carbidopa), another with Mucuna plus carbidopa, and the third only with Mucuna. All the animals experienced an improvement in their symptoms. Dyskinesia was then assessed by the study of spontaneous activity in the substantia nigra. Larger dyskinesia appeared in the Sinemet group. In those treated with the combination of Mucuna and carbidopa, dyskinesia seemed more moderate. Interestingly, in those who had only taken Mucuna, no dyskinesia was found [35]. Mucuna and Parkinson’s Disease: Treatment with Natural Levodopa By Rafael González Maldonado

CentralCoastCamper I’m 41, taking 8 pills per day!! I don’t have any tremors. Only beginning symptoms!?

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Susan, At outset I must mention I am not a Neurologist. I was diagnosed with early signs of Parkinsons Disease 5 years ago. I saw two Neurologists to make sure the Diagnosis was right. I have been taking Sinemet 25-100 and it works well most of time. It takes about 30 minutes for the med to start working, so you have to keep that in mind I suggest you see a good Neurologist, it seems you have Parkinsons, and you shouldnt suffer waiting for an MDs diagnosis

It does not actually slow the progression of the disease. Presently we have no medication that does slow it down. Sinemet helps reduce the symptoms, but the underlying process is not changed, sadly.

Andrew Reeves Neurology thank you- is there any thing in your professional opinion that you believe helps slow progression?

So, Sinemet reduces some symptoms and with it we get new symptoms... It does not make sense.

Yes, that works. I've had a few patients who have used/tried that approach. They have sometimes found it a bit difficult to get a steady stream of Sinemet into their system, but if done right, it works.

Different person as in better or bad?

Hard to say without seeing exactly what happens. I certainly would recommend she try to get in to see a neurologist. Falls are a serious problem, and can cause significant injury, or even death, so please have her evaluated.

First, I think you're on the right track with seeing a movement disorders specialist. That's probably the most important thing you can do at this point. He/she should be able to give you a better understanding of what your future options might be.

Andrew Reeves Neurology same thing...nothing further to say...just to adjust doses as needed...ah well it is what it is :)

GoPro Goalie Uzi ✨ It is what it is... You're so right! Sending a cyber hug, as a hug speaks volumes & warmest wishes... ~~~~ ~~~⛵~~~~~~~~~~~~~~~~~~~~🌅

Colette Michell thank you my dear!! I’m dropped to 7 pills per days. No tremors yet. Still have some issues. I’m very active as you can see on my channel. I plan on going day by day...saw a movement disorder clinic...nothing really new. I will see the dr. Every 6-9 months.. ✌🏽

R G I take my thyroid pill as soon as I wake up. I set my alarm for 530 am to be sure to take it at same time on days where I will be sleeping in. I eat a small meal between 30-60 mins after. I then take my carb/Levo at 8a,2p,8p. I also have to take my vitamin supplements at 10am as to not interfere with my thyroid and carb/levo. Have to set reminders on my watch as I am taking pills every couple of hours it seems. 😑

I eat nothing after dinner and take my levothyroxine before bed (empty stomach)

Could be essential tremors passing into parkinsonism. You can try metazepine

Usually it is ok.

CBGD is a difficult disease to manage. We often try the different Parkinson's medications, to varying degrees of success. And currently we have no proven way to slow down the progression, sadly.

Carbidopa inhibits DDC (dopa decarboxylase) and prevents conversion of L-dopa to dopamine in the body. If L-dopa is given alone, there is a lot of nausea due to local dopamine action outside the CNS. Although carbidopa does increase the amount of L-dopa available to cross into the brain, the primary purpose is to reduce/eliminate nausea from dopamine peripherally (otherwise, just giving more L-dopa would be the obvious solution to peripheral metabolism). This effect is why carbidopa/levodopa got its US trade name: Sinemet (sin="without" and emet="emesis...or throwing up")

Thank you. The etymology of the name is particularly fascinating!

Andrew Reeves Neurology aq

@@ColonelFredPuntridge it is , innit ? Haha .

@@saraivatoledo1842 As it turns out, it's both.

Often I recommend taking more carbidopa with the carb/levo. A 1/4 ratio of carbidopa to levodopa is enough to prevent nausea for MOST people, but not ALL. There is a pill that is just 25mg of extra carbidopa (marketed as Lodosyn in the US) that often works great. Some of my patients need this, and they take 1 pill of Lodosyn with each Sinemet dose. It used to be inexpensive, but someone apparently got hold of the patent and jacked the price to the sky (may worms invade their colon!) Maybe check with your insurance about coverage? Some of my patients get by with taking the Sinemet with a cracker (no protein to speak of in a saltine) and it helps. Best of luck to you both!

@@andyreevesarchive528 Thank you for your quick reply. My wife is struggling she’s been bouncing around with Neurologists because they can’t determine what exact type of Parkinson’s does she have. She will see a Parkinson Specialist but that’s not until June 27th. The DatScan said my wife has Parkinisom Syndrome,we have no idea what it is until we see her Specialist. My wife needs help with some relief I will look into this medication you suggested. Thank you so much for your help and time.

Are there not vitamin drips or blood transfusions or oxygen bars that can help work to strengthen the body? Has anyone ever tried those.

@@videomanic411 yes my wife and I have memberships to a IV drip spa. They help but in my wife’s circumstance with her having Young On Set Parkinson’s disease it is just a temporary fix for decreasing her symptoms , most of the time she will get about 2 or 3 IV drips a month and it varies on how much or little it helps.

DBS is usually most helpful for folks who have dopa-responsive tremor, but have developed problems with on/off fluctuations or with dyskinesias. DBS tends not to help balance, walking (in fact, can make them worse) and it doesn't tend to do so much for folks without dopa-responsive tremor. How many medicines? Generally most folks have used Sinemet and one of the dopamine agonists (pramipexole or ropinirole)

@@AndrewReevesNeurology a

Tremors do go away during sleep. They may come back very early in the waking up process, before the person is fully awake and making memories, so the person feels like the were tremoring in their sleep.

Andrew Reeves Neurology thanks for the reply. My left arm aches just about all the time, as it pronates and supinates especially. I find myself having to constantly move it for relief. Is that part of my PD too?

I think it will take approximately one day to drain your system oh any signs of having any of the carbida ladopha of my drugs from your body.. I this is just a best guess on my part as I take these drugs and I know when I miss taking them at a given point in time as my body starts to let me know that it is timed to take my next dose of medications I would think that if you wanted to drain all drugs related to this medication you will probably be told to stop taking them one day in advance... Good luck with your new move into some new form of medications.

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AnI think it will take one day of not taking any of the carbida ladopha drugs from your body.. I am not a doctor so they could probably give you a better answer ... I am just trying to

Lo siento, pero mi español no es muy bien. Pero puedo hacerlo en japonés....quizas no es muy utîl....

where to get shinemet650 tablet in India, give the name of the shop Gitanjali chatterjee. India

@@AndrewReevesNeurology Hhahahah

You're exactly right, Ann! Speech therapy, occupational therapy, physical therapy...all are very important. The LSVT Big and Loud is a good program.

Dr. Andrew Reeves neurologist l have lot respect, No Dr. in Honolulu recommended time for take pills Dr. Reeves has Breakfast-Lunch-and-dinner You take this 30-before meal and 90-meal after I like that too. All my kids said “you watch KZfaq all the times”

Does it say "25/250" or "25/100" on your prescription label? 15 pill dosage seems high, but some doctors believe that many are "under dosed" with Sinemet...