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Loss of muscle mass


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#1 AG2FOX

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Posted 29 February 2012 - 10:37 AM

I was diagnoised with PD over twelve years ago. However, I have kept up a rigorous exercise program. I function at a very high level independently. Lately I am experiencing loss of muscle mass. What can I do about it?

#2 Kathrynne Holden, MS

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Posted 02 March 2012 - 11:55 AM

Loss of muscle mass is very common among people with PD, and further, aging itself leads to loss of muscle. Usually this is due to a decline in physical activity combined with slowed metabolic rate. In people with PD, it may be due to insufficient protein intake. I would speculate that your exercise regime has so far sustained you -- and will continue to serve you well.

Do be certain to get sufficient protein -- You require about ½ gram per pound of body weight per day, to restore and repair cells, hair, skin and nails, and muscles (including the heart). If you use levodopa, I would divide this amount about equally among morning, midday, and evening meals, taking levodopa about 30 minutes before the meals.

If this did not answer your questions, write back and let me know. Additional helpful data would include:

- age
- gender
- when diagnosed with PD
- the names of all medications used (both PD, and other medications, including over-the-counter medications, vitamins, herbal or other supplements)
- any other diagnosed conditions (such as elevated blood pressure, food allergies, diabetes, high cholesterol, etc.)
- any particular complaints or concerns such as nausea, edema, weight changes, constipation, sadness, etc.




Best regards,

Kathrynne Holden, MS

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#3 AG2FOX

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Posted 13 March 2012 - 03:26 PM

I was diagnoised with PD over twelve years ago. However, I have kept up a rigorous exercise program. I function at a very high level independently. Lately I am experiencing loss of muscle mass. What can I do about it?



#4 Kathrynne Holden, MS

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Posted 16 March 2012 - 03:56 PM

Perhaps you missed my response. Please review this thread to see my answer, and let me know if you have further questions.
Best regards,

Kathrynne Holden, MS

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#5 AG2FOX

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Posted 12 June 2013 - 02:44 PM

Yes, I lost track of this question. In the interim I underwent DBS surgery last September. Iam 72 years old, male and was diagnosed with PD 13 years ago. since the surgery, my medication dosage is as follows:
Daily Medication & Dietary Supplements of AG2FOX as of Feb. 21,2013 a.m. p.m. Medication 6.00 9.00 12.00 3.00 6.00 10.00 TABLET TABLET TABLET TABLET TABLET TABLET TOTAL Amantadine 100 mg 1 1 Sinemet 25-100 1.5 1 1 1 1 5.5 Comtan 200 mg 0.5 0.5 Clonazepam 0.5 mg 1 1 Lipitor 10 mg 1 1 Flowmax 0.4mg 1 1 Timolol Maleate 0.50% one drop right eye once a day Dietary Supplements Vitamin B 12 2 000 m cg Vitamin D 1000 IU Vitamin E 400 IU

#6 Kathrynne Holden, MS

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Posted 13 June 2013 - 06:34 PM

Dear AG2FOX,
Please re-read my previous response from last March, as it may be applicable. Your additional information is helpful, and I will comment as able:

Sometimes medications can, directly or indirectly, lead to loss of muscle mass. Have you lost weight as well as muscle mass? If so, do you feel you are eating as much as usual? Amantadine, clonazepam, and medications containing levodopa can all cause appetite loss, and thus loss of bothweight and muscle mass.

Clonazepam is a beneficial medication, but not all people with PD do equally well on benzodiazepines; further, it should be used with caution in people over age 70. You might discuss this with the prescribing physician and ask if some other medication might be useful.

Statins, such as Lipitor, can in some people lead to myopathy. For more information on this, please read:

Statin Myopathy Overview
http://www.freemd.co...hy/overview.htm

If you think this might apply to you, ask the prescribing doctor about one of the resin drugs, or high-dose niacin such as Niaspan.

I also like to check for possible drug interactions. Checking on Drug Digest provided the following information:

4 potential interactions were found for the drugs you selected.

You searched for interactions between the following drugs :

Amantadine Tablets
Clonazepam Tablets
Comtan Tablets
Lipitor
Sinemet

Add or Delete Drugs

Start Over with a New List of Drugs

(Note: Not all drug interactions are known or reported in the literature, and new drug interactions are continually being reported. This information is provided only for your education and for you to discuss with your personal healthcare provider. )

LEVODOPA (in Sinemet) may interact with CLONAZEPAM (in Clonazepam Tablets)

Although the cause of this potential interaction is not clearly understood, clonazepam may decrease the effectiveness of levodopa to control the symptoms of Parkinson?s disease. Although there are currently no recommendations for change when clonazepam and levodopa are used together, make sure your doctor is aware that you are taking these drugs at the same time. If you begin to experience a worsening of symptoms (such as difficulty walking or uncontrollable shaking of the head, hands, or feet), your doctor may consider stopping therapy with clonazepam.Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is poorly documented and is considered minor in severity.

Last Updated:June 2004

ATORVASTATIN CALCIUM (in Lipitor) may interact with CLONAZEPAM (in Clonazepam Tablets)

Although the cause of this interaction is not completely understood, it is thought that atorvastatin may interfere with the breakdown of clonazepam in the body. If this happens, blood levels of clonazepam could increase leading to an increase in clonazepam's effects such as increased or prolonged drowsiness. Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is poorly documented and is considered moderate in severity.

Last Updated:February 2009

ATORVASTATIN CALCIUM (in Lipitor) may interact with GRAPEFRUIT JUICE

Grapefruit juice may block the breakdown of atorvastatin in the intestines and thus more atorvastatin can get absorbed into the bloodstream. Increased blood levels of atorvastatin could be could cause a serious or potentially life-threatening side effect that involves the destruction of muscle tissue and could lead to kidney failure. Avoid taking atorvastatin with any form of grapefruit, including the actual fruit as well as drinks and nutritional supplements that contain grapefruit juice. Other drugs in the same class as atorvastatin, such as fluvastatin and pravastatin, are not affected by grapefruit juice and may be safer alternatives.Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is well-documented and is considered moderate in severity.

Last Updated:May 2007

ALCOHOL may interact with CLONAZEPAM (in Clonazepam Tablets)

Although the cause of this potential interaction is not fully understood, intolerable or otherwise undesirable side effects may occur when clonazepam is taken with alcoholic beverages or alcohol-containing products (such as some cough syrups and elixirs). Potential side effects include drowsiness, dizziness, blurred vision, headache, and nervousness. Because the combination of clonazepam and alcohol (ethanol) may impair your judgment and/or reflexes, it may be dangerous to drive or to perform tasks which require you to be alert after taking these together. It would be advisable to avoid consuming alcohol while you are taking clonazepam. Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is well-documented and is considered moderate in severity.

Last Updated: December 2003

=========================================================

If you think any of this information might apply to you, please check with your doctors and see if your medication regime might benefit from an adjustment.

I would check and be certain your vitamin D supplement is vitamin D3, which is much better absorbed than D2.

Let me know if I can help further.
Best regards,

Kathrynne Holden, MS

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#7 AG2FOX

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Posted 20 June 2013 - 12:57 PM

Kathrynne,
Thank you very much for your informative response. I will continue this discussion with my question for finding a registered dietition.

#8 Kathrynne Holden, MS

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Posted 20 June 2013 - 05:23 PM

You are most welcome; and perhaps you have not seen my post with contact information for two dietitians who you might care to contact regarding consultation. Let me know how it goes.
Best regards,

Kathrynne Holden, MS

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