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What to eat and when


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#1 aab

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Posted 11 March 2012 - 10:13 AM

Dear Ms. Holden

I have had Parkinson's disease for 17 years and gastropareisis. I am supposed to take Sinemet 125mg every 2 hours of my waking time. It takes every pill 30-40 minutes to kick in. I eat small snacks (cup of dry wholegrain cereal, one cheese toast, an apple or yogurt) after I am ON in order to give the food the time to clear the stomach before the time for the next pill. At 5 PM, I eat small main meal (fish, vegetables and bread). After this meal, I must wait 5 hours before I take the next pill, otherwise it will not work. During the most part of these 5 hours, I am OFF. I tried to distribute the main meal over the day times, but that resulted in OFF times 0f 1-2 hours every time.

What would you recommend to do in order to improve my diet situation?

Thank you

#2 Kathrynne Holden, MS

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Posted 12 March 2012 - 05:43 PM

Dear Friend,
Gastroparesis, unfortunately, is not uncommon among folks with PD, and it does “play hob” with levodopa absorption. You are doing a good job, but still having a lot of off time.

Fatty foods delay stomach emptying more than proteins and carbohydrates, and it sounds like you’re avoiding high-fat meals. I am concerned, though, that you might not be getting enough protein to meet your daily needs. In light of this, I think the best course would be to post your question on “Ask the Doctor” and ask:

1) if one of the newer PD medications might be useful, such as Neupro (in Europe), or Duodopa

2) if you should try a medication to speed stomach emptying, such as domperidone, which I believe is now available in the U.S.

3) whether use of liquid Sinemet might be better than pill form. Liquid Sinemet is made by dissolving one regular Sinemet plus some vitamin C in a liter of water; then drinking a small amount about every hour. Although the effects do not last as long, it is absorbed much quicker than the pill. For the recipe, see:

Medications
A Formula For Liquid Sinemet p. 55 http://www3.parkinso...ponbef3.app338a

It may be that with the right solution you will be able to enjoy better-balanced meals. You require about ½ gram protein per pound of body weight per day, to restore and repair cells, hair, skin and nails, and muscles (including the heart). Ordinarily, I would divide this amount about equally among morning, midday, and evening meals, taking levodopa about 30 minutes before the meals. In your case, however, the slowed stomach emptying needs to be managed so that you can do this. Let me know what the doctor says, and I will help further if I can.
Best regards,

Kathrynne Holden, MS

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#3 aab

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Posted 14 March 2012 - 03:33 AM

Thank you Ms Holden. The link you provided is very useful.

#4 Kathrynne Holden, MS

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Posted 16 March 2012 - 03:59 PM

I'm glad it was helpful, and let me know if you have other questions.
Best regards,

Kathrynne Holden, MS

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