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Urate vs. Low Protein Diet


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#1 ShakingTheChi

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Posted 04 April 2013 - 01:26 PM

I'm a few months shy of beginning carbidopa/levodopa treatment and am confused about how to alter my diet. Experts warn that protein diminishes the effect of the CL and some recommend a low protein diet, others suggest taking the CL an hour before eating. I've been on the Paleo Diet and like it and even wonder if there is a connection between my slow progression and the high protein nature of the diet, possibly because of its effect on blood urate levels. How do you suggest balancing the potential positive effects of a high protein diet and the known negative effects on CL effectiveness?

#2 Kathrynne Holden, MS

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Posted 06 April 2013 - 04:23 PM

Dear Shaking,
First, you may not need to change your diet at all. And, second, I would not change it until you have used levodopa for at least a few weeks.

Initially, some folks experience nausea when starting levodopa, and should take it with meals to help control this. Gradually, the body adjusts to this, usually in 2-4 weeks. At this point if you are responding well to levodopa, there is no need to make any dietary change at all.

However, some people are more protein-sensitive -- especially in later stages of PD. Proteins are broken down in the small intestine to their various amino acid components, and these aminos have special "carries" in the intestinal walls that allow them to cross over into the bloodstream. Some of the amino acids in protein foods compete with levodopa for absorption.

In some people, the small intestine moves more slowly, and the large amount of amino acids blocks the levodopa from entering the bloodstream. When this happens, PD symptoms are not well controlled.

If you find that this should be the case, then if nausea is no longer (or never was) a problem, begin taking the levodopa about 30 minutes before meals, which will allow the levodopa to enter the bloodstream ahead of the protein in your meal.

You may well be correct that the serum urate from the high protein diet has slowed progression of your PD; there is considerable interest among researchers on this topic, although the results are suggestive, rather than definitive. In any case, I would continue your current eating plan -- there may be no need whatever to change it. Let me know if I can answer further questions.
Best regards,

Kathrynne Holden, MS

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#3 Beachdog

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Posted 07 April 2013 - 08:19 AM

If you are experiencing symptoms, I wouldn't wait a few months to start a C/L treatment plan. A low dosage 25/100 ER (extended release) worked wonders. I too thought it best to delay but soon determined there was no value to waiting. Of course, check with your neurologist.




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