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Exercise and MAO B Inhibitor


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#1 JW Blade

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Posted 06 April 2013 - 11:03 AM

I was diagnosed two weeks ago by a general neurologist and I have an appointment with a movement disorder specialist in two weeks to get a second opinion. I am age 51 slightly overweight but will be height/weight proportionate in a matter of a few months. I have done some research and come with a plan and wanted to run it by someone. I know doctors hate people like me because we don’t know enough to be effective just enough to be dangerous.
I have two main problems related to my Parkinson’s that I want to make better. My first goal is to continue to play golf at the highest level possible. My current problem is I am unable to hit the ball as far because my right side moves slowly (no explosiveness). My second goal is to improve the small motor skills in my right hand (dominate hand) specifically my handwriting and typing on a keyboard. When I try to write fast my handwriting gets sloppy and small and when I try to type on a keyboard quickly my right hand can’t keep up (specifically my middle finger).

My plan is as follows:
1. Eat a balanced diet of mostly fruits, vegetables, whole grains, non-fat dairy and lean meats. I am also concentrating on foods high in vitamin C (fruits and peppers) and vitamin E (sunflower seeds and almonds). I am also eating a daily dose of spinach and kale.
2. I am taking the following supplements: Ubiquinol (100 mg twice daily), Vitamin D3 (5,000 IU once daily), Omega 3 fish oil (EPA+DHA 250 mg twice daily).
3. Exercise vigorously 5 to 7 days per week for more than 20 minutes. Why? It is my understanding that exercise in excess to 20 minutes produces extra dopamine as well as all the other health benefits of exercising. I know it has not been proven but some of the research suggests that this type of exercise may provide neuro-protection. Exercising also make me feel empowered in my treatment.
4. Take a dose of Azilect daily. Why? Since I am will be producing excess dopamine through exercise I want to keep the dopamine instead of breaking it down and discarding it. It is my understanding that this is what this class of drug does (MAO B inhibitor). I know this drug was turned down as a neuro-protector by the FDA recently but somebody thinks it has those properties so just in case the FDA is wrong I like the idea of taking it.
5. Take a dopamine agonist before golfing only. Why? Working out before golf would be difficult so I may need a shot of dopamine. I usually play once or twice a week.

Let me know what I am missing or the flaw in my thinking.

Thanks,

John

#2 Dr. Okun

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Posted 07 April 2013 - 06:40 PM

There is currently no evidence to support one diet over another, or one supplement over another, so I advise patients not to go crazy in this area. It is sometimes helpful to take your medicine one hour before you eat (it helps them absorb). Exercise is a great idea. The MAO-B inhibitor has symptomatic benefits and is a good idea. Taking agonists only before golf would be an atypical approach. It is better in general to try to maintain a steady blood level of an agonist or sinemet (or both) throughout the day and not to provide unnecessary peaks and valleys in blood level. Some people already on sinemet benefit from a booster a half hour before golf, but this is done on a case by case basis.

See a specialist is a great idea. I love patients that read and advocate, so keep it up.

Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips


#3 joy h

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Posted 07 April 2013 - 09:26 PM

My movement disorder dr suggest a Mediterranean diet.

#4 omalley

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Posted 08 April 2013 - 01:32 PM

As far as exercise goes, I have gained the most from a minimum one hour a day (rowing machine, treadmill, exercise bike). It is best to practice cardio-exercise that makes you sweat and increases your breathing. This aerobic exercise should be in addition to PD-specific directed exercises for balance, coordination etc of the sort outlined by David Zid in his book called Functional Fitness. I am 66, diagnosed for 6 years, have not used agonists but do use Sinemet and Azilect. I do often take a booster of half a 25/100 Sinemet either before or after exercise as I find the vigorous exercise seems to burn off levodopa. Good luck.

#5 Dr. Okun

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Posted 08 April 2013 - 07:30 PM

Thanks for the comments. I have no experience with the mediterranean diet. I also do not recommend a specific exercise regimen to people-- it must be safe, get the heart rate up, and it should not be a one size fits all.

Hope that helps.

Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips


#6 Golden01

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Posted 09 April 2013 - 07:58 AM

The NPF Center of Excellence where I live also offers golf classes for people with PD.

#7 JW Blade

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Posted 09 April 2013 - 11:34 AM

Is there any evidence to support the idea of exercising everyday to naturally produce more dopamine while taking a MAO B Inhibitor to preserve that excess dopamine for use throughout the day. If so, does it make more since to exercise once per day for an hour or twice per day for a half an hour to get the maximum benefit?

John

#8 Dr. Okun

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Posted 09 April 2013 - 02:30 PM

I am not aware of any evidence to support the notion exercise plus a MAO-B is better.

We do recommend daily exercise.

Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips





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