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Tremors/Wearing Off After Exercise


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#1 ShakingTheChi



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Posted 11 December 2013 - 08:16 AM

Dr. Okun,


I am taking Sinemet (25/100) and Comtan 3x a day at a 3.5 hour interval, which on a good day reduces my tremor to a fairly consistent, mild level I am comfortable with. I exercise frequently, and I notice that after an intense workout my tremor increases markedly. Others in my support group note the same phenomenon. Does exercise burn the levodopa at a faster rate than it's normally metabolized? If so, can we adjust the medication to anticipate a heavy workout, either adding an extra Sinement or fraction of it or accelerating the next dose (or fraction of it)? 



#2 Dr. Okun

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Posted 11 December 2013 - 08:23 AM

We don't know exactly why this phenomenon of heavy exercise can make some PD symptoms worse (especially post-exercise).  It could be stress on the system, metabolism or other factors.  In cases where it requires treatment we sometimes add 1/2 to one sinemet tablet just before exercising.

Michael S. Okun, M.D.

Author of Amazon Kindle and Paperback 10 Breakthrough Therapies for Parkinson's Disease
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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