April 14, 2016

My Pills: Part One – the Four I Take Regularly

"Less is more" is my mantra for almost everything, and it's particularly relevant to the prescribed medications and supplements I take. I discussed this subject last year in a post that began with this cartoon:

While the following list may actually seem short to many, here’s what I take now.

My Prescribed Medications
Carbidopa-levodopa: This is the medication most often prescribed for those of us with Parkinson's disease (PD). Sinemet is the brand name, approved by the FDA in 1988.

The body converts the active ingredient levodopa into dopamine, the neurotransmitter that PD depletes. Carbidopa helps the levodopa pass the blood-brain barrier, enhancing the medication’s effectiveness.

After 40 years of clinical experience, levodopa remains the gold-standard treatment for Parkinson's. But this miracle drug isn't perfect. It brings unwelcome side effects, some of them serious. Patients typically find that the drug wears off toward the end of each regular dosing cycle. 

As the PD progresses, doctors usually prescribe increased dosages. I started with two pills three times a day. Now, nearly seven years into my own experience with PD, I take two pills seven or eight times a day. My neurologist told me he will not increase this daily dosage.

I’d been using regular carbidopa-levodopa. But last year I switched to the extended-release form because it seemed to moderate the blood pressure spikes that plagued me when I took the OTC supplement 5-HTP in addition to my regular PD med. I stopped using 5-HTP a month ago, so now I’ll try switching back to the regular version of carbidopa-levodopa – not the extended-release variety – to see which version works best for me.

In a future post about the major meds I no longer take, I'll describe the controversy that developed around my use of 5-HTP. 

Fluticasone propionate: I use this nasal spray every morning – more often if necessary – to deal with frequent runny nose incidents.

My Supplements
Vitamin D:  Several years ago, my former GP recommended I take 2000mg of vitamin D every day. I take this supplement at night.

Curcumin: This compound is the active ingredient in the Indian curry spice turmeric. The most-studied botanical, it yields beneficial effects confirmed by nearly 5,000 peer-reviewed studies. The scientific evidence shows that curcumin has anti-inflammatory properties to treat Alzheimer's, Parkinson's, MS, cancer, diabetes, arthritis, and other conditions. I've written countless posts about this supplement. Just put "curcumin" in the search box above and you’ll find a multitude of links to all the earlier comments.

Curcumin isn't a cure for PD, but studies show its potential to slow down the disease’s progression. I can’t prove that curcumin has played a role in the slow progress of my own PD experience. Nonetheless, I have a gut feeling it has.

Because so much of the compound is absorbed in the intestines, curcumin’s big problem is its limited bioavailabilty – the fraction of the dosage of the unchanged drug that actually makes it into the bloodstream. (Medications administered intravenously are by definition 100% bioavailable.) Researchers have found that adding other ingredients – like black pepper extract – measurably increases curcumin’s bioavailability.

I try to keep up with the research to help me figure out which brand of curcumin to buy. Currently, I'm taking 500mg of Doctor's Best Curcumin.

That's it. Two prescribed medicines and two supplements… the only pills I take regularly.

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