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Parkinson's patients on l-dopa need folic acid

BOCHUM, GERMANY. People suffering from Parkinson's disease have an increased risk of heart attacks and strokes. A team of German and Swiss medical researchers believe they have uncovered the reason for this and propose a simple solution to the problem. The researchers studied a group of 48- to 73-year-old people. Fifteen of them had Parkinson's disease and were treated with levodopa plus decarboxylase inhibitor (Sinemet), 15 had Parkinson's disease, but were not treated as yet, and 15 were healthy controls. All study participants had their homocysteine levels measured after a 10-hour fast. The drug-treated Parkinson's patients had an average level of 17.3 micromol/L as compared to 9.1 micromol/L in the untreated group, and 9.2 micromol/L in the group of healthy controls. Other research has found that men with a level of 15 micromol/L increase their risk of coronary heart disease by 60 per cent while women increase it by 80 per cent. The risk of a stroke at the 15 micromol/L is two to five times higher than at the 10 micromol/L level in both men and women and the risk of peripheral vascular disease (eg. intermittent claudication) is seven times higher among people with elevated levels. The researchers believe that prolonged treatment with levodopa and decarboxylase inhibitor increases the blood level of homocysteine resulting in a greater risk for heart disease and stroke. They point out that elevated homocysteine levels can be lowered easily and effectively by supplementation with folic acid (400-800 micrograms per day or more depending on homocysteine level). The research team concludes that Parkinson's patients who are treated with levopoda should have their homocysteine levels monitored on a regular basis and should supplement with folic acid as required. (Editor's Note: Folic acid is non-toxic and no cases of overdosing have ever been reported. In these times of tight medical resources it would seem reasonable to suggest that Parkinson's patients on levopoda routinely supplement with 400-800 micrograms per day - unless, of course, their physician has specific objections to this).
Muller, Thomas, et al. Nigral endothelial dysfunction, homocysteine, and Parkinson's disease. The Lancet, Vol. 354, July 10, 1999, pp. 126-27 (research letter)

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