How long have you been on L-DOPA? It's well-known to build up a strong tolerance with Parkinson's patients after around 5 years, so I'd be careful with it.
It's been a few months now. L-DOPA tolerance is dose-dependant, term-dependent as well as drug-dependant. After looking for ways to work around this, I found L-DOPA from Mucuna pruriens does not have the two major side-effects I was concerned about:
1. LID (Levodopa induced dyskinesia) - ironically the "cure" for Parkinson's disease (abbreviated to PD from here on) induces PD like side effects!
2. tolerance built up over chronic use.
We're not sure why Mucuna is able to do this but regarding LID one hypothesis advanced in a paper I read was that it might have something to do with pure L-DOPA being co-administered with Carbidopa in order to prevent peripheral metabolism of L-DOPA so that a greater amount reaches the brain. In the paper they show Carbidopa worsens LID and patients on pure L-DOPA alone took longer to get LID. Mucuna group didn't see any LID symptoms for the duration of the study.
Regarding tolerance, there are a few papers that compared Mucuna with other common PD drugs and found trial participants remained responsive throughout the study to a greater degree while on Mucuna compared to the other drugs. Here's one such paper: "Mucuna pruriens in Parkinson’s disease: a double blind clinical and pharmacological study", https://jnnp.bmj.com/content/jnnp/75/12/1672.full.pdf
Tolerance also seems to depend on the dosage and delivery regimen, the key thing to watch out being the prevention of dopamine peaks and to maintain a smooth steady level through continuous administration via IV — "Does Tolerance Develop to Levodopa? Comparison of 2-
and 21-H Levodopa Infusions ", https://pubmed.ncbi.nlm.nih.gov/8474479/
Having done all this work, I'm still highly wary of continuing Mucuna for years. I keep a watchful eye on any behavioral (hallucinations, insomnia) and physiological (tachycardia) abnormalities in myself, just in case. Also because I don't have PD, I can stick to a relatively low dosage (PD patients are given 45g of Mucuna/day equivalent to 1.5g of L-DOPA; I take 2.4g/day, roughly a twentieth of the therapeutic dose) which seems to be highly correlated with LID (what I'm most anxious about).
What gave me the confidence to move forward was knowing that Mucuna has been used in traditional Ayurvedic and Siddha medicinal systems here in India for thousands of years and is still actively in use as treatment for mood disorders¹. Something that lasts long and is also backed by science can't be wrong. Even so, I won't deny that L-DOPA via Mucuna is a minefield I'm gingerly stepping across.
1. LID (Levodopa induced dyskinesia) - ironically the "cure" for Parkinson's disease (abbreviated to PD from here on) induces PD like side effects!
2. tolerance built up over chronic use.
We're not sure why Mucuna is able to do this but regarding LID one hypothesis advanced in a paper I read was that it might have something to do with pure L-DOPA being co-administered with Carbidopa in order to prevent peripheral metabolism of L-DOPA so that a greater amount reaches the brain. In the paper they show Carbidopa worsens LID and patients on pure L-DOPA alone took longer to get LID. Mucuna group didn't see any LID symptoms for the duration of the study.
Regarding tolerance, there are a few papers that compared Mucuna with other common PD drugs and found trial participants remained responsive throughout the study to a greater degree while on Mucuna compared to the other drugs. Here's one such paper: "Mucuna pruriens in Parkinson’s disease: a double blind clinical and pharmacological study", https://jnnp.bmj.com/content/jnnp/75/12/1672.full.pdf
Tolerance also seems to depend on the dosage and delivery regimen, the key thing to watch out being the prevention of dopamine peaks and to maintain a smooth steady level through continuous administration via IV — "Does Tolerance Develop to Levodopa? Comparison of 2- and 21-H Levodopa Infusions ", https://pubmed.ncbi.nlm.nih.gov/8474479/
Having done all this work, I'm still highly wary of continuing Mucuna for years. I keep a watchful eye on any behavioral (hallucinations, insomnia) and physiological (tachycardia) abnormalities in myself, just in case. Also because I don't have PD, I can stick to a relatively low dosage (PD patients are given 45g of Mucuna/day equivalent to 1.5g of L-DOPA; I take 2.4g/day, roughly a twentieth of the therapeutic dose) which seems to be highly correlated with LID (what I'm most anxious about).
What gave me the confidence to move forward was knowing that Mucuna has been used in traditional Ayurvedic and Siddha medicinal systems here in India for thousands of years and is still actively in use as treatment for mood disorders¹. Something that lasts long and is also backed by science can't be wrong. Even so, I won't deny that L-DOPA via Mucuna is a minefield I'm gingerly stepping across.
¹https://www.youtube.com/watch?v=CyxVCPgUVMI (sorry, the video is in Tamil, "poonaikali" is vernacular here for Mucuna pruriens)