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Someone asked for an explanation of diamox in one page. The best thing to do would be for someone to do a trial TI: Acetazolamide therapy of menstrual-related fluctuations in Parkinson's disease. AU: Factor-SA AD: Department of Neurology, Albany Medical College, New York. SO: Mov-Disord. 1993 Apr; 8(2): 240-1 ISSN: 0855-3185 PY: 1993 MESH: Adult-; Carbidopa-administration-and-dosage; Carbidopa-adverse-effects; Drug-Administration-Schedule; Drug-Therapy,-Combination; Levodopa-administration-and-dosage; Levodopa-adverse-effects; Neurologic-Examination-drug-effects MESH: *Acetazolamide-administration-and-dosage; *Menstruation-Disorders-drug-therapy; *Parkinson-Disease-drug-therapy This is the only Medline reference to ACZ and PD, but the effect,if not placebo, may not be limited to premenstrual worsening of PD. Factor suggests a trial may be worthwhile. ACZ retains carbon dioxide which makes the blood acidic, which increases brain bloodflow, and stimulates breathing, which increases oxygen delivery to the brain, which is a suggested mechanism for improvement in PD, THE EVIDENCE FOR IMPROVEMENT IS PURELY CASE HISTORIES. Another way to create a mild acidosis is to rebreathe some air, using a supermarket vegetable bag. Once breathing becomes slow and deep, breathe some fresh air as well. An ill fitting plastic oxygen mask can be attached to the bag. If the mask is a tight fit, make holes in it with a hot darning needle on a cork. Breathing slowly and deeply, has the same effect. Ramos suggests rebreathing for half an hour three times a day, in addition to low dose ACZ and potassium, which comes in fruit. Alkalosis is too little acid or too much alkali, caused by eg too much antacid, and some diuretics.People who hyperventilate from anxiety lose carbon dioxide and become alkalotic, which causes nerves to fire at random, whereas acidosis stabilizes nerves which may relieve tremor. Alkalosis slows bloodflow and breathing and may not be good for brain oxygen levels. Angel Ramos proposes that in some cases there is a swing or oscillation from acidosis to alkalosis, triggered by lactate buildup. Lactate buildup usually happens with prolonged anaerobic exercise, but also in mild exercise if breathing is not increased in proportion, or, one supposes, if mitchondria are damaged, both of which are possible in PD. Some PD persons can hardly blow out a match, and have very soft voices, so it is easy to see the breathing system is not working properly. Diamox might make people worse if they already have high carbon dioxide, or low blood pressure. Low dose, 65 to 250 milligram/day, is possibly the way to go. Other respiratory stimulants, like theobromine in chocolate, may help, but one needs to eat up to a quarter pound block at a time. Sometimes one can improve exercise performance by breathing at the rate a normal eg swimmer or bicycle rider breathes. Getting L-dopa levels right is the first step, since the diaphragm is probably doing what the other muscles are doing. TOO MUCH ACIDOSIS IS A VERY BAD THING, AS IN COMA. Eye doctors and neurologists use diamox. PD is also a respiratory disease, and needs respiratory expertise in it's management.