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When I read Joyce Tames' message about the result of her B-vitamin injection in Spain, I was not surprised. More years ago than I like to acknowledge, I was beavering away in a nutrition research lab, contributing my small bit toward establishing the human requirement for Vitamin B6. I had no idea then that my husband would develop PD 20 years later. What I learned then has been very useful today as we cope with keeping Neal functioning as well as possible. Vitamin B6 performs a large number of essential functions in the process of converting the food on our plates into brain neurotransmitters and other important cogs in the wheels that turn to keep us alive and functioning. With too little B6, we can experience, among other things, psychotic episodes and develop peripheral neuropathies(numbness, twitching, burning, etc.)and dermatitis. I had a good friend who developed PD in the early 1960s. She was one of the first patients to begin to receive levodopa after it was approved late in that decade. Its benefits for her were mixed, with terrifying psychotic hallucinations which required hospitalization. In those days, dosage regulation was pretty iffy, and there was the belief that B6 was bad for PD patients to contend with too. Levodopa, itself, can produce these toxic mental aberrations. But when B6 and other B vitamins are deficient, the results are enhanced. In the 60's, when Ldopa was first being used, it was thought that giving the patient a whopping dose of B6 would help the process of converting dopa to dopamine in the brain. After all, we knew that B6 was necessary for this function. Unfortunately, the more B6 the patient was given, the less good the Ldopa did and the bigger the dose that was needed. The result was the same as with too little B6. The patient often became psychotic and suffered peripheral neuropathies and all the other side effects. It was reasonable to believe that B6 supplementation was bad for a person with PD. Soon, the problem was found to lie in the fact that B6 combined with Ldopa to form a compound that rendered the levodopa useless. When the combination of Ldopa with carbidopa(Sinemet)was developed, this problem was pretty much eliminated. Now it is not usually considered harmful for a person with PD who is taking a Carbidopa-Levodopa drug to also take a vitamin supplement PROVIDED the amount of B6 does not exceed the Recommended Dietary Allowance or RDA. These days it is very hard to find a multi-vitamin that does not exceed the RDA for all nutrients, including B6. Its necessary for caregivers or Parkies to read labels of vitamins, as well as those of all highly supplemented foods (like dry cereals) very carefully. Too much B6 can inhibit the functioning of Sinemet(or its generic form). But too little can contribute to problems like restless legs and hallucinations. It is important to recognize that B6 does not function alone. The entire spectrum of vitamins and minerals required by humans work together along with proteins, and all the other nutrients. Events like stress or amount of sleep can make a difference in our individual needs and our performance. Body size also makes a difference in our needs. Because individual differences and other medical problems must be considered, it is essential to consult with your doctor before taking a supplement. I try to provide my husband with a diet that includes optimum amounts of all of the nutrients, rather than relying on supplements. Sometimes, however, this is not enough and an occasional supplement is helpful in preventing bad episodes. One more thing... many of the medications we take for other ailments can increase our need for certain vitamins. B6 is one that is frequenty involved in these drug-nutrient interaction problems. Check with your doctor or pharmacist, or the PDR. Good grief, I think I have just presented a lecture to a Nutrition 101 class! Sorry about that!! Martha (Martha Rohrer [log in to unmask])