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Dear Bonnie, As you have allowed it, I will post my response to your question to the PD list, as I believe it has relevance for others. > First, I should say that my dad is taking Sinemet (I do not know the amount) > for his PD & that is the only med he's on currently. I print out the majority > of (important) post for him to read & he's taken the "Sinemet & protein" issue > quite seriously & my mother fears it's been too seriously. > This past week, my dad was hospitalized for an ulcer. When dad finally let mom > take him to the doctor, he took with him a stool sample & when it was > confirmed that there was blood in his stool, the doctor sent him right to the > hospital. The (2nd) ulcer was discovered & I am told it was the size of a > quarter. The ulcer was cauterized & dad is now home & back to "normal". > Dad's basically kept himself on a low (almost no) protein & high fiber diet. > But now the doctor has reversed that to making sure he gets protein & very > little fiber. Mom believes the ulcer was caused by aspirins he had been taking > as he's now been told not to take ANY aspirin. > My question to you is - what do you suggest re. the Sinemet vs proten now? My > dad believes in the "connection" but his doctor (not the neuro) says he's > never heard of such a thing. > Thanks for your input. > Bonnie > daughter of Jim 77/3 > ps It is ok w/me if you post your response to the PDlist It sounds to me as though your Dad is not getting enough protein. Also, I believe you are correct in thinking that aspirin use may have contributed to his ulcers. Your Dad needs to get adequate protein. Adults need .8 to 1 gram protein per kilogram of body weight per day. A less accurate but simpler rule is: about 1/2 gram protein per pound body weight per day. Thus, a 100-pound person would need about 50 grams protein daily. If he doesn't get enough protein, he will become very sick. If he does not experience "on-off fluctuations" he should be able to take Sinemet 30-60 minutes before meals, and get good results. If he has fluctuations, then protein adjustment should give him better results from Sinemet. He can avoid protein during the day, then have a large serving of protein foods at night (one ounce of meat, poultry or fish has 8 grams protein); or he can try the "7:1 ratio" eating plan. The 7:1 ratio seems to work quite well for most people, although a few are extremely protein-sensitive, and must avoid all protein except at the evening meal. I prefer the 7:1 plan when possible, because it is better balanced, and allows for a greater variety of protein foods. For more information, you can view the Hearty Balance website at: http://www.balancenutrition.com/ It's not surprising that your dad's doctor hasn't heard of the protein-sinemet connection, as he's not a neurologist. Most general physicians have only a very few patients with PD, so they are much less familiar with PD meds and their food-drug interactions. My very best regards to you and your father, Kathrynne -- Kathrynne Holden, MS, RD "Nutrition you can live with!" Medical nutrition therapy http://www.nutritionucanlivewith.com/ Tel: 970-493-6532 // Fax: 970-493-6538