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Parkinson's Disease

Can high Homocysteine levels be treated ?

05/25/2005

Question:

My father . who has Parkinsons disease and is on a high level of Sinemet Plus , is suspected to have high Homocysteine levels . Can these be treated with vitamins b6 , b12 and Folic Acid ? If so , in tablet form or by way of dietary needs ? I look forward to your reply

Answer:

In recent years there has been growing evidence that levodopa treatment in PD may increase homocysteine levels through the metabolic pathway in which it is converted to dopamine.  However, what has not yet been firmly established is whether or not:

1) those increased levels of homocysteine increase a person's risk of cardiovascular disease or stroke as is thought to occur in other states of high homocysteine levels

2) treatment with vitamins and folate would successfully lower homocysteine elevated from this cause, or

3) blocking the COMT enzyme pathway with drugs known as COMT inhibitors will help to lower levels of homocysteine in levodopa treated patients. 

The latter is a possibility due to this pathway being involved in the production of homocysteine during levodopa conversion.  There are still too many uncertainties to make recommendations in this matter other than, in general, trying to follow normal cardiovascular health recommendations is certainly appropriate. 

Consulting with your father's neurologist or internist regarding recommendations for stroke and heart attack prevention would be recommended. 

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Response by:

Karen M Thomas, DO Karen M Thomas, DO
Formerly:
College of Medicine
The Ohio State University