A sort of complement referred to as the “dopamine bean” can include very excessive ranges of levodopa — in some instances, greater than prescription formulations used to deal with Parkinson’s illness, researchers discovered.
Amongst 15 manufacturers of Mucuna pruriens dietary supplements, levodopa content material ranged from 2 mg to 241 mg, and the latter quantity was near the utmost dosage of prescription levodopa accessible, which ranges from 50- to 250-mg doses, Pieter Cohen, MD, of Cambridge Well being Alliance in Massachusetts, and colleagues reported in a research letter in JAMA Neurology.
Cohen stated the excessive doses of levodopa present in these dietary supplements “pose direct challenges to managing sufferers with Parkinson’s illness who’re utilizing these dietary supplements. The dose of levodopa the affected person is receiving can be a lot higher than what we predict the affected person is utilizing based mostly on our prescribed drugs.”
Exterior of Parkinson’s illness, individuals who use them solely for his or her dopaminergic results might expertise a “huge number of severe unwanted side effects together with paranoia and psychosis,” Cohen informed MedPage As we speak.
Cohen stated he and his workforce started investigating Mucuna dietary supplements after involved mother and father stated they believed their son was having severe psychiatric results from the merchandise and would not cease utilizing them.
Mucuna dietary supplements are “marketed from Amazon to Vitamin Shoppe for his or her dopamine results, to assist with temper, exercises, focus, power — you identify it,” Cohen stated. The pure bean does include small quantities of the dopamine precursor levodopa.
How generally Mucuna is used within the U.S. is not recognized, however the researchers cited a latest survey of 205 sufferers with Parkinson’s illness discovering that 7% of those that used dietary supplements had been taking Mucuna merchandise.
To additional their earlier work investigating how “botanical” dietary supplements are literally formulated as potent medicine, Cohen and colleagues searched the NIH Dietary Complement Label Database in November 2021 to determine dietary supplements with Mucuna pruriens on the label. They bought on-line the 20 manufacturers most just lately added to the database in 2021.
Additionally they obtained two samples of Mucuna pruriens seeds from the Nationwide Heart for Pure Merchandise Analysis repository on the College of Mississippi to find out the quantity of levodopa in seed extract.
Finally, of the 20 samples, one wasn’t accessible, one was a replica entry, and two didn’t have each “Mucuna pruriens” and “dietary complement” on the label, so the researchers ended up with 16 merchandise. Of those, one product contained no detectable ranges of levodopa.
For Mucuna seed extract, authenticated samples contained 2.5% to three.9% levodopa. However amongst Mucuna dietary supplements that listed a particular amount of seed extract on the label, the precise amount of levodopa was 228% to 2,186% higher than the estimated amount.
The researchers warned that it isn’t doable to instantly evaluate the pharmacologic results of levodopa in Mucuna dietary supplements with prescription levodopa as a result of pharmaceutical variations embody a peripheral decarboxylase inhibitor — which limits conversion of levodopa to dopamine — that’s not current in Mucuna dietary supplements.
Cohen informed MedPage As we speak that unwanted side effects shall be “very laborious to foretell,” as it’ll “rely upon how a lot of the levodopa in these dietary supplements enters the central nervous system.” Nonetheless, he stated, extra dopamine “can result in a variety of hostile results together with agitation, impulse management issues, peripheral neuropathies, and orthostatic hypotension.”
The researchers famous their research was restricted as a result of they solely analyzed two samples of seed extract, so it is doable that different variants of Mucuna pruriens or completely different extraction strategies could have an effect on the amount of levodopa. Additionally, just one pattern from every complement model was analyzed, so it is unknown whether or not levodopa doses fluctuate from batch to batch.
Nonetheless, they concluded that “clinicians could determine unsuspected levodopa consumption by asking sufferers about the usage of dietary supplements and advising that consumption of M. pruriens dietary supplements could unpredictably complicate the administration of Parkinson’s and different illnesses.”
Cohen reported receiving grants from The Pew Charitable Trusts and Customers Union and being the topic of a civil go well with introduced by Hello-Tech Prescription drugs, a complement firm (the jury present in Cohen’s favor), each exterior the submitted work.