Dosage and presentations
To use mucuna correctly the premise is to be clear about what you want: it is simply a legume that contains levodopa naturally. Synthetic levodopa usually used in pharmaceutical preparations may be replaced in whole or in part by the levodopa contained in mucuna.
This sounds simple, but the point is that the dosages and concentrations can vary, so the guidelines must be individualized and, as we said, at present the patients (and even some doctors) lack sufficient information.
It is essential to find a neurologist who is interested in mucuna and who is adequately informed about this amazing plant and how it can influence the treatment of Parkinson’s disease.
You should confirm everything with him and not conceal any information that may affect the treatment of your disease.
First of all, ask your neurologist who knows your case. He can tell you if you can be treated with mucuna or not, based on your specific situation, the stage of your Parkinson’s disease, and taking account other pathologies and conditions.
Secondly, your doctor will advise you on the purchase of the adequate formulation of mucuna depending on the dose administered.
It is prudent to start with low dose tablets and subsequently increase gradually; there is always time to increase the dosage.
Patience is key in the beginning: if you rush treatment for quick results, it is likely that you will experience some side effects which, although they are usually mild, can be bothersome. If the treatment proceeds too slowly on the other hand, you may think that the mucuna is not working and give up.
Third, adjustment the treatment: you almost always have to modify the dose and frequently have to remove some of the drugs previously prescribed (for Parkinson’s disease or for your other pathologies).
There is no proven effective dose for mucuna. In clinical studies, some patients take 15 to 30 grams (half an ounce to one ounce) of mucuna preparation orally for a week, but I discourage such quantities, which I consider too high.
Any medication (which mucuna is) should be administered initially in small amounts, keeping in mind the particular case of the patient and the purpose of the treatment.
Doses of 15 and 30 grams of mucuna seed extract were used for a specific experiment, with strict medical check-ups, knowing well the formulation of the product and its origin, and taking into account many other factors.
The researchers work under controlled conditions: they select patients without contraindications and remove any incompatible drugs and other medications that may alter the absorption or metabolism of levodopa, etc.
That is not what happens when a patient buys mucuna just anywhere, and self-medicates with little information and without medical supervision.
A consumer may purchase capsules of 200 mg of levodopa with a 15% concentration or 800 mg tablets with a 50% concentration, and these are two completely different products .
Sometimes patients have bought the product on eBay knowing nothing of their provider, and they receive a package whose content is not guaranteed and whose concentration is not safe. The patient then will then dilute the material in water without knowing how much to measure out.
Always use mucuna extracts that are dispensed by known, reliable suppliers. In our website you can find where to buy mucuna online.
The price of mucuna, while not expensive, can be too much for some. That should be considered in the long-term as it could be in use for many months or years.
However, at first, the price does not matter much because the goal is to establish the dose for each patient. The main advice I give is to buy a product from a trusted brand and start with very low doses to be increased later. In this first stage the daily cost will be minimal because the doses are low and the tablets or capsules have low concentrations of levodopa.
The important thing is to know if you feel better with mucuna. At this stage you should not buy any foreign preparation from distant countries through unknown sellers on eBay. Later, when we find the dose that fits a particular patient, then we can ultimately plan a more affordable product once we make sure that it is trustworthy.
There are so widely available that the Internet is flooded with numerous commercial offers.
I have selected some brands based on logical criteria: those with the longest history or best known, the most widely used, those that describe the content more clearly, and those coming from trusted providers.
Below is a summary of the presentations of mucuna grouped into seven sections.
- Mucuna powder
- Mucuna in tinctures or concentrated extracts
- Mucuna capsules or tablets, low dose (15 to 30 mg of “real” natural levodopa), ideal to start taking mucuna.
- Mucuna in capsules or tablets, medium dose
- Mucuna in capsules or tablets, high dose
- Tincture or mucuna drops
- Mucuna mixed with other substances
There are many cheaper versions available, but I know their contents, and I have chosen prominent and accredited suppliers.
The classic presentation is powder from mucuna seeds. It is very bothersome to prepare as the powder must be diluted in water or other liquid (not milk because it hinders absorption). It has a very unpleasant taste that laboratories try to hide by sweetening it.
The great advantage is the ability to adjust the exact for smaller doses that are always recommended at the beginning. In countries (such as Spain) where it is more difficult to find capsules or tablets with small doses, one may start with mucuna powder. There are many brands offered, but here I describe only the original, which is sent directly from India.
This drug was marketed in India after the publication of an innovative study in Parkinson’s patients in which an average of 6 sachets (+ -3) of mucuna seed powder (7.5 grams with levodopa 250 mg, i.e. 3.3%) were administered to each patient.
I would like to emphasize that this mucuna levodopa dose is relatively high (1,500 milligrams), especially for those who had never taken levodopa, and if combined with one or two tablets of Sinemet there is an obvious risk of overdose.
Other than those patients, there were no problems probably because this natural levodopa is not combined with carbidopa (as in Sinemet).
In theory the levodopa from mucuna, as it lacks carbidopa, should be removed rapidly from the blood… unless the plant contains other ingredients to avoid it.
After taking the mucuna powder (dissolved in water), blood levels of levodopa behave similarly to those observed with the synthetic version of levodopa. The difference is that the maximum dose does not show as marked an effect1, and clinical efficacy is similar or greater. You can find and buy Zandopa in Amazon.com.
Equivalences of Zandopa powder are administered to people who take only levodopa (without carbidopa), something which hardly occurs in the West, so that errors are very common.
According to the manufacturer every measure of mucuna powder (7.5 grams) is equivalent to 250 mg of synthetic levodopa. But this is only when the patient does not take carbidopa at all. However, almost all patients mix mucuna powder with some Sinemet or Stalevo in which case it is necessary to assume that the carbidopa is working.
The equivalence for Zandopat is not clear to the uninitiated. If you follow the laboratoy indications you must give 30 grams of powder to replace the Sinemet 25/250 tablet (4 small cups).
This is the ratio that was used in the original study, but in practice it is too high and can cause side effects (nausea, vomiting, and malaise) so I do not recommend it.
The dosage is individualized and you have to start with small, adequately spaced doses.
The laboratory has verified this and thus expressed it in the brochure, although not sufficiently emphasized.
We said that it is highly recommended to start with low doses of mucuna in order to discern a suitable treatment for each case and situation. Therefore, I suggest starting with presentations of very low amounts of mucuna, for example, rather than those listed principally to treat the Parkinson’s disease, those that are sold with general indications as “tonics”, aphrodisiacs or “revitalizers”.
This brand is promoted as a “nerve tonic.” It comes in a capsule of 250 mg of mucuna extract 6% which is equivalent to 15 mg of pure levodopa.
Currently, this product only appears on the web pages of the United Sates and is not sent to Europe. You can find it on Amazon.com.
Mucuna extract comes in 200 mg capsules with no concentration indicated on the label, which usually means it is low (15% or less).
This is not shipped to Europe either, for US shipping you can buy it on Amazon.com.
Sold as a dietary supplement, without specifying that it is used to treat Parkinson’s disease.
Each capsule contains 333 mg of extract of the Mucuna pruriens (velvet beans) seed in a concentration of 15%, which is 50 mg of natural levodopa (equivalent to the synthetic levodopa in half a tablet of Sinemet Plus or one fifth of Sinemet 250). It is a good choice to start with. Some websites sell this online in Europe and it’s sell in US by Amazon.
Very similar to the previous one, it contains 370 mg of extract of mucuna 15% which translates to 55 mg of natural levodopa. You can order it on Amazon France.
These are vegetable capsules with mucuna 400mg 15%, i.e. 60 mg of levodopa. It is another French product available through Andorra but is also provided by a pharmacy in Barcelona and you can buy it online.
I will mention two brands, both of which can be obtained through the French web page of Amazon. They contain significant doses and thus it is highly recommended that it be prescribed and controlled by a doctor.
Capsules of 500 mg mucuna 15%, about 75 milligrams of levodopa.
This mucuna preparation is possibly the easiest to obtain in Europe.
It contains 100 mg of natural levodopa (the same as a tablet of Sinemet Plus) in a capsule of 200 milligrams of extract of mucuna which is quite concentrated (50%).
BIOVEA MUCUNA DOPA
You can buy it from almost anywhere in the world. Each capsule has 250 mg mucuna seed extract 40% equivalent to 100 mg of levodopa.
These capsules are large because it contains 120 mg of levodopa and, as it is a low concentration (15%), 800 mg of powdered seeds are needed. It can be ordered online
These are difficult to buy, their concentrations are often too high, and it is more troublesome to establish the dosage unless you are an expert. I don’t recommend it.
Some theories assert that there are people with a relative nutritional deficiency or imbalance of certain precursor amino acids of dopamine and serotonin2, and that this causes or worsens Parkinson’s disease, depression and other related disorders involving centrally acting monoamines.
In this vein, some have proposed mucuna combined with tyrosine, tryptophan and others to relieve this imbalance of amino acids. This theory, enthusiastically promoted by Dr. M. Hinz 3 recommends products that combine levodopa with tryptophan, tyrosine, cysteine and cofactors in order to recuperate the balance.
These treatments can be useful, and future studies are needed to expand on the effect of amino acids and other nutritional aspects of Parkinson’s disease and their influence on the behavior of levodopa.
There is some progress in treatment from that angle, but it is not yet confirmed and results can be highly variable.
So far I do not recommend the combined preparations as some do, mixing tyrosine, green tea (carbidopa action exerted a slight), lipoic acid, ginseng, ginkgo, etc. It will suffice to adjust the dosage of mucuna.
- Mahajani SS et al. Bioavailability of L-DOPA from HP-200 : a formulation of seed powder of Mucuna pruriens (Bak) : a pharmacokinetic and pharmacodynamic study. Phytotherapy Research 1996; 10:254-256. ↩
- Hinz M, Stein A, Uncini T. Relative nutritional deficiencies associated with centrally acting monoamines. Int J Gen Med 2012; 5:413-430. ↩
- Hinz M, Stein A, Uncini T. Amino acid management of Parkinson’s disease: a case study. Int J Gen Med 2011; 4:165-174. ↩