Is Parkinsons Hereditary?

Parkinsons and related health issues

• I am 77 years old and these are my symptoms: I have a rapid heart rate and feel very sick. I went to the emergency room and they did tests on me for several hours but said there was nothing wrong. My electrolytes were fine and they sent me home. But I feel as though I am going to die. I have had Parkinsons for 6 years, for which I take Carbidopa/Levo (Sinemet), see below for my dosage and other medications that I am also taking. My doctor told me two days ago to double the dosage rate of this Parkinsons medication, thinking that my current symptoms may be the result of worsening Parkinsons. I do feel marginally less unwell immediately after taking my Parkinsons medication, but the effect doesn't last very long. I have poor thyroid function for which I take Levothyroxine (levoxyl), again see below for dosage. I am malnourished. I have no appetite and cannot eat very much even though I try to. I do not think my digestive system is working properly. I have been taking various over-the-counter digestive aids but they have not helped. I have lost 20 pounds since last June (it is now the end of March) and I am very frail and almost immobilized. I have depression. I have been prescribed Zoloft but I have only taken 2 25 milligram doses so far. If my symptoms of depression are relieved by the Zoloft I hope I may be better able to eat. I am very anxious and am having panic episodes. I need an antianxiety medication. I had an abscessed tooth for at least six months due to a root canal that didn't work. The tooth was removed March 26 2006. Could my poor health symptoms be caused by general infection in my body from the infected tooth? My question: Is there anything I can do to help myself feel better? I am currently taking the following medications, but I have not followed the dosage schedule very well, I tend to not take as much of the medication as I am prescribed: 1. Carbidopa/Levo (Sinemet) 25/250 1/2 to 1 tablet 4-5 times a day in divided doses spread evenly over the day. (On March 27 she was told her to double this dosage). 2. Levothyroxine (levoxyl), 50MCG tablet Take one tablet every day. 3. Clindamycin hcl 150 MG CAP Take one capsule by mouth 4 times a day until gone 4. Zoloft 25 milligrams per day to start 5. Multivitamin, various daily

• Answer:

  Hello Shockspray, Wow, you MUST feel miserable, but your situation is NOT hopeless. First things first. You MUST take your full dose of levothyroxine, (and all your medications). An out of kilter thyroid can cause numerous problems, an irregular heartbeat being one of them. Zoloft can also cause dizziness, especially during the first days you take it. These are the symptoms of hypothyroidism (Low thyroid): -------------------------------------------------------- Weight gain Puffy face Loss or thinning of eyebrows Cold intolerance Low sex drive Depression Abdominal bloating Cold hands or feet Dry or thinning hair Joint or muscle pain Thickening of the skin Thin, brittle fingernails? As your thyroid hormone levels fall over the following months, the skin becomes rough and dry, hair coarsens, and mental activity?including concentration and memory?may become slightly impaired. Depression can develop, and some experts believe that even mild thyroid failure can lead to major depression. Other later symptoms include a husky voice and numbness of the arms and legs. Muscle pain, weakness, and carpal tunnel syndrome may occur. Some people experience hearing loss, depression, mental confusion, uneasiness, daytime sleepiness, or memory problems, especially in the elderly. Obstructive sleep apnea, in which tissues in the upper airway collapse at intervals during sleep, thereby blocking the passage of air, is common. http://www.armourthyroid.com/hypothyroidism/symptoms.html#summary ?They found that the older patients had fewer symptoms, and some of the classic signs (eg, cold intolerance, weight gain) were often absent. Moreover, the common clinical features of hypothyroidism (eg, fatigue, constipation, cognitive loss) are often attributed to normal aging (table 1). These factors, along with the fact that hypothyroidism has an insidious onset and affects multiple organ systems, may cause considerable delay and difficulty in diagnosis. Therefore, it is important to have a high index of suspicion and a low threshold for screening for thyroid dysfunction in elderly patients who present with vague, nonspecific symptoms.? http://www.postgradmed.com/issues/2003/05_03/mohandas1.htm Continue on with the Zoloft, unless you experience side effects, and if you do, notify your doctor. Antidepressants can take 2-3 weeks to work well. In 2-3 weeks you should see an improvement. If not, let your doctor know; there are many other good SSRIs (A form of antidepressant) available, and not all work for all people. Lexapro is one that works quickly and has few side effects for most people, if any. ?Other aspects of seniors' lives can also put them at risk for depression. While living longer, many will also be living with some condition such as arthritis, heart disease, or diabetes, which limits their activities or causes chronic symptoms or pain. These limitations can deprive older people of the satisfactions of exercise, social contact, and meaningful activities such as volunteer jobs or participation in cultural events. Understandably, chronic pain often causes depression -- what could be more discouraging than being uncomfortable most of the time? In addition, some medical conditions which are common in the elderly cause depression directly through physiological mechanisms -- Parkinson's disease and stroke are the most obvious examples. Finally, excess use of prescription drugs or alcohol, surprisingly common among the elderly, may contribute to depression (or be a symptom of it). So far we have been discussing depression in the abstract, as if we know what it is. But what, in fact, constitutes true depression, and how does it differ from a normal response to life's difficulties?? ?If depressive symptoms are more serious, professional attention may be necessary. Counseling may help a person cope with loss, family conflict, or health problems. Antidepressant medications are also a mainstay of treatment for significant depression. Modern antidepressants are much safer and have fewer troublesome side effects than older ones. These medications, once shunned except in extreme cases, often produce dramatic improvement and welcome relief from suffering. Perhaps most importantly, today's primary care doctors are much more alert to depression than in past years, and many of them know how to use antidepressants wisely. In more serious cases, they may refer elderly patients to a psychiatrist for evaluation and treatment. Either way, the important thing is for depressed older patients to get the attention that they need. Fortunately, today's elderly are more willing to acknowledge depression as a problem than in previous generations -- and are less hesitant to get help for it. Detecting depression in the first place is the most critical step. As long as someone recognizes the problem, modern treatment is more effective and more available than ever.? http://www.pamf.org/health/toyourhealth/depressedelders.html ?Older depressed individuals often have severe feelings of sadness, but these feelings frequently are not acknowledged or openly shown. Sometimes, when asked if they are "depressed", the answer from persons suffering from depression is "no". "Depression without sadness" is one of those seeming paradoxes that impedes its recognition. Some general clues that someone may be suffering from depression in such cases are persistent and vague complaints and help seeking, along with frequent calling and demanding behavior.? ?Although there is no single, definitive answer to the question of cause, many factors -- psychological, biological, environmental and genetic -- likely contribute to the development of depression. Scientists think that some people inherit a biological make-up that makes them more prone to depression. Certain brain chemicals -- like norepinephrine, serotonin, and dopamine -- are probably involved in major depression. While some people become depressed for no easily identified reason, depression tends to run in families, and the vulnerability is often passed from parents to children. When such a genetic vulnerability exists, other factors like prolonged stress, loss, or a major life change can trigger the depression. For some older people, particularly those with lifelong histories of depression, the development of a disabling illness, loss of a spouse or a friend, retirement, moving out of the family home or some other stressful event may bring about the onset of a depressive episode. It should also be noted that depression can be a side effect of some medications commonly prescribed to older persons, such as medications to treat hypertension.? http://www.nami.org/Template.cfm?Section=By_Illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=7515 ?Symptoms ? depressed or irritable mood ? feelings of worthlessness or sadness ? loss of interest or pleasure in daily activities ? temper, agitation ? change in appetite, usually a loss of appetite ? change in weight o unintentional weight loss (most frequent) o weight gain ? difficulty sleeping o daytime sleepiness o difficulty falling asleep (initial insomnia) o multiple awakenings through the night (middle insomnia) o early morning awakening (terminal insomnia) ? fatigue (tiredness or weariness) ? difficulty concentrating ? memory loss ? abnormal thoughts, excessive or inappropriate guilt ? excessively irresponsible behavior pattern ? abnormal thoughts about death ? thoughts about suicide ? plans to commit suicide or actual suicide attempts ?Antidepressant drug therapy has been shown to increase quality of life in depressed elderly patients. These medications are carefully monitored for side effects, and doses are usually lower and increased more slowly than in younger adults.? http://www.nlm.nih.gov/medlineplus/ency/article/001521.htm Your Parkinsons? medication may be responsible in part for your depression! However, do NOT discontinue taking the Sinemet! Discuss this with your doctor. Physical factors, including genetics ? inherited tendencies toward depression ? co-occurring illness (such as Parkinson's, Alzheimer's, cancer, diabetes or stroke) ? vascular changes in the brain ? a vitamin B-12 deficiency (as yet unclear if this is caused by poor eating habits or a result of depression) ? chronic or severe pain Personality characteristics (may also be symptomatic of unresolved trauma) ? low self-esteem ? extreme dependency ? pessimism Medications (all medications have side effects, but some can cause or worsen the symptoms of depression) ? some pain medicines (codeine, darvon) ? some drugs for high blood pressure (clonidine, reserpine) ? hormones (estrogen, progesterone, cortisol, prednisone, anabolic steroids) ? some heart medications (digitalis, propanalol) ? anticancer agents (cycloserine, tamoxifen, nolvadex, velban, oncovin) ? some drugs for Parkinson?s disease (levadopa, bromocriptine) ? some drugs for arthritis (indomethacin) ? some tranquilizers/antianxiety drugs (valium, halcion) ? alcohol. http://www.helpguide.org/mental/depression_elderly.htm Side Effects of Zoloft: ---------------------- ?Adverse Effects In clinical development programs, sertraline has been evaluated in 1902 subjects with depression. The most commonly observed adverse events associated with the use of sertraline were: gastrointestinal complaints, including nausea, diarrhea/loose stools and dyspepsia; male sexual dysfunction (primarily ejaculatory delay); insomnia and somnolence; tremor; increased sweating and dry mouth; and dizziness. In the fixed dose placebo controlled study, the overall incidence of side effects was dose related with a majority occurring in the patients treated with 200 mg dose. http://endoflifecare.tripod.com/huntdiseasefaqs/id52.html http://www.rxlist.com/cgi/generic/sertral_ad.htm Sinemet ------- Have you tried Sinemet CR? If not, you may want to speak to your doctor. Fewer ?off times? are reported with Sinemet CR than Sinemet. Sinemet can also cause dizziness and light-headedness, especially when standing up from a sitting position. A rapid heartbeat (tachycardia) and loss of appetite can be caused by Sinemet. Your blood should be checked regularly for kidney and liver function while taking Sinemet. You are probably aware that over time, Sinemet may be less effective than it was when you started taking it. ?In clinical trials, patients with motor fluctuations experienced reduced off time with Sinemet CR when compared with Sinemet. Global ratings of improvement and activities of daily living in the on and off states, as assessed by both patient and physician, were slightly better in some patients during therapy with Sinemet CR than with Sinemet. In patients without motor fluctuations, Sinemet CR provided therapeutic benefit similar to Sinemet but with less frequent dosing. Pyridoxine hydrochloride (vitamin B 6), in oral doses of 10 mg to 25 mg, may reverse the effects of levodopa by increasing the rate of aromatic amino acid decarboxylation. Carbidopa inhibits this action of pyridoxine.? http://www.rxcarecanada.com/Sinemet%20CR.asp Charts of side effects: http://www.rxlist.com/cgi/generic3/sinemet_cr_ad.htm See page 5 of this document for side effects. (I am unable to copy this material) http://www.msd-newzealand.com/content/downloads/SINEMETCR%200720004%20(%20Code%20No%20only)%20CMI.pdf (Sinemet) ?Dosage should be titrated to the individual patient needs and this may require adjusting both the individual dose and the frequency of administration. Studies show that the peripheral dopa decarboxylase is saturated by carbidopa at approximately 70 to 100mg a day. Patients receiving less than this amount of carbidopa are more likely to experience nausea and vomiting.? http://www.medsafe.govt.nz/Profs/Datasheet/s/Sinemettab.htm Take your medications as prescribed. If you suffer from side effects, you must visit your primary care physician for an assessment and blood tests to determine your medication levels, thyroid, etc. I would recommend not wasting money on digestive aids. Instead, as I previously mentioned, eat a balanced diet,take your meds properly and see your doctor. Keep all your medication in a dry, dark place, away from moisture and sunlight. Do you have one of those weekly pill boxes? This is an easy way to remember which pills you took. Make yourself a schedule or chart where you can record your medications, perhaps checking them as you take them. It?s important to take your pills on time, in full dosage, as needed! Pill Box http://www.forgettingthepill.com/cgi-bin/ForgettingThePill/order.cgi?orderone++Organizers+1+312+1 Here?s a printable reminder chart http://www.derwentside-pct.nhs.uk/medicine_management/documents/medication/med_reminder_chart.pdf Here?s a reusable chart: http://www.epill.com/chart.html I?m concerned with your loss of appetite, which your medications can worsen. Try to eat small portions, but eat often ? grazing, it?s called. Do you have dentures, and if you do, do they fit well? It sounds as if you need to be seen by your doctor, and take care of these problems. Are you able to take short walks? Exercise will do wonders for your outlook and spirit, not to mention your muscles, heart and lungs! On days when you don?t feel like eating, try nutrition-enriched drinks, such as Ensure or Boost. Ovaltine in a glass of milk provides needed vitamins and protein. Do you have friends or family to eat with? Is there a senior center you could join to have meals with company? Continue taking a (one) multi-vitamin each day, but don?t take extra B vitamins that can interfere with your Sinemet. Add more fiber (formerly called roughage!) and calcium to your diet by way of fruits, vegetables, whole grains, and dairy products. Be sure and stay hydrated by drinking plenty of water and juices. A glass of orange juice a day can supply needed folic acid needed to produce stomach acid for digesting food. ?Do you have trouble chewing? If so, you may have trouble eating foods like meat and fresh fruits and vegetables. What to do: Try other foods. Instead of: fresh fruit Try: fruit juices and soft canned fruits, like applesauce, peaches and pears Instead of raw vegetables Try: vegetable juices and creamed and mashed cooked vegetables Instead of meat Try:ground meat, eggs, milk, cheese, yogurt, and foods made with milk, like pudding and cream soups Instead of sliced bread Try:cooked cereals, rice, bread pudding, and soft cookies Problem: Can't shop You may have problems shopping for food. Maybe you can't drive anymore. You may have trouble walking or standing for a long time. What to do: ? Ask the local food store to bring groceries to your home. Some stores deliver free. Sometimes there is a charge. ? Ask your church or synagogue for volunteer help. Or sign up for help with a local volunteer center. ? Ask a family member or neighbor to shop for you. Or pay someone to do it. Some companies let you hire home health workers for a few hours a week. These workers may shop for you, among other things. Look for these companies in the Yellow Pages of the phone book under "Home Health Services." Problem: No appetite Older people who live alone sometimes feel lonely at mealtimes. Loneliness can make you lose your appetite. Or you may not feel like making meals for just yourself. Maybe your food has no flavor or tastes bad. This could be caused by medicines you are taking. What to do: ? Eat with family and friends. ? Take part in group meal programs, offered through senior citizen programs. ? Ask your doctor if your medicines could be causing appetite or taste problems. If so, ask about changing medicines. ? Increase the flavor of food by adding spices and herbs. http://www.proteinhealth.com/weight_loss_eating_well_older_adults.php ?Since you are eating less food to maintain a healthy weight, you have to be more careful about choosing low-fat and nutrient-rich foods. As the years pass and you lose lean body mass (muscle), your metabolic rate slows down and you burn calories more slowly. Exercise is the best way to maintain lean body mass and speed up your metabolic rate. As for vitamin and mineral requirement, even healthy elderly people may exhibit deficiencies for vitamin B6--resulting from lower intake and higher requirements; vitamin B12 and folate -- due to low intakes and malabsorption; vitamin D -- as a result of reduced exposure to sunlight, low intakes, age related decreased synthesis; and zinc -- resulting from low intake associated with low energy intakes.? Dental problems may incline some seniors to avoid eating foods that must be chewed well?skin on fruits and certain meats, for example. Changes in the senses of smell and taste?which can result from aging itself or from drug therapy?can cause decreases in food consumption or disinterest in, even aversion to, formerly preferred foods. By age 75, people have only half as many taste buds as they did at 30. In addition, loneliness, depression and the financial restrictions of living on a fixed income can interfere with an older person's ability to buy and prepare good food. Since food is often associated with family and social events, preparing food and eating alone can be difficult for older people who have reached a stage in life where many of their loved ones have either died or moved away. For many, a loss of appetite follows the loss of companionship. Older men who have lost their wives (who did the cooking) may be at special risk. ? Add a little more spice or sugar to foods to enhance their flavor. ? Due to the importance of getting enough calcium, ensure that you focus on high calcium foods. If milk is unacceptable, try fish with bones like ikan bilis or sardines, tofu, cooked beans or even low-fat ice cream. Take a supplement if you know you are not consuming enough calcium. ?Elderly patients with unintentional weight loss are at higher risk for infection, depression and death. The leading causes of involuntary weight loss are depression (especially in residents of long-term care facilities), cancer (lung and gastrointestinal malignancies), cardiac disorders and benign gastrointestinal diseases. Medications that may cause nausea and vomiting, dysphagia, dysgeusia and anorexia have been implicated. Polypharmacy can cause unintended weight loss, as can psychotropic medication reduction (i.e., by unmasking problems such as anxiety). A specific cause is not identified in approximately one quarter of elderly patients with unintentional weight loss. A reasonable work-up includes tests dictated by the history and physical examination, a fecal occult blood test, a complete blood count, a chemistry panel, an ultrasensitive thyroid-stimulating hormone test and a urinalysis.? Polypharmacy means taking many medications. http://www.aafp.org/afp/20020215/640.html ?An estimated 30% of seniors lose their ability to make stomach acid, and this interferes with the absorption of some nutrients such as vitamin B12 and folic acid. Deficiencies in these nutrients, as well as vitamin B6, can cause neurological changes such as decline in alertness, loss of memory, and numbness of the extremities. The reduction of the natural movement of food and enzyme activity in the gastrointestinal tract, known to be associated with aging, often results in digestive difficulties in dealing with certain foods. Also, this reduction in the natural movement of food through the intestines causes food to remain in the intestines for a longer period of time, producing harder stools and resulting in constipation. Aging affects certain senses, such as taste, smell, vision, and in turn affects the types of foods that will be chosen. Salty and sweet taste sensations can decline markedly with age, causing some to prefer foods that are richly seasoned. However, certain spicy foods produce gas. Many older persons complain of "heartburn," that often is not caused by increased acidity but by gas production. Others resort to extra salt in order to overcome their gradual loss of taste. Sodium and its role in water retention and high blood pressure may then become a problem.? Ideas for adding variety to your meals ? Get out of the rut of thinking that certain foods are meant only for certain meals. Try vegetable soup and a tuna fish sandwich on pumpernickel bread at breakfast, or a cheese omelet, bran muffin, vegetable salad, and fresh fruit for dinner. ? Experiment with recipes created especially for one or two people. ? Combine leftover meats and vegetables into one-dish casseroles that can be easily heated for lunch or dinner, or frozen for later use. ? Share pot-luck lunches and dinners with friends or acquaintances on a rotating basis. Not only will it add variety to your diet, but it's also a great way to make new friends. http://seniors-site.com/nutritio/guides.html ?Some older people have a poor appetite as a result of their health conditions, lack of exercise, or as a side effect of certain medications. Older people with low food intake who rely on a nutritional supplement to help provide needed amounts of protein, vitamins and minerals should seek the advice of a health professional when selecting a supplement. Well-meaning family or friends do not have the educational background to help you avoid dangerous drug interactions. Store clerks may be more interested in selling products than providing reliable information. Liquid nutritional supplements are very expensive and don't always contain other important dietary components such as phytochemicals or fiber. Your doctor, dietitian, or pharmacist is the best source of information.? http://www.ext.vt.edu/pubs/nutrition/348-020/348-020.html ?Malnutrition is often due to one or more of the following factors: inadequate food intake; food choices that lead to dietary deficiencies; and illness that causes increased nutrient requirements, increased nutrient loss, poor nutrient absorption, or a combination of these factors.4 Nutritional inadequacy in the elderly can be the result of one or more factors--physiologic, pathologic, sociologic, and psychologic (Table 1). The difficulty for the clinician is in identifying the underlying factors contributing to the problem and how to intervene effectively.? ?Interventions appropriate for addressing nutritional deficiencies may include one or more of the following actions: ? Remove or substantially modify dietary restrictions (ie, liberalize the patient's diet); ? Encourage use of flavor enhancers and frequent small meals; ? Offer liquid nutritional supplements for use between (not with) meals; ? Improve protein intake by adding meat, peanut butter, or protein powder; ? Treat depression with antidepressants that do not aggravate nutritional problems; ? Remove or replace medications that have anorexia-producing side effects; ? Evaluate swallowing as well as functional ability to manage eating; ? Obtain a social services assessment of living situation of community-dwelling adults.6 http://xnet.kp.org/permanentejournal/sum05/elderly.html A tooth abscess can indeed have caused you to feel poorly. Tooth abscesses can cause spread of infection, infection to the jaw, soft tissues, even cause brain abscesses, heart infections and pneumonia! http://www.nlm.nih.gov/medlineplus/ency/article/001060.htm Oral infections such as an abscess or yeast/fungal infection, lost teeth, poor dentition can cause dry mouth and loss of taste. A dry mouth can also increase risk of cavities and dental disease. ?Saliva substitutes and oral lubricants are available without a prescription. Although they can provide some relief, they do not have any of the protective properties of saliva. The risk of oral or dental disease in people with dry mouth can be greatly reduced by maintaining good oral hygiene, along with dietary restrictions such as eating less sugar. Everyone with a dry mouth should have comprehensive and frequent preventive dental care, including regular fluoride treatments.? ?Problems in the mouth can have a major effect on overall health and social well-being. Proper oral health is important for everyone, but particularly for older adults who are frail or at risk of nutritional problems (see also Nutrition). Older adults tend to have more oral problems than younger people, because underlying health problems and side effects from medication are more common as we age. However, there is no evidence that oral health and function specifically decrease with age. Therefore, mouth problems such as tooth decay, missing teeth, gum disease, and low saliva levels are not a part of normal aging. In most cases, these problems can be avoided or adequately treated. With proper oral care, most people can expect to have a healthy mouth well into advanced age.? http://www.healthinaging.org/agingintheknow/chapters_ch_trial.asp?ch=46 You didn?t say why you were taking Clindamycin, but I can guess you had a respiratory tract infection or a skin rash/infection. While Clindamycin is not a drug known for its side effects, it can bother some people. ?Although side effects from clindamycin are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away: ? upset stomach ? vomiting ? gas ? diarrhea Tell your doctor if any these symptoms are severe or do not go away while using clindamycin vaginally or on your skin: ? dry skin ? redness or irritation ? peeling ? oiliness ? itching or burning If you experience the following symptom, or any of those listed in the IMPORTANT WARNING section, stop taking clindamycin and call your doctor immediately: ? skin rash Please visit your doctor and explain all you?ve told me. Do you have family and friends nearby? Do you live alone? You may benefit fm talking with a geriatric therapist and a social worker who can help you with your meals and getting out a bit. I believe you can conquer your depression and anxiety, through proper use of your medications, a balanced diet, a bit of exercise, and contact with friends and family. I wish you the best! I see that your question has gone unanswered for a while... I am sorry, but I hope this answer is still useful to you. I hope this has helped you out! Please ask for an Answer Clarification if anything is unclear, and allow me to respond, before rating this answer. I will be happy to assist you further, before you rate. Sincerely, Crabcakes Search Terms ============= Zoloft + adverse effects stimulating appetite + elderly Sinemet CR Sinemet + Adverse effects Anorexia + elderly loss appetite + senior citizens Nutrition + senior citizens Depression + senior citizens Hypothyroid symptoms