“ASK THE DOCTOR” WITH DR. REBECCA GILBERT
Q: My friend was recently diagnosed with Parkinson’s, but I am not convinced that she has it. She was prescribed carbidopa/levodopa. Is there any harm in taking this medication if you do not have PD?
A: It is not harmful to take carbidopa/levodopa if you do not have PD. Having said that, levodopa is given to treat symptoms. Sometimes it is not clear if the symptoms are due to PD or not, so on occasion, it may be given to someone who ends up not having Parkinson’s. If it is given for symptoms and does not help to improve the symptoms, talk with the prescribing doctor about potentially stopping it.
Q: No matter how much I exercise my legs, they don’t get any stronger. They seem to just get weaker. What am I doing wrong?
A: It can be frustrating when you hear about how important exercise is and how much good it can do you – but then you don’t seem to be reaping the benefits. You may need to alter the frequency and/or types of exercise you are doing in order to build muscle strength. I would ask your neurologist for a referral to a physical therapist. You can explain your issue to the physical therapist and he/she can come up with an exercise regimen that meets your needs and goals. Please note, Parkinson’s disease should not cause actual weakness in your legs, but rather slowness and stiffness of movement. If your legs are truly weak, which your neurologist can assess, he/she may want to order other tests to rule out causes of weak legs.
Q: My dad has PD and had COVID about three weeks ago. Since then, he has been extremely fatigued. Is this related to COVID? To PD? Will he recover?
A: Fatigue is a common symptom of COVID and can linger longer than other COVID symptoms. Fatigue is also a common non-motor symptom of Parkinson’s. Additionally, people with Parkinson’s are often less medically resilient when they experience a health problem, like an infection with COVID. So, the combination of COVID and PD may be conspiring to make your dad’s course more complicated and drawn out. I would expect him to slowly recover to his baseline, although I don’t know the time course. I would talk with his neurologist about this setback and if any changes in his PD medications may be helpful for him as he recovers.
Q: I was just diagnosed with mild PD and was told that I do need to take a medicine. Is there any disadvantage to me if I am not taking medicine now?
A: In general, there is no downside to postponing PD medications if your PD symptoms are not affecting function. However, you want to maximize your ability to exercise, which research suggests may be neuroprotective. So please discuss with your neurologist if he/she thinks that you are able to exercise effectively and up to your maximal capabilities while unmedicated. If you are, then delaying the start of medication makes sense.