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Dr. Keith Roach: Parkinson’s disease meds not likely related to cirrhosis

September 17, 2018

DEAR DR. ROACH: My dad recently passed away as a result of cirrhosis of the liver. He also had Parkinson’s disease for 10 years. Several other people we know who have Parkinson’s also have cirrhosis. Is it possible that his Parkinson’s medication could have caused the cirrhosis? My dad was 78. He did drink beer up until about 10 years ago, mainly socially and nothing real extensive. He was a little overweight, probably by 30 or 40 pounds. The medication that he was on was carbidopa/levodopa. It just seems like it would be too much of a coincidence that there are several people with the exact circumstances as my dad. — E.S.

ANSWER: I am sorry to hear about your dad passing.

Carbidopa/levodopa (Sinemet) is a common, well-established treatment for Parkinson’s disease. While it’s impossible to say with certainty in any given person, carbidopa/levodopa is almost never associated with serious liver damage, so cirrhosis related to this drug would be exceedingly unlikely. In your dad’s case, it’s much more likely that he had fatty liver disease, which is associated with being overweight (and especially in people with diabetes, if your dad had that). This is a much more likely cause of cirrhosis, in my opinion. Although he may not have consumed a lot of beer, any alcohol increases the risk of liver damage in a person who already has some liver problem, including fatty liver. The only definitive treatment for fatty liver is a better diet and weight loss (and, of course, alcohol abstinence, at least in people with abnormal liver enzymes by blood testing). A diet of mostly plants with little meat, almost no refined sugar or processed carbohydrates, and with nuts and whole grains, can help control diabetes and foster weight loss, which can sometimes reverse the damage to the liver.

To answer your question directly, Parkinson’s disease and cirrhosis both are common, and it’s not too much of a coincidence to see several people with that combination.

DEAR DR. ROACH: I recently opened up some stored tuna that my son had saved for me. He loves to hunt his own food. When I ate it, I realized that when he had gone to Alaska, he had not only hunted tuna but also black bear. He had used the black bear grease to cure the tuna. I was mortified that he had used a protected animal to preserve his tuna. I reluctantly ate it anyway. Now, I am worried about my health. Will anything happen to me healthwise because I have eaten the grease from a black bear from Alaska? The bear was wild, so could it have had a disease, like rabies? I’m sure it has never been vaccinated. — Anon.

ANSWER: Black bears are hunted in many states, and although it is regulated (you need a license) in Alaska, they are not a protected species under the Endangered Species Act. Black bears are hunted for both sport and meat. The major health risk from consuming bear meat is trichinella, a muscle parasite. The meat must be heated to a high temperature to be sure of killing the parasite. Grease from the bear should not have trichinella risk.

Another concern is rabies. Rabies is possible but rare in bears. I doubt it could be transmitted from grease, though, as rabies virus lives in nervous tissue, not fat.

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