What is Mucuna pruriens?
Mucuna pruriens, a tropical legume that naturally contains L-dopa, has been used for centuries in traditional Ayurvedic medicine as a treatment for Parkinson’s disease. Recent studies are investigating its potential as an alternative or supplement to levodopa.
Mucuna pruriens: a natural remedy for Parkinson’s disease
Mucuna pruriens is a legume that grows in tropical and subtropical regions. For centuries, it has been used in Ayurveda—a comprehensive, traditional Indian system of medicine—to treat various disorders, including Parkinson’s disease. Although Mucuna pruriens has been used to treat Parkinson’s symptoms since ancient times, L-dopa was only discovered in the seeds of Mucuna pruriens in 1937 1.
Mucuna pruriens vs. levodopa/L-dopa for the relief of Parkinson’s disease
Levodopa is a synthetic form of L-dopa, the precursor of the neurotransmitter dopamine, whose level is reduced in Parkinson’s disease. Levodopa is the standard treatment for controlling the motor symptoms of Parkinson’s disease. The medication is taken orally and absorbed in the intestine before it reaches the brain via the bloodstream.
Levodopa is usually administered together with another drug such as carbidopa or benserazide to prevent its metabolism in the periphery before it reaches the brain (Figure 1). This prevents associated gastrointestinal side effects (e.g. nausea and vomiting) that only occur with levodopa. However, long-term use of levodopa has serious side effects, including abnormal involuntary movements that can interfere with daily life.
Figure 1: Levodopa is taken together with carbidopa or benserazide to prevent its metabolism to dopamine outside the central nervous system. This image was created with Biorender.com.
Mucuna pruriens seeds contain 4-7% L-dopa and other plant compounds. The L-dopa content depends on the origin of the Mucuna pruriens seeds. Due to its natural L-dopa content, researchers have investigated the pharmacological potential of Mucuna pruriens to replace levodopa.
How Mucuna pruriens works in Parkinson’s disease: Possible mechanism of action
By increasing dopamine levels in the brain, levodopa compensates for the reduced dopamine production – caused by the death of dopaminergic neurones – and restores motor control in Parkinson’s patients. Interestingly, the motor improvement after treatment with Mucuna pruriens may not only be due to L-dopa.
In a 2018 study, researchers analysed whether other bioactive components of Mucuna pruriens influence parkinsonism 2. To do this, they modified Mucuna pruriens seeds to have a low L-dopa content (less than 0.01%) and treated two different Parkinson’s animal models: fruit flies and worms. They observed that the animals exposed to Mucuna pruriens had better motor coordination and a longer lifespan, and concluded that additional components besides L-dopa have neuroprotective properties.
Mucuna pruriens is rich in polyphenols, flavonoids, alkaloids, and tocopherol (vitamin E), which provide antioxidant and anti-inflammatory properties. These compounds could protect dopamine neurons from degeneration.
Clinical studies on Mucuna pruriens in Parkinson’s disease: benefits and side effects in patients
Several clinical studies have investigated the effect of Mucuna pruriens compared to levodopa treatment in people with Parkinson’s disease. The table below summarises all clinical studies published up to May 2024, including the dosage of Mucuna pruriens and the L-dopa content. It is important to note that Mucuna pruriens seed powder was used in these studies, not commercial formulations or Mucuna pruriens supplements. Dried or roasted Mucuna pruriens seeds were ground into a powder and mixed with water before ingestion.
Abbildung 1. Aus Caronni et al. Parkinsonism and Related Disorders. 2024
Although the number of participants was small and the clinical trials were short, the researchers consistently found Mucuna pruriens to be as effective as levodopa: patients treated with the seed powder showed improved or similar Parkinson’s symptoms compared to those treated with the synthetic formulation. In addition, Mucuna pruriens had a faster onset of action (34.6 vs. 68.5 min) and a longer “on” time (37 min).
Gastrointestinal symptoms, including nausea and vomiting, were among the most common side effects of Mucuna pruriens treatment. Blood tests showed high levels of urea nitrogen in patients taking Mucuna pruriens, which could indicate impaired kidney function 3.
Mucuna pruriens as a complementary therapy to L-dopa / levodopa for Parkinson’s disease?
Tthe combination of levodopa and Mucuna pruriens could be potentially toxic and cause undesirable side effects 4.
In a 2021 study, a 42-year-old woman with Parkinson’s was prescribed Mucuna pruriens as an adjunct to her levodopa/carbidopa therapy due to disabling motor fluctuations and inability to pay for other antiparkinsonian medications 5. After trying different concentrations of levodopa/carbidopa (62.5, 100 or 125 mg) in combination with Mucuna pruriens (10 or 20 mg), the researchers found that the greatest benefit was observed at 62.5 mg levodopa/carbidopa with 10 mg Mucuna pruriens.
This treatment enabled a faster onset of action and had a longer duration than levodopa/carbidopa alone. In terms of side effects, the patient reported nausea, dizziness, confusion and visual hallucinations when taking 20 mg of Mucuna pruriens. It should be emphasised that this study does not mention how Mucuna pruriens was administered (e.g. as a powder or in branded formulations). The authors were also unable to determine the L-dopa content in Mucuna pruriens.
In addition, there is little to no knowledge of chemical interactions between the active compounds of Mucuna pruriens and other antiparkinsonian drugs (amantadine, zonisamide, anticholinergics, etc.). Such studies are necessary to prevent undesirable effects. Always consult a doctor before starting a complementary Mucuna pruriens therapy.
Long-term use of Mucuna pruriens as an L-dopa substitute for Parkinson’s disease
To date, there are only two published cases of long-term use of Mucuna pruriens in people with Parkinson’s disease.
In 2019, Radder and colleagues described the case of a 48-year-old woman with Parkinson’s disease who self-administered 800 mg of Mucuna pruriens four times a day (about 160 mg of levodopa per day) 6. However, her condition worsened over the following five years: What began as tremors on her right side developed into painful spasms and an unsteady gait, accompanied by difficulty eating and writing. Following a medical assessment, she was prescribed carbidopa (25 mg three times a day) to increase the effectiveness of Mucuna pruriens. Six weeks later, she had fewer spasms, less tremor and a better gait.
In 2020, Margolesky and colleagues reported on the case of a 71-year-old man who had been suffering from Parkinson’s disease since the age of 53. Due to an intolerance to levodopa/carbidopa, he treated himself with Mucuna pruriens 7. He experimented with various brands of Mucuna pruriens powder supplements, which he dissolved in water and took several times a day. After 10 years of taking Mucuna pruriens exclusively, he developed severe motor fluctuations with off-states every 2 hours. Eventually he received deep brain stimulation to treat the motor fluctuations, which enabled him to stop taking Mucuna pruriens.
Mucuna pruriens supplements: a natural alternative to Parkinson’s disease?
There is growing interest in “natural” products – made from plant or plant-based ingredients – for the treatment of Parkinson’s disease. In fact, herbal products such as Mucuna pruriens have antioxidant properties that could combat some pathological pathways in Parkinson’s disease and are therefore worth a closer look 8. It is widely believed that natural products are safe. However, due to their active properties, they deserve the same thorough scrutiny as laboratory-produced drugs before their use.
The above clinical studies were conducted under strict supervision and laboratory control 9: Researchers identified the source of Mucuna pruriens seeds, described the method for obtaining the seed powder, and determined levodopa content. All of which is very important to ensure same results in future studies.The effects observed in these studies with Mucuna pruriens powder cannot be extrapolated to Mucuna pruriens supplements or other commercially available formulations. Unlike pharmaceuticals, there is no regulatory body that oversees the manufacture and testing of dietary supplements (or herbal products) prior to their introduction to the market. Such regulations are crucial as food supplements are often sold over the counter.
While Mucuna pruriens seeds contain up to 7% levodopa, the percentage in supplements is variable and unpredictable. A recent study analysed 16 Mucuna pruriens supplement products – labeled with the specific amount of Mucuna seed extract – and found that they contained 228% to 2186% more levodopa than the estimated amount. This precludes a direct pharmacological comparison between Mucuna pruriens supplements, seed powder and levodopa.
Conclusion: Mucuna as an L-dopa substitute for Parkinson’s disease
It is disappointing that 50 years after its introduction, levodopa remains the best symptomatic treatment for Parkinson’s disease. Treatment with Mucuna pruriens is an excellent alternative, given its positive effects on motor symptoms, faster onset of action and seemingly better tolerability. The low-cost preparation of Mucuna pruriens powder particularly benefits people in low-income countries who may have difficulty obtaining branded levodopa. It could also be a substitute for people who are intolerant to the synthetic formulations.
For Parkinson’s patients who are considering taking Mucuna pruriens, it is crucial to do so in close consultation with a doctor and to observe the following:
- Mucuna pruriens does not prevent the “on/off” phenomenon or associated dyskinesias.
- Mucuna pruriens may not be an effective substitute for levodopa in individuals with legume allergies.
- Levodopa content in Mucuna pruriens supplements is variable and unpredictable.
- High/unlimited amounts of Mucuna pruriens may cause gastrointestinal and neuropsychiatric side effects.
- Mucuna pruriens and other anti-parkinsonian drugs could potentially interact and cause adverse effects.
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References
- Damodaran M, Ramaswamy R. Isolation of l-3:4-dihydroxyphenylalanine from the seeds of Mucuna pruriens. Biochem J. 1937;31(12):2149-2152. doi:10.1042/bj0312149
- Johnson SL, Park HY, DaSilva NA, Vattem DA, Ma H, Seeram NP. Levodopa-Reduced Mucuna pruriens Seed Extract Shows Neuroprotective Effects against Parkinson’s Disease in Murine Microglia and Human Neuroblastoma Cells, Caenorhabditis elegans, and Drosophila melanogaster. Nutrients. 2018;10(9):1139. Published 2018 Aug 22. doi:10.3390/nu10091139
- Cilia R, Laguna J, Cassani E, et al. Daily intake of Mucuna pruriens in advanced Parkinson’s disease: A 16-week, noninferiority, randomized, crossover, pilot study. Parkinsonism Relat Disord. 2018;49:60-66. doi:10.1016/j.parkreldis.2018.01.014
- Sakata M, Miyamoto K, Koh J, Nagashima Y, Kondo T, Ito H. Japanese Mucuna pruriens (Hasshou Beans) Showed Fast-acting and Long-lasting Effects in Parkinson’s Disease. Intern Med. 2024;63(20):2773-2779. doi:10.2169/internalmedicine.3171-23
- Botello-Villagrana, Fernando, & Martinez-Ramirez, Daniel. (2021). Mucuna pruriens as adjunct therapy to Levodopa in advanced Parkinson’s disease. Revista mexicana de neurociencia, 22(5), 180-183. doi:10.24875/rmn.21000010
- Radder DLM, Tiel Groenestege AT, Boers I, Muilwijk EW, Bloem BR. Mucuna Pruriens Combined with Carbidopa in Parkinson’s Disease: A Case Report. J Parkinsons Dis. 2019;9(2):437-439. doi:10.3233/JPD-181500
- Margolesky J, Shpiner DS, Moore H, Singer C, Jagid J, Luca CC. From Mucuna Pruriens to deep brain stimulation: A two-decade case history. Parkinsonism Relat Disord. 2020;77:26-27. doi:10.1016/j.parkreldis.2020.06.014
- Amro MS, Teoh SL, Norzana AG, Srijit D. The potential role of herbal products in the treatment of Parkinson’s disease. Clin Ter. 2018;169(1):e23-e33. doi:10.7417/T.2018.2050
- Caronni S, Del Sorbo F, Barichella M, et al. Mucuna pruriens to treat Parkinson’s disease in low-income countries: Recommendations and practical guidelines from the farmer to clinical trials. Paving the way for future use in clinical practice. Parkinsonism Relat Disord. 2024;124:106983. doi:10.1016/j.parkreldis.2024.106983