Monday, 23 September 2019

Supplements update following metabolic analysis

In this blog post I want to update my supplement protocol based on a metabolic analysis of my urine - but first some background info. Six months ago I set out my supplement protocol (see here). As noted then, and remains true now, it is hard to find good advice regarding the efficacy of each supplement. Indeed there are often views diametrically opposing. There is lots of hype, claims and suggestion around many of the supplements that might show considerable promise, for example, one product might look good in a petri dish or animal study, but have never properly been trialled with humans. 
Equally I find, for example, others like Cancer Research UK, are very very cautious with their advice and rely on certain peer reviewed science, but ignore others. For example Cancer Research UK write: 'there is no clear evidence in humans to show that turmeric or curcumin can prevent or treat cancer.’ Yet there are over two thousand studies published on turmeric and curcumin (the active ingredient in the spice); many of these studies demonstrate clear anti-inflammatory and immune enhancing properties with well over six hundred of them relating specifically, and consistently, to it’s anti-cancer properties (i).

In the last six months my protocol has changed and adapted, you can follow most of the key changes and some of the reasoning, by reading through the other blog posts tagged ’Supplements’ (see here). I want too note that the supplements are only part of my approach to cancer. I also say again that we are all different and respond differently. For me, I consider diet, exercise and meditation to be more central to healing than other parts of my protocol, but nevertheless I think supplements can have a place for some people (including me) in their healing journeys. 

Health update

As previous posts have shared, I appear to continue to have an issue with absorbing certain nutrients and minerals. Magnesium for example has remained low despite significant supplementation. Some of this is a bit of a mystery considering my excellent diet and supplement protocol. Recent blood tests have also seen my PSA climb and reveal, among other things, a low white blood cell count. You can see my response to the low white blood cell count here.

So following a couple of visits to an integrative doctor that I see, considering the metabolic analysis of my urine plus some research of my own, I have put together the next steps. Some of this is to tackle the lack off absorption. I will also be seeing the oncologist at the end of September and it might be that then is the time to go for hormones again plus radiotherapy. If you are a regular reader to this blog you will know I have some considerable reservations about the radiotherapy (see some of those here). This blog was mostly written in August but I haven’t managed to publish it so by the time you get to read it I will have already embarked on some of this supplementation. As the protocol changes and develops it is hard to capture it in one blog so I am finding it more useful to explain the possible potential of each supplement for my health.
Malabsorption and more

Several markers from the metabolic analysis indicated malabsorption. I don’t fully understand how all this works but the test showed for example that I have:

(a) Elevated phenylacetic acid (PAA) which is a malabsorption marker; this is often due to the amino acid phenylalanine not being sufficiently digested in the small intestine.
(b) Elevated 3-Hydroxyphenylacetic acid (3HPAA) which is a bacterial dysbiosis marker; this could reflect recent high rates of ingesting quercetin (eg teas, fruits) or a colonic flora population that creates the rise.
(c) Above normal Tartaric Acid which is a yeast/fungal dysbiosis marker; found high in grapes and wine so could indicate recent ingestion but not sure about that - it seems more likely to be the result of intestinal yeast overgrowth.
(d) Elevated Citramalic Acid, which is another yeast/fungal dysbiosis marker; this indicates intestinal dysbiosis and can cause not so great metabolic interference with the ‘malate shuttle’.

Most of the other markers were in the normal range but other interesting markers included;

(a) Lactic Acid; this is formed from glucose and used by working muscles for energy. This was low for me and there are no known clinical problems associated with low lactic acid. This is likely to be a good thing as lactic acid is an important energy source for tumour cells (ii); indeed cancer cells make your body even more acidic as they produce lactic acid. The more acidic your cells are, the less oxygenated they will be. To make matters worse, the fermentation process cancer cells use to produce energy creates lactic acid, further increasing acidity and reducing oxygen levels (iii). Interestingly endurance athletes tested after exercise have high levels of lactic acid but then later have very low levels (iv). Low levels of lactic acid can be the result of reduced amounts of its precursor, pyruvic acid.

(b) Pyruvic Acid; this was subnormal and there are several possible reasons, a couple of the most likely are deficiency of magnesium and pancreatic insufficiency. Interestingly studies have shown that potentially malignant disorders have shown a significant increase of pyruvic acid levels (v).

(c) Liquid peroxides; these were elevated. Lipid peroxidation is a mechanism of cellular injury and is used as an indicator of oxidative stress, also known as “free radical damage.” The elevation of lipid peroxides serves as an early warning of the potential long-term effects of oxidative stress which leads to chronic degenerative diseases like cancer (vi).
What to take?

Well in a recent blog I touched a bit on epigenetics and SNPs. I loved the Steve Ottersberg quote from this years Trew Fields (vii): "You can’t change your genetics but you are not a victim of your genetics. What you can change is the expression of your genetics and that’s what epigenetic is about.”  
So a lot of this supplementation is part of changing the expression of my genetics - and supporting areas where perhaps I have SNPs. The suggestions for supplements below are based on the metabolic analysis and some of the issues raised already in this blog post. They are suggested in addition to my current/initial protocol. One of the challenges is working out how much of this I can do within my budget, bearing in mind that some can be ‘pulsed’ ie have a break and then return to them. So I won’t purchase all of these extra ones - indeed am using this blog post as a way to understand them better and seek out priorities. I’ll try and look at all this under the following headings:

1. Antioxidants
2. B-Vitamins
3. Minerals
4. Probiotics
5. Amino Acids
6. Additional immune support
7. Initial protocol

Taken from my test results
In details 

1. Antioxidants

The test highlighted a couple of aspects that were considered ‘high need’ for supplementation;

Vitamin A
Apparently an extreme vegetarian diet could deplete vitamin A but that is not me! Chris Woollams writes (viii): "The overwhelming conclusion when studying vitamin A (as opposed to Beta-carotene) is that where cancer is concerned the jury is out. There are research papers that conclude it is helpful; others that conclude it has no effect. Vitamin A does, however, have many health giving properties. Of relevance to cancer, it helps strengthen the immune system (especially the white cells) and, in particular, it strengthens epithelial tissues (and, by implication, blocks the process by which many cancers form). Vitamin A also helps the action of vitamin C, a known anti-oxidant".

Vitamin E
The impact of vitamin E in terms of preventing cancer has been suggested by many epidemiologic studies. Of interest is that several recent large-scale human trials with α-tocopherol, the most commonly recognized and used form of vitamin E, failed to show a cancer preventive effect. There was even evidence of higher prostate cancer incidence in subjects who took α-tocopherol supplementation. However tests in animal models have shown the cancer preventive activity of γ- and δ-tocopherols as well as a naturally occurring mixture of tocopherols, but the lack of cancer preventive activity by α-tocopherol. Yang et al (ix) concludes that "On the basis of these results as well as information from the literature, we suggest that vitamin E, as ingested in the diet or in supplements that are rich in γ- and δ-tocopherols, is cancer preventive; whereas supplementation with high doses of α-tocopherol is not”. 

Chris Woollams writes on prostate cancer (x): "The Journal of the National Cancer Institute (1998) showed that a Finnish study, whilst studying the vitamin E effects on smokers, spotted that among over 29,000 males, the vitamin E study group had a 41 per cent decrease in prostate cancer over the placebo group. The protected group took 50 mgs of alpha-tocopherol per day for 5-8 years. In a USA test amongst people deficient in vitamin E, a 50 mgs daily supplement reduced prostate cancer cancer by 20 per cent”. It would seem that perhaps the synthetic form of Vitamin E may be more limited in its helpfulness and may even cause harm, but overall research seems to conclude Vitamin E and increasingly tocotrienol vitamin E is essential in the fight against cancer.

α-Lipoic Acid
This one is a great free-radical scavenger and antioxidant, that can regenerate other antioxidants that are used fighting free-radicals. It has been shown that Alpha Lipoic Acid and its metabolite Dihydrolipoic Acid (DHLA) can cause cell death in colon cancer cells and enhance the oxygenation of healthy cells. It can also reduce blood sugar levels which is advantageous in fighting cancer (xi). When taking this I will stop the Berberine as that all has that effect and I am not sure of the impact of both.

2. B-Vitamins

The test showed borderline concerns around Vitamin B1,2,6,9 and 12. My B3 and B7 were considered normal.

B Vitamins are key for correct cellular division and replication and play a role in the nervous system. Increased plasma homocysteine has been shown to be closely related to cancer. B Vitamins can keep this under control. Normally our gut bacteria makes our B vitamins when it gets fibrous foods, however antibiotics and chemo can mess with our guts (xii). Could the malabsorption markers noted above be a reason for the need to supplement? A Vitamin B looks like a useful way forward. See also my previous blog post on B6 and B12 here.

3. Minerals

Once again Magnesium comes out strongly needed. Zinc was normal and Manganese was borderline.However Zinc was only normal with the current protocol of supplementation so it looks like that needs to continue.

Magnesium and Zinc - See previous update on Magnesium and Zinc here and here.

Manganese - this, among other things, is needed for the development and health of the reproductive organs. It is also linked to prostate health and supports bone health (the latter is important as that is often where prostate cancer spreads first). Low levels have been linked to breast cancer (xiii).

4. Probiotics

This topic is huge and having read lots on this I think it is a key area to consider - really should have several blogs of it’s own. However in the meantime see Chris Woollams blogs:

I will continue with a probiotic supplementation and diet that includes fermented foods. The additional suggestion highlighted as a need, was for pancreatic enzymes. This is a complicated area and I need to investigate this further.

5. Amino Acids

Now this is a new area for me to get my head around. For years it was thought that there are only 20 amino acids, but a couple of new aminos were recently discovered making a total of 22 amino acids. Are there more? Amino acids are the basic building blocks of the body, are in abundance within the body (ixx). I had thought Braggs (or similar) Amino Acids might be a good way of ensuring I get all the amino acids but I read that there is some controvesy over the process they use so I need to look further before going down that route. Certainly they do great Cider Vinegar!
Here is just a very brief taster of what the urine test showed in terms of more interesting stuff:

N-Acetyl Cysteine - I previously noted that I have been taking the amino acid supplement N-Acetyl Cysteine; this contains glutamine (which stimulates the liver to produce glutathione), and L-Cysteine, which is particularly important in DNA repair. N-acetyl cysteine is a free radical scavenger on its own, effective at reducing oxidative stress, particularly due to heavy metal toxicity as it can directly replenish glutathione stores (xx). The test indicated that with the supplementation I am in the normal range for this amino acid. It is worth noting that there is some research with mice showing that antioxidants can change cells in ways that fuel the spread of some cancers.

Taurine - This amino acid came out as the one needing significant support. Taurine suppresses PSA and several metastasis-related genes in human prostate cancer cells, LNCaP and PC-3. In addition, taurine inhibited migration of LNCaP and PC-3 (xxi). I’m going for a Magnesium taurate supplement; the mix of magnesium and taurate is thought to help speed absorption of magnesium - so hopefully also tackling the magnesium deficiency at the same time.

Glycine - Another amino lacking is this one. Glycine has been used in cancer prevention (xxii). Dr Brind writes (xxiii): “...many human cancers are selected for, and therefore arise in, bodies which are chronically methionine-loaded and glycine-deficient. Thus, they underscore the need for the proper balance between glycine and methionine.”

Lysine - another amino acid I was lacking - interestingly a unique amino acids-plus formulation of lysine, proline, arginine, ascorbic acid, and epigallocatechin gallate was proved to have anticancer properties, and could become a natural anticancer agent to treat prostate cancer (xxiv). Some research also shows it could have a role with blocking cancer growth (xxv).

Methionine - this was only slightly lacking in my test but interestingly it along with tyrosine (that was also low) and phenylalanine, it has been found to play a key role in preventing prostate cancer (xxvi).

Tyrosine - as noted this was also a little low - the thyroid makes two hormones - triiodothyronine (called T3) and thyroxine (T4) which are tyrosine-based hormones and both are partly composed of iodine. Tyrosine is a non-essential amino acid has been linked with cancer regulation (xxvii).

Leucine - this also showed low but only just and I would be reluctant to supplement this as I’ve read that prostate cancer cells need leucine to grow, multiply and spread. This was in a "Journal of the National Cancer Institute" study published in 2013. However it is not known if taking supplemental leucine and significantly increasing the amount of available leucine in the body could increase your risk of prostate cancer or speed the growth of tumors in men (xxviii).

6. Additional immune support

Lots mentioned above and below clearly supports my immune system - see also my blog post here on the additional immune support.

7. Initial protocol

My initial protocol that has developed over the months is here; there are still some key elements which I am using or will use again.

(iii) There are some mixed views about the acid/alkaline balance and cancer; read one view at: 

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