Friday, March 14, 2008

Visit to Naturopath

Sunshine and I visited our naturopath Dr. Healy Wednesday, to deal with several questions raised by the new CC-4047 drug trial that I have started:

Bone Building:

At Mayo, Dr. Lacy and I discussed a prescription for generic fosamax to strengthen my bones. I don't actually have that prescription yet - perhaps she's rethinking it. Dr. Healy seemed uncomfortable with the fosamax, partly because of the risk of osteonecrosis, and referred me to a recent article in WebMD explaining the benefits of Vitamin K2 for rebuilding bones AND for scavenging calcium away from places it shouldn't be, such as arteries. A double-good whammy!

The issue is complicated for me because Vitamin K1, the most readily-available form, enhances the ability of the blood to clot. In my case, the CC-4047 drug that I take brings its own modest risk of blood clots, usually seen as a "deep vein thrombosis" (DVT). I don't want to increase that risk by taking the wrong supplement. Most Vitamin K supplements contain a lot of K1 and a little K2, but happily there are a few that are Vitamin K2 only, such as this Carlson brand. Until I get a better handle on this issue I am going to take only a modest amount of K2, in the range of 5 mg, with no K1 except what I get in food.

And I think I should talk to my doctor about getting my INR checked once in a while. INR is a measure of the blood's ability to clot.


Tetrahydro-iso-alpha acids are derived from hops (who knew?) and sold under the brand name Kaprex AI. It is advertised for joint support and for normalizing the immune system. Recently, however, scientists have discovered that THIAA has anti-angiogenic properties - it inhibits the growth of tiny new blood vessels. This is one mechanism by which thalidomide is thought to go after myeloma. Therefore, it is possible that Kaprex AI or an equivalent product might have some of the benefits of thalidomide without its side effects, though I am not aware of any studies to show this. Dr. Healy suggested that an appropriate dosage might be one tablet three times per day.

I am already taking a thalidomide analog, CC-4047, so Dr. Healy and I agreed that it would be quite inappropriate for me to take this as well. But in the future, if my participation in the CC-4047 trial ends, I may want to remember this product.

Side note: The manufacturer of Kaprex AI does warn against use by pregnant women, but the warning is generic and not very emphatic. If it really is anti-angiogenic, Kaprex AI should carry a very strong warning which would include mention of birth defects as a likely consequence of taking Kaprex AI.

Borage Oil:

Dr. Healy suggested borage oil instead of evening primrose oil, because borage oil contains about two and a half times as much GLA. I seem to recall that a blog reader also made that comment. GLA has several benefits, but in particular it is an anti-inflammatory and may combat myeloma in the same manner as other anti-inflammatory agents. She suggested organic borage oil, but I was unable to find it in organic form. Barleans Organic Oils is one company that sells borage oil, but theirs isn't organic, though they do make it hard to figure that out. Isn't that false advertising? I think so. Anyway I ended up ordering it from LEF because they have a special going. If you have a source for organic borage oil, please comment.

Recent lunch - Homemade pizza: Gluten-free brown rice pizza crust, chunks of free-range bison, organic parsnips, fresh pineapple, homemade organic pizza sauce, parmesan cheese.

Recent dinner: Turkey curry (organic turkey, organic peas, coconut milk, more), clementine, organic medjool date, cantaloupe.


  1. Hi Don,
    thank you so much for sharing this important information!
    Take care, Sherlock

  2. Hi Don, when you mentioned borage oil, something triggered vaguely in the back of my brain. So I looked it up. I found the following on the Sloan-Kettering website:
    "Borage contains small amounts of the alkaloid amabiline, which is hepatotoxic. Consumption of 1-2 g of borage seed oil daily can result in an intake of toxic unsaturated pyrrolizidine alkaloids (UPAs) approaching 10 ug. The German Federal Health Agency now specifies consumption of such products should be limited to no more than 1 ug of UPA daily. Borage oil products should be certified free of UPAs (meet criterion of no more than 0.5-1 ug/g)." Check your LEF oil, it may be ok.
    I also found on Italian websites that we should be careful about using parts of the borage plant in cooking: leaves and flowers, in particular.
    Apparently, thought, borage oil is safer. I just wouldn't take too much of it.
    Very interesting posts, thank you!
    Florence, Italy

  3. Hi Margaret,

    THANK YOU for sharing this information. My naturopath didn't mention it. The LEF web site doesn't mention UPAs, except in a different product (not borage oil), so I have written to get their response. In the past they have given good answers to questions like this.

    Take care, Don