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.

THIAA:

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.

Myeloma Treatment Regimen

I saw the naturopath more than two weeks ago. Now I'm feeling a little guilty that I haven't already implemented all of her recommendations, because my Mayo visit is only about four weeks away, not a lot of time to see results from the enhanced regimen.

Nevertheless I can't start any sooner than today, so here goes the new supplement regimen:

	Daily
Supplement	Quantity
Coenzyme Q-10	200 mg
Curcumin, NSI	4640 mg
Curcumin, Dr Best	4000 mg
EGCG	1750 mg
Feverfew	1600 mg
Flaxseed Oil	1000 mg
Genistein	70 mg
Quercetin	4000 mg
Reishi Mushroom	3000 mg
Resveratrol	400 mg
Selenium	200 mcg
Vitamin D	5000 iu
Vitamin K	8.1 mg

This is divided into a morning dose and an evening dose, in both cases at least a half hour before a meal. For more details including brand names, sources, and supplements intended to treat other health conditions, visit this page.

In addition to the supplements, other lifestyle choices may help hold off the cancer:

• Low-dose naltrexone.
• Diet intended to minimize inflammation:
  • No beef or pork,
  • Free-range bison only once every week or two,
  • Fish (especially wild-caught salmon) or chicken every other day or so,
  • Lots and lots of different and colorful vegetables and fruits, in season when possible,
  • Lots of nuts, especially tree nuts of all kinds,
  • Gluten-free,
  • Treats, when required, are nuts, fruits, and a little bit of dark chocolate,
  • No exceptions!
  • If you've seen my food pictures, you won't feel sorry for me.
• Exercise galore, especially aerobic but also resistance,
• One gluten-free beer every evening,
• Plenty of lovin'. :-)

For what it's worth, that's the regimen. I'll let you know in a month or so how it's going.



Recent salad: Organic salad greens, cucumber, Danish blue cheese, avocado, organic medjool dates, jicama, roasted pistachios, raspberry vinegar and a dash of olive oil, organic apple, naval orange.

My Naturopath

I saw a naturopathic doctor today, for my first time, Doctor HH. I already knew Dr. HH from other circumstances, and had recently discovered that she is has a specialty in cancer and is a member of the Oncology Association of Naturopathic Physicians. So it was high time that I spent the effort and money to hear what she might have to say about staving off myeloma. The expense is actually quite modest.

We talked about a LOT of things, including some issues other than myeloma, and I'm still digesting it. Dr. HH isn't like my conventional doctors, who tend to listen to the problem and then prescribe a specific treatment and walk out the door. Dr. HH apparently believes that I already know a little about the potential treatments (the jury's still out on that), so she more or less considered this a teaching session. She frequently checked in ("do you know about so and so?"), then explained if I didn't and amplified if I did. She also took notes for me, and did write down several specific suggestions, but I probably should have been the one taking notes. Actually, both would be best. We discussed several health issues, and then I did a bit more internet research; here are a few items specific to myeloma:

• EGCG, from green tea, inhibits cancer growth and induces apotopsis (normal programmed cell death) in cancer cells. Dr. HH suggested 1,650 to 1,800 mg per day. That's a lot. Here is one of several sources of EGCG. These contain 350 mg of EGCG per capsule.
• Genistein is a soy isoflavone which can act as an antioxidant, and more importantly, can inhibit the uncontrolled cell growth of cancer. It may also reduce bone loss, which of course is beneficial to myeloma patients in particular. Here is a NLM resource page. Dr. HH suggested 40 to 300 mg per day. I have not yet found a good source for genistein alone, without an assortment of other soy isoflavones. I may ask the doctor about that.
• Quercetin is a highly active flavonoid which is also a good anti-inflammatory agent and a powerful antioxidant. More importantly, it has significant anti-tumor properties. I have been taking 1000 mg of quercetin, but Dr. HH suggested up to 4000 mg. I'll do 3000 first, and if no reaction I will increase it to 4000 mg. This is a good source.
• Resveratrol is another powerful anti-inflammatory and anti-cancer agent, with other purported health benefits such as anti-aging. Dr. HH suggested 100 to 400 mg per day. I am already taking 400 mg per day, in two capsules from this source.
• Vitamin K has a reputation for helping with blood clotting and improving bone strength, which I definitely need, but it also can promote normal cell death in cancer cells. Dr. HH suggested 5 to 10 mg (not mcg) per day, with the highest possible fraction of K2 and the remainder K1. Here is the best brand I've found so far.
• Vitamin D inhibits replication and induces normal cell death of cancer cells. For a normal person a recommended daily dosage might be 2000 IU, but for someone fighting cancer it might be 6000. Here is one source of many.

Here are a few items that were discussed in another venue:

• Medicinal Mushrooms are a very ancient remedy which can reduce cancer cell proliferation, activate natural-killer cells, and actually protect against the toxicity of chemotherapy. Shitake mushrooms were mentioned, at a dosage of 1500 mg twice daily between meals. I have been taking Reishi mushrooms, but at a much lower dosage. I think I will continue with the Reishi, from this source, but take at least four capsules per day.
• Selenium stimulates the activity of natural-killer (NK) cells and has been associated with a 50% reduction in risk of mortality from cancer. It has been shown to help fight cancers of lung, colon, prostate, stomach, esophagus, liver, and therefore is likely to help fight others. Suggested dosage: 200 to 400 mcg per day. Here is one inexpensive brand, and here is another
• Coenzyme Q-10 is an antioxidant and has protective properties. It has been shown to protect the heart from the effects of adriamycin. Dr. HH suggested at least 200 mg per day for me, for treating headache. I have been taking 100 mg per day, but may increase it to 200 mg. Bioavailability is an issue with CoQ-10; I use this brand. Life Extension claims that theirs is even better.
• Melatonin is an interesting hormone that can have a lot of different effects on the body. According to a web page of the Mayo Clinic: "It has been proposed that melatonin may benefit cancer patients through antioxidant, immune-enhancing, hormonal, anti-inflammatory, anti-angiogenic, apoptotic, or direct cytotoxic (cancer cell-killing) effects". That same web page also states: "Results have been mixed, with some patients stabilizing and others progressing." One of the sources of melatonin capsules is Life Extension, with this disclaimer: "Patients with leukemia, Hodgkin’s disease, or lymphoma should avoid melatonin until more is known about its effects on these forms of cancer." Since myeloma is a variety of non-hodgkins lymphoma, I wonder whether to try this or not. Some sources speculate that it might not be the best idea to stimuate the immune system, as melatonin does, when the cancer is IN the immune system, as it might thereby stimulate the cancer. Further, it seems to me that the means by which melatonin benefits cancer may be similar to the action of low-dose naltrexone, which I am already taking in any case. More research needed here before I start it.

Some other hints:

• Stop taking extra Vitamin C two days before blood tests, because it can artificially raise the creatinine count and suggest kidney problems where there may be none;
• Do the same with calcium supplements, to avoid artificially-high calcium readings;
• Take your weight in pounds, divide that number by two, and that is the number of ounces of water to drink every day;
• Curcumin: Eight grams per day is an appropriate dosage;
• For bones: do resistance training of the muscles that connect to those bones which especially need to be strengthened. In my case, since I'm a runner, that probably means upper-body muscles surrounding the spine, ribs, and arms; and
• Read up on this study in which pomegranite extracts were used to cause cancer cells to revert to their normal states. What a cool concept! The extracts may eventually become available as prescription medicines, and possibly as supplements.

Next: I'll re-read these notes and decide on additional supplements to take for at least the next six weeks before going to Mayo Clinic. When I've decided, I will post the entire new regimen, for what it's worth. I have more questions for Dr. HH too, and will probably go back to see her again soon.


Organic salad greens, Maytag blue cheese, pecans, avodado, hibiscus blossoms, kiwi, raspberry vinegar.