Metformin effect or just coincidence?

That's great Paul. And I wonder if it points to a connection between insulin control and PC, something that's been discussed here quite a bit.

Grinnell86 said...
My RO released me from his care in January when my PSA was holding steady between .04 and .05 for 2 years, and told me to get my PSA checked yearly during my annual physical with my GP. I did this in July, and my PSA had jumped 40% from .045 to .063. Coincidentally, I was diagnosed at that time with type 2 diabetes. He prescribed 1000mg of metformin for me twice daily, and told me to get my labs done in November. I did that, and not only did my A1C go down from 6.6 to 6.0. But my PSA went down 19% back to .051. I have also been on 20mg of atorvistatin for years. This held my cholesterol at about 200. This check, my cholesterol dropped to 158, and triglycerides dropped from 333 (gravy) to 97. Not convinced yet that it is a miracle drug, but my numbers would indicate that it had an effect. I have also dropped 30 lbs while on it. I'll take it.

Cheers,
Paul

Well, it seems you have lucked out by getting T2 diabetes , because, as has been pointed out on this forum a few times- sometimes to prove that excess sugar has no relationship to PC- diabetes has been associated with protection from PC. So there you go, get 1 disease, avoid the other.

I have been the steady spoil sport regarding that lucky(?) swap of diseases, however, by pointing out that quite possibly it is not the diabetes and it's attendant high blood sugars and blood insulin that is protecting against the PC, but rather the treatment of the diabetes, which has a goal of lowering both blood sugar and insulin. And sense virtually all folks diagnosed with T2D or even pre-diabetes get some sort of treatment for it, even if nothing more than a sugar lowering diet, or oral drugs that increase insulin sensitivity(thus lowering blood insulin) such as Metformin, it should not be surprising that they also appear to get some "protection" from PC. And it appears that Metformin has improved your sugars and insulin, just judging by your A1C.

Now, is that the reason for your drop of PSA? Hard to tell for sure, folks do see these random fluctuations. Up and then back down, sometimes being clueless as to the cause. Then again, Metformin has been touted by some as possibly beneficial in the war against PC- even for non-diabetics I think. So though it may be just a random coincidence that your PSA dropped for unknown reasons at exactly the same time as you improved your blood sugar and A1C #s by taking Metformin(any diet changes?), it seems at least equally likely that your #s improved because you improved sugar/insulin with the drug and dietary improvement, if any.

Since more carbs/sugar in the diet have been shown repeatedly to be associated with- among many other nasties- higher triglycerides, and improvements of the order which you have seen are easily accomplished by cutting net carbs/sugar(I have been known to go from over 200 to 49 in < 6 months, no drugs, and have never exceeded 80 during the 18 years since, just because I always at least make some tiny effort to take it easy on the sugar, occasionally very careful about that). Also has been known to help with cholesterol, especially raising HDL. How was your HDL?

Since cutting net carbs/sugar can have such a profound effect on these blood tests, as well as blood sugar and A1C, ( it is very hard to suffer from T2D- aka sugar diabetes- if you eat little or no sugar/net cabs), then I personally would not be surprised if a drug that has a positive result on blood sugar, A1C and blood insulin levels, would have many of the same effects. Any unwanted SEs from the drug?

Post Edited (BillyBob@388) : 11/28/2017 9:16:23 AM (GMT-7)

This are two hypotheses which could explain how Metformin works. I do not think that anybody could prove this yet.

It is more important whether trials show that Metformin has an anticancer effect.

Grinnell86 said...
HDL went from 34 to 49. It just seems like too much of a coincidence that I have been taking atorvistatin and Trilipix for years, which lowered my levels from pre-treatment, but after adding Metformin, it seemed to act as a catalyst to those drugs. The only thing I have dropped from my diet is potatoes. Weight loss is a known side effect of Metformin, so that had to help my numbers. The PSA drop is the one that is hard to explain. I know that the jury is still out. Tall Allen posted a link a few years back that showed studies that argued for both sides. I would tend to believe that lower glucose levels contributed to the drop.

HDL improved 44% in 5 months? That actually is pretty spectacular. I have known folks on Statin drugs and low fat diets who could not increase their HDL 1 iota, or it has even gone down. But, apparently, just by using a drug that helps control blood sugar and blood insulin, you have dramatically improved this and several other parameters. Or at least you have improved blood tests considered to be indicators of improving health. Not bad.

That PSA drop may not be all that hard to explain, though again, sometimes they do go up and down a bit and folks never really know why. But if actually caused by the metformin, you have most likely cut your blood levels of insulin, as well as blood sugar. Plus, by cutting potatoes, if not replaced by another high carb food, you have also cut carbs which lowers sugar which lowers insulin. I personally would expect cutting blood insulin levels(and perhaps blood sugar also) to have a positive effect in the fight against PC, just as it does a long list of other health concerns. If you have not already, go back and read what I quoted from the link George supplied. That way it is not just me making wild claims, but rather the Univ. of Oxford and Univ. Hospitals of London/Uro dept. making the claims.

Then perhaps research the subject of blood insulin and PC, if you feel up to it. Here is one just to get you started, if interested. Notice it shows(caution: Chinese men only, so might not apply to you 100% or at all unless Chinese! ) that the men with the highest insulin sensitivity(Metformin raises insulin sensitivity) had a reduced odds of PC( reduced by 2/3, to OR .35) compared to the guys with highest insulin RESISTANCE (metformin LOWERS insulin resistance) had INCREASED odds of PC by 2.78 times. 2.78/.35= an increase of risk by 7.9 times from lowest to highest! "Considering insulin resistance and WHR together, the effect of insulin resistance was apparent in all tertiles of WHR, with men in the highest tertile of insulin resistance and WHR having the highest risk ( OR = 8.21....). EIGHT TIMES! Is there anything else we know of that approaches those #s? Maybe, I just don't know what it is. I have asked this numerous times and so far no one has given me an example. ( But OK, yes I know, that is just one study)

But if that study is shown by other studies to be even 1/2 correct, do you not want to lower your insulin resistance and blood insulin levels to help your battle against PC, plus many other reasons? And are you surprised that lowering you blood insulin with the drug Metformin, or by any other means(diet), may well have improved your PSA as well as several other items? I'm not, not at all. Can't prove they are related and not just a huge coincidence, but still, it does seem to be a rather huge coincidence if it is that at all. In fact, I'm glad you popped in here to help me make my point(from other threads) about the importance of keeping our blood insulin under control, with your study of one (N1)! Thank you!

Post Edited (BillyBob@388) : 11/28/2017 12:06:20 PM (GMT-7)

Same as Jerry, maybe longer.

Good news on the PSA.

Andrew

Grinnell86 said...
My RO released me from his care in January when my PSA was holding steady between .04 and .05 for 2 years, and told me to get my PSA checked yearly during my annual physical with my GP. I did this in July, and my PSA had jumped 40% from .045 to .063. Coincidentally, I was diagnosed at that time with type 2 diabetes. He prescribed 1000mg of metformin for me twice daily, and told me to get my labs done in November. I did that, and not only did my A1C go down from 6.6 to 6.0. But my PSA went down 19% back to .051. I have also been on 20mg of atorvistatin for years. This held my cholesterol at about 200. This check, my cholesterol dropped to 158, and triglycerides dropped from 333 (gravy) to 97. Not convinced yet that it is a miracle drug, but my numbers would indicate that it had an effect. I have also dropped 30 lbs while on it. I'll take it.

Cheers,
Paul

Well, you know, much as lowering carbohydrates does(but not as well), Metformin improves one's insulin sensitivity and other things related to insulin. One way is by decreasing hepatic glucose production and improving peripheral insulin sensitivity.

Some have claimed that diabetes is protective against PC, or at least less likely to be diagnosed with it.(though some studies do not confirm that theory) I have said "BS. It is the treatment for diabetes that is protective". Most diabetics are diagnosed with and treated for diabetes well before PC comes along. Treatment often starts with diet, exercise and if drugs are needed, usually metformin until it gets worse.

Treatment, if successful, will lower blood insulin levels by increasing insulin sensitivity. Insulin levels have shown a strong association with many cancers, including PC. Improving the insulin situation might well improve the PC situation, just as it improves a wide range of health issues.

So, perhaps that is what you are seeing? In addition, lowering carbs- which lowers insulin produced by the body to deal with the blood sugar that carbs are turned into- is well known to absolutely slash triglycerides(TGL). But, if you have improved your insulin situation via metformin (any dietary changes as well?), then an improvement in TGLs is not surprising to me.

Finally, excessive blood insulin is the #1 major player in weight gain. So, you have lost weight. Is it all coincidence? Hard to say for certain, but there might be a relationship. Either way, good or you!

EDIT: Sorry! I did not catch it(until now) that this was an old thread, one in which I had in fact already responded in a similar fashion to this response! Pardon me.

Post Edited (BillyBob@388) : 8/21/2018 8:32:07 PM (GMT-6)

Dr. Lam has had me on metformin, 1000mg/day for a few years now.

I am also on atorostatin.

Mel

George:

The statin is due to borderline high cholesterol.

Dr. Lam says metformin has good action against PC, I guess based on some studies.

One unintended issue:

Every time I have some medical appointment, they see my list of meds and assume I am a diabetic!

Mel

Mel,

Atorvastatin may also help against PCa. See this article:
Statin Use May Improve Survival in Advanced Prostate Cancer
It says: "Statin use alone by these patients was associated with a 22% decreased risk of PCa mortality, whereas concomitant use of a statin and metformin was associated with a 46% decreased risk. Notably, the study found that different statins varied in their effect, with atorvastatin appearing to offer the strongest protection. Atorvastatin users had an 82% decreased risk of PCa mortality compared with individuals who did not use statins"

George

Hi Hogo,

Curious. I don't know your story. Did an RO encourage you to start SRT at PSA .05 or was that your own decision?

FYI, I'm a T2D and have been on Metformin 2000 mg. daily for years. Also on the max dose of Atorvastatin. As you can see, my PSA has been bouncing around at low levels for over 3 years. My total cholesterol, HDL's and LDL's are low and very well controlled. No idea whether Metformin or Atorvastatin has anything to do with PSA levels. Have there been any studies that indicate Metformin or Atorvastatin may mask PSA or understate the true PSA value? I'm not aware of any.

Good luck to you.