Vitamin B supplements and recurrent pca

I have learned on here that extra iron is bad for PSADT.

Iron and PCa progression.

"Iron is an essential nutrient that facilitates cell proliferation and growth.
However, iron also has the capacity to engage in redox cycling and free
radical formation. Therefore, iron can contribute to both tumour initiation
and tumour growth; recent work has also shown that iron has a role in the
tumour microenvironment and in metastasis."

/www.ncbi.nlm.nih.gov/pmc/articles/PMC4036554/

NKinney,

Thanks for your post. I will study the article you mentioned and also follow your
other comments and those of caslessclay and try to learn more.

about your first comments - to quote
You have recurrent PC, and you are now on lupron...so you are seeing a Medical Oncologist.

Everything, absolutely everything you take either prescribed or over the counter should be shared with your physician...all physicians you see. You certainly had a discussion with your oncologist before starting lupron about your history with anemia, and what counter measures did you mutually decide on? Androgen deprivation therapy can, indeed, lead to worsening anemia...so this is important to closely monitor.

--- Yes, I abolutely agree and with other oncologists where I lived before, that
would have been the case (I was not recurrent or on adt then) -

but now, the doctor/practice I go to does not care about side effects, denies that there are any adt side effects, will not allow patients to have any labs that might track some side effects (they do allow psa and T), and give a whole corporate list of reasons related to this.

(none of the other oncol practices in my area allow these kind of labs so will conclude also that they do not care or admit to side effects.
(and at least one practice does not believe in imaging for recurrent patients

I've found this to be a common thing but not at all what I expected.

I realize that the comment here might be for me to find another dr, but as mentioned that is the way it is where I am and I believe so for many other areas, but certainly not all drs feel this way - its just the way it is here.

And the pcp feels that the specialist should own giving the labs for side effects of the treatment the specialist is providing, so they are not giving labs either, or care
about side effects either.

And I cannot go out of the area for a number of reasons, and would somehow need to know in advance if some dr would be one who believed in tracking side effects, etc.

I'm not trying to be a complainer here, just trying to explain.

tomhw,

This is not exactly what you asked, but wanted to make you aware that some vitamins may cause inaccurate readings on PSA tests. Whether or not same vitamins actually affect PCa, not sure, but sure can jack around with the PSA test itself.

/www.labcorp.com/test-menu/33781/prostate-specific-antigen-psa-ultrasensitive-serial-monitor#

Please coordinate this with your docs around test time, if you are in fact using the vitamins that may interfere with good test readings.

Robert

NKinney,

I finally read the article you pointed to on anemia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472681/

Wow, the causes of it for men on ADT are more complex than I thought
and that it can be multiple effects or adt and pca itself that contribute to it.

One thing I read somewhere, said that taking iron might not be helpful if
it is adt or pca caused, assuming one's iron levels are ok, but can't remenber
if am recalling that correctly, and can't remember where I read it.

My iron levels - some have been in middle range and some, like iron saturation, have been at lower range.

I have been perhaps too conservative in taking the iron supplements (I don't get much iron at all from my diet) - due to IBS and thus fear of some stomach issues by taking more iron.

I started with time release iron - 45mg elemental - but that did not help and read that time release might not be that effective.

Then moved to 1/2 of a normal 65mg elemental iron pill, just to see how stomach was.

Was going to move to full 65 mg pill, but then read about chelated iron (ferrochel) which supposed
to be more absorbable and available, and less stomach upset. the pills come usually in 18mg
or 27mg elemental, so started with one pill (taken with 250mg vitamin C) last week.

I haven't gotten firm answers from company that makes it if the reason for the smaller value of one pill
(ie 27 mg) could be equivalent or better to that of traditional ferrous sulphate 65 mg pill, that is, if the chelated is better absorbed and available, that even though its less mg, it might in effect be as good or better than the 65 mg.

I guess I could try another 27 mg during the day, since they are not time release.

pcp had said to take 1 or perhaps even more than one 65 mg pill (they are not aware of the chelated)
but it was my concern of stomach issues that led me to go slow on this.


Thus I gotta track down what I read that perhaps iron might not be helpful if anemia due to ADT and/or pca, and if so, look into that medication/infusion mentioned in the article you pointed to.

Want to get back to the topic of my post and refine questions:

1. Do you take iron supplements to help with ADT caused anemia ?
(esp if your diet does not have a lot of iron)

if so, what type of iron and how much a day
ie ferrous sulphate, ferrous fumarate, chelated, etc ?
and how many mg of elemental iron each day ?

2. Has taking the iron supplements helped you blood count numbers ie hemoglobin, hematocrit, RBC ?

3. Do you take vitamin B complex while on ADT ? Had read that some Vitamin B might not be good
re pca, but can't find that now ?

trailguy, thanks for your comments. on the exercise, it was good for me to read this as have
been lagging alot in doing that even though have felt it is important to help me in dealing with
adt and also overall energy and focus. I don't do as much as you do for sure but it would be
great if I can just get back to what I was doing.

tomhw said...
Want to get back to the topic of my post and refine questions:

1. Do you take iron supplements to help with ADT caused anemia ?
(esp if your diet does not have a lot of iron)

if so, what type of iron and how much a day
ie ferrous sulphate, ferrous fumarate, chelated, etc ?
and how many mg of elemental iron each day ?

2. Has taking the iron supplements helped you blood count numbers ie hemoglobin, hematocrit, RBC ?

3. Do you take vitamin B complex while on ADT ? Had read that some Vitamin B might not be good
re pca, but can't find that now ?

trailguy, thanks for your comments. on the exercise, it was good for me to read this as have
been lagging alot in doing that even though have felt it is important to help me in dealing with
adt and also overall energy and focus. I don't do as much as you do for sure but it would be
great if I can just get back to what I was doing.

I don't know of anything specific re: B12 taken with ADT. But there are these:
/www.ncbi.nlm.nih.gov/pubmed/23508410

Somebody said...
Vitamin B12, MMA and methionine concentrations were not associated with prostate cancer risk. Compared with the MTHFR 677CC genotype, the CT and TT variants, both of which were related to lower folate concentrations, were associated with reduced prostate cancer risk [OR 0.82 (0.72-0.94) and OR 0.78 (0.64-0.94), respectively].
CONCLUSION:

This large-scale population-based study suggests that high serum folate concentration may be associated with modestly increased prostate cancer risk. We did not observe an association between vitamin B12 status and prostate cancer risk.

/www.ncbi.nlm.nih.gov/pubmed/20501771

Somebody said...
RESULTS:

In the ProtecT study, increased B(12) and holo-haptocorrin concentrations showed positive associations with prostate cancer risk [highest versus lowest quartile of B(12) odds ratio (OR) = 1.17 (95% confidence interval, 0.95-1.43); P(trend) = 0.06; highest versus lowest quartile of holo-haptocorrin OR = 1.27 (1.04-1.56); P(trend) = 0.01]; folate, holo-transcobalamin, and tHcy were not associated with prostate cancer risk. In the meta-analysis, circulating B(12) levels were associated with an increased prostate cancer risk [pooled OR = 1.10 (1.01-1.19) per 100 pmol/L increase in B(12); P = 0.002]; the pooled OR for the association of folate with prostate cancer was positive [OR = 1.11 (0.96-1.28) per 10 nmol/L; P = 0.2) and conventionally statistically significant if ProtecT (the only case-control study) was excluded [OR = 1.18 (1.00-1.40) per 10 nmol/L; P = 0.02].
CONCLUSION:

Vitamin B(12) and (in cohort studies) folate were associated with increased prostate cancer risk.
IMPACT:

Given current controversies over mandatory fortification, further research is needed to determine whether these are causal associations.

Those associations seem pretty small to me, or inconsistent, but they are there.

Of course, OTOH, no one can get by without adequate B12, and in the case of any treatment causing anemia, it might be that the odds of a bad outcome from not enough of it would far outweigh any slight increase of odds for promoting PC, if that increase even exists. Finally, risk(high vs low) is not mentioned, nor is mortality, just PC in general.

There are more than one study out there that indicate that while nutrient/food/ XYZ(whatever) either has no benefit for lowering odds of getting low risk PC, and maybe even(by association at least, which is not the same as cause) slightly increases the odds of getting PC, when it comes to high risk PC and/or PC mortality, it is often quite the opposite. It is associated with- in several studies at least- less mortality and a lower risk score(i.e. lower Gleason scores, stage, etc).

Could be the same regarding the small association in these studies of B12(and/or folate) with PC. It might be that the main thing it is associated with is low risk PC, while it is not associated with high risk or mortality, and possibly even reduces the chance of those. Unless someone has other studies indicating otherwise, I'd say we don't really know. But like I said, with or without PC, we need a certain amount of B12.

Post Edited (BillyBob@388) : 4/13/2018 1:32:44 PM (GMT-6)