I have stage IV PCa and have gone through Xtandi, Zytiga and now on 3 treatment of taxotere. I heard that large dosed of vitamin D3 has had an effect of lowering PSA (mine is 126). Has anyone had good results with D3? And if so, what dosage should I take daily or weekly?
LP16
Hi LP,
Your mention of "Dosage of Calciterol" (i.e. calcitriol?) threw me, since calcitriol cannot be bought as a supplement.
Nonetheless, calcitriol (& analogs) are associated with PSA decline:
ncbi.nlm.nih.gov/pubmed/250...
"Respectively, 85% and 76% of the {CRPC} patients had ≥30% PSA decline within 3 months and ≥50% PSA decline at any time during the study." Used Inecalcitol, a calcitriol analog).
ncbi.nlm.nih.gov/pubmed/231...
"... high-dose calcitriol, docetaxel and zoledronic acid combination in CRPC"
"Out of 23 evaluable patients, there was a response of prostate-specific antigen (PSA) in 11 patients (47.8%); 6 (26.1%) had a stable PSA level for a median of 4.2 months."
I am not aware of CRPC studies using supplemental vitamin D (cholecalciferol). There probably will never be any, since the aim is to deliver calcitriol, & there is no guarantee that cholecalciferol will do that, or by how much.
The aim of cholecalciferol use is to get levels of calcidiol above 50 ng/mL. This may require doses of over 5,000 IU daily. A dose of 50,000 IU implies a periodic vitamin D2 shot - not recommended.
I believe that vitamin D is beneficial in PCa. It is important that calcidiol (25-D) be monitored {not calcitriol (1,25-D)}. Some aim for higher levels, e.g 60 or 70 ng/mL.
Calcitriol, however, is the active hormone. Calcium from dairy or supplements will suppress it. So will phosphorus from deli meats, soft drinks or large sevings of fresh meat. Fructose will boost levels.
-Patrick
Thank you Patrick for your response. It was very educational. I purchased through Amazon D3-50 Cholecalciferol after reading a posting. I have not started taking it and was wondering how much and frequency. You mentioned in your response that there are not studies regarding cholecalciferol and maybe I purchased the wrong one. I will discuss with Oncologist but it looks like a bought the wrong one?
Lou
Hi Lou,
50,000 IU cholecalciferol is perhaps good for someone who wants to take a weekly dose, or for someone with calcidiol (25-D) in the teens who wants to get above 50 ng/mL fast.
But some experts say that a daily dose is more effective. The body seems to like a steady dose. One theory is that some cells use cholecalciferol directly, but it is cleared fast, making a weekly dose inappropriate. I don't know about that. The main thing is to know & monitor calcidiol. And to limit calcium/phosphorus intake.
-Patricl
Hi Patrick,
I have to push my doctor perhaps annually for my 25-D tests. My baseline was 41. I got to 54 taking 5000 IU daily. But I wanted to be in the over 60 group, which is supposed to do even better. I got there & am maintaining it by taking 10,000 IU daily. What do you suggest is a reasonable frequency for checking my level? I don't think I'm in any danger whatsoever of going too high. I just want some very occasional reassurance that I'm maintaining. Thank you.
Neal
Neal,
If you were OK at the last but one test, & did not change dosage, & the current test is in the same ballpark, you really know what your dose should be,
True, there are seasonal considerations for some, but it seems that older men don't sit out in the sun much.
For those who need high doses (6,000-10,000 IU), there doesn't seem much point in worrying about seasonal variation, unless there is a lot of summer sun exposure. Even then, I'd be inclined drop the winter dose a little & forgo a test. If 25-D varies between 60+ & 70+ ng/mL, it's no big deal.
-Patrick
My labs for vit D reached 60. The normal range goes to 100. You should be able to hit a D level over 50 by taking 5,000 IUs 3x/day for a while. I'd guess a few weeks. Or sunbathe.
Also see YouTube videos by Bruce Hollis, or stuff by Steve Strum, whom I like a lot, except I see bottles of pills with his name on the bottle that creep me out.
LP16,
If you're running out of treatment options, you might consider clinical trials. You can go to clinicaltrials.gov and search for prostate cancer treatment trials. It's a time consuming process and you'll find many, many more trials that really aren't useful to your particular circumstances than trials that are, but it may be worth a few hours of research.
Two other things that may be worth considering are 1) retreatment with a drug that worked once and has stopped working. Zytiga sometimes stops working and then starts again. And 2) treatment with drugs that improve the success rate of other drugs. Triptolide may be available in clinical trials. It has been claimed to restart Xtandi ( ncbi.nlm.nih.gov/pubmed/286... ncbi.nlm.nih.gov/pmc/articl... ). There are claimed to be drugs that may make docetaxel more effective too.
Others may have more info about these alternatives than I do.
I wish you the best of luck in your journey.
Alan
I started at a very respectable 41. I pushed it to 54 by taking 5000 IU D3. But based on a Scandinavian study I'd read, I wanted to be over 60. I accomplished that by taking 10,000, & I've stayed there to maintain it. That level is recognized as safe, e.g., in a video of a presentation at UCSF Medical School about PCa & also pregnant? lactating? women. The video rips up the ancient study that still has some MDs recommending 400 IU.
Thank you Neal for your response. I think that I will increase my D3 dosage and verify the calcidiol levels in my blood tests.
Regards,
Lou
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