I was diagnosed as Gleason 4+5 eighteen months ago with a PSA of 78. I was immediately put on three-monthly injections of Triptorilin (decapyptyl) and soon started a six infusion course of docetaxel. This brought my PSA down to a low of 0.55 twelve months ago. Since then my PSA has been creeping up and with it now at 2.28 I have just been prescribed Enzalutamide. I have been taking Vitamin D and Curcumin+piperine supplements but the Oncologist consulted the Pharmacist who suggested that I should stop the Curcumin as he was not familiar with Curcumin supplementation and was unsure of what, if any, inter-reaction their could be. He did say that he would look into it further but for me to stop in the mean-time.
Has anyone experience of the combination?
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cromone
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I have been taking Tumeric Curcumin extract 500 mg and Pomegranate extract 250 mg daily since 2006 recurrence after prostatectomy in1999. I don't know if these have helped or hurt. This is in addition to oncologists recommended treatments listed in my profile. My doctors have not advised for or against these supplements. I started taking them on my own, based on a literature search I did 2006. I started Xtandi August 15, 2017. Only noticeable side effect of Xtandi so far has been a little more fatigued then before starting Xtandi.
Turmeric - the source of curcumin - has been used in Ayurvedic medicine for many centuries. It is an important component - albeit small - of many Indian dishes, & has to be considered safe, since many consume it every day.
Could curcumin interact with Enzalutamide? Enzalutamide binds to the androgen receptor [AR]. Curcumin downregulates AR [6], so there should be synergy.
When I see "piperine" mentioned by someone on meds, I wonder about dose interference. The liver quickly metabolizes the greater portion of many drugs. A therapeutic dose might be a tenth of the prescribed dose, because the assumption is that the liver will destroy 90%. Piperine inhibits at least one of the enzymes that metabolyze many meds: CYP3A4, therefore it could increase the potency of many drugs, just as grapefruit juice does.
Ironically, Enzalutamide is more of a threat to other drugs than piperine, since:
"Enzalutamide is reported to be a strong inducer of the enzyme CYP3A4 and a moderate inducer of CYP2C9 and CYP2C19, and can affect the circulating concentrations of drugs that are metabolized by these enzymes." [1]
& so piperine might actually be beneficial if other drugs are being used.
On the other hand, since your curcumin is not a bioavailable form (why else is it paired with piperine?), and the piperine will likely be trumped by the Enzalutamide, it may be pointless to use it. If you are nevertheless interested, consider LongVida [2], which is bioavailable without the help of piperine, and add piperine [3]. Even so, Enzalutamide-induced CYP3A4 might overwhelm the dose. In which case, liposomal curcumin [4] might be the answer.
This list of supplements that can interact with Xtandi, & how strongly, was provided by an oncology pharmacist with a PharmD degree. (Each item says View Details, but I don't have them.)
The list doesn't include curcumin, so I'm still on that & Zyflamend after starting Xtandi a month ago. PSA declined after 4 weeks. Like 1 of the guys who posted before me, my side effect is fatigue. It hits hard after my 2nd meal of the day, & has forced more naps already than any of my previous decade of PCa meds.
My radiation doctor told me I could take B17, I read about it and it has a very positive results. I did order the apricot kernals on ebay. and its loaded with B17 and its a natural part of the inside of the apricot seed, All natural too.
Thanks a lot for taking the time to reply folks. It is exactly the information I was after. Thats my first week of Enzalutamide over with relatively minor side effects. My next appointment is in three weeks time, if they then OK the use of curcumin plus piperine I will report back on here.
Why take the chance...Dr. Myers said to drop Curcumin when using Meformin because of gastro intestinal problems...IMO Curcumin is worthless because of its poor absorbtion and extremely short half life
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