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Advanced Prostate Cancer
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Metformin & Statins - what dosage?

Please advise what dosage to take for:

1) Metformin

2) Statins

3) what is best brand to take for Statins...is it Crestor?

Many thanks for your considered replies and support.

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The Swiss Metformin study that convinced Dr. Myers used 2,000 mg Metformin. That's what I take. The pills are each 500 mg. I am up at 5 a.m. & take two with my coffee. I eat breakfast at 9-10 a.m. & take the other two.

I don't really want to eat anything at 5 a.m., but Metformin should be taken with food, so I have a bite of something.

It's best to ease into the full dose. Start with one pill & add a pill every 2 weeks.

As for statins, the most lipophilic are best for PCa uptake. The benefit is dose-dependent, so go for the highest dose for your chosen brand.

"Atorvastatin, fluvastatin, lovastatin, simvastatin, and pitavastatin are lipophilic drugs, while pravastatin and rosuvastatin are hydrophilic."

I selected Simvastatin based on data that was new at the time. There may be a better choice now, but it is unclear. We need a study that only looks at the high doses.

-Patrick

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Hi Patrick,

Is 40 mg of statins sufficient?

If I recall I think Myers use to recommend Crestor or is this outdated?

Many thanks and good health to you.

Mike

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Mike,

Crestor (Rosuvastatin) is hydrophilic & I would not use it.

I think that Dr. Myers was initially concerned only with reducing serum cholesterol in patients who were having difficulty lowering it naturally. Although he subsequently recognized that PCa on ADT might begin to make cholesterol, I don't think that he paid much attention to the issue. Otherwise, he would have advised all patients to use a statin, regardless of blood levels, & after reading the literature, would have recommended a lipophilic.

40 mg does not have the same strength across all brands. Go for the highest available dose.

-Patrick

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Thank you Patrick.

I am onto it right away.

Much appreciate and best of health to you.

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Dear patrick

I look forward reading your each post. Thank you for your most helpfull information.

I have been thinking of using metformin and statins for my husband who has high cholesterol and PCa but i am concerned about muscle mass loss they couse.

What do you suggest for that?

Kamile

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Kamile,

I tend to view the drugs as being generally safe, based on the number of users:

"Among the US population, 26% of adults were using statins in 2012, according to the Centers for Disease Control and Prevention."

Metformin use is largely restricted to diabetics, but there were 12.5 million U.S. prescriptions in 2014.

...

It is prudent for statin users to take CoQ10 to counter muscle aches.

Muscle loss due to rhabdomyolysis is extremely rare.

Best, -Patrick

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Thank you for your kind reply.

I preciate it.

Kamile

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Agree with the CoQ10 recommendation. Studies show that statins lower CoQ10 levels. This is because cholesterol and CoQ10 are made in the same pathway, so when you block the production of cholesterol, you also block the production of CoQ10. We need CoQ10 to help our bodies make the energy our organs and cells need. Our muscles need a ton of energy to work properly, which explains why CoQ10 can help reduce muscle pain. There was even a patent on a statin combined with CoQ10!

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Since everyone is different, ask your urologist and your G.P., then decide.

In my case, I've been using Metformin for 25 years with no adverse reactions. When I began, 3,000 mg was the maximum daily recommended dosage. Today, it's only 2,500, which is what I take...500 at breakfast, 1,000 each at lunch and dinner. BUT...if you have a lighter lunch and a heavier breakfast, make it 1,000 at breakfast and dinner, 500 at lunch. I also -- from time to time -- take an extra 500 with an evening snack.

Re Atorvastatin (generic for Lipitor): docs started me at 10 mg daily at age 55, then 20 at age 65, now 40 at age 81. All levels seemed to work fine per blood test results, but docs agree that aging requires a greater dose.

The main point here is that you need a regimen that's right for you. Just because my intake works for me, doesn't mean it's appropriate for you. Go to the professionals and ask!

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Whatever you are doing is WORKING!! 81 years and counting. Congratulations and long may your good health continue.

I will check with oncologists and also GP.

Sincere thanks for your opinion and direction...greatly appreciated.

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I take 40 mg Crestor (rosuvastatin) and 500mg metformin twice daily. My RO thinks 1000mg twice daily is optimal but my stomach doesn’t agree. I find it’s necessary to take metformin right after eating .

Bob

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Hi Bob,

thank you...The amounts you are taking are about what I am thinking of taking. I will confirm with MO before commencing.

Good health to you and thank you so much.

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FWIW, my PCP after listening patiently to my case for a statin prescription calmly said that he was prescribing a 40mg dose of simvastatin daily because that was the brand and dosage most of the studies he read had used and recommended.

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I am (was) also a Dr. Myers patient. Some were prescribed Metformin and 1000 a day and others like me at 2000 mg (2 x 500 twice daily)

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Many thanks. This sounds like the right dosage for me.

Wishing you continued good health.

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some doctors suggest taking metformin after a 5 mile walk.

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