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Advanced Prostate Cancer
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Metformin and possible Lactic acidosis

Hubby had his 3rd PSA checked and again Non detectable! But. Recently has been having achy joints we chalked it to the ADT but he is also on Metformin XR because of research we found supporting it while you are on ADT. I had a blood test done for Lactic acid it was 2.7 range is 0.6 -2.4 so he is going off the Metformin for a week to see if it changes anything but I know he’s not happy.

He has done research on the effects of Metformin and how they help out when your on ADT and also help you not become castrate resistant.

Has anyone else had problems or are also on this.

Please advise.

Stephanie Csokmay

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Steph---it is most likely something else---ADT by itself hits men in many ways. It alters blood sugar, causes one to be anemic, and when in physical stress because of the drugs, the body puts out inflammation markers, that can upset the chemistry of the blood.

But those who take Metformin, to prevent aggressiveness of Pca from occurring, even when PSA undetectable--we still have cells that cannot be detected or seen on scans. We do not have the ability to get down and detect that which is undetectable--by our blood tests, or scans---we cannot see a group of Pca cells that might stretch a millimeter.

Most men I know take 2,000 mgs a day. Some like to spread it thru the day with food, and some use extended release, and combine it with regular Metformin--where they take the last 500 mg Extended Release tablet, an hour before bed---with some food.

I am not a doctor--just reporting certain things I am aware of. Key is to have protein/fat with Tabs--to prevent stomach upset.

Nalakrats

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Do you think it’s a good idea to stay on the metformin even when you are in a adt/ Zytega vacation ? I’m .02 PSA for 7 months now. Any one else have any thoughts on the subject ?

Schwah

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I do not know if it is good or not--but I watch my blood sugar numbers, Quarterly--and they stay about 100 with Metformin---and I took it 22 months on ADT, and now 11 months no ADT--but still take my Avodart, Proscar, DIM, and Arimidex, to modulate DHT and E2 as my T is now very High. My PSA test for last 31 months has been <0.03--that is as far as the Analyzer, that is used at my local hospital can go. So you know how I operate--I am not a Doctor. I just report. So reporting what I do is not a reason to follow. Suggest you discuss this with your MO.

Nalakrats

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Thanks so much for the quick reply. We certainly understand you are no doctor, but we have tremendous respect for your "layman's" knowledge of this disease. Based on your experience and research, do you believe Metformin delivers an appreciable anticancer benefit?

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The benefit reported in most papers==and you can check Pubmed--for publications, or check Patrick's Metformin's posts[pjoshea13]--is that the benefit appears most beneficial with men who have low burden, another words, their treatments has reduced their cancer to Low PSA's or Undetectable PSA's--as the cancer comes back or tries to grow, the Metformin purportedly--lowers the aggressiveness, thus enabling Standard of Care Treatment to be more effective. That is the best summary I can give, at this time.

Nalakrats

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I’ve been on metformin since 2015. I had achy joints when on Lupron. I switched to trelstar and aches disappeared. Resistance exercise also helps joint pain.

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He has always worked out and still does it just this awful neck pain in same spot and bicep pain. That’s when I looked Into the connection with Metformin and lactic acidosis and decided to have it checked.

His came back at 2.7 which is out of range so his primary wants to see if it’s the Metformin causing it. He’s also in ADT. And was taking the Metfirmin to counter the effects of the ADT with possible diabetes effects and also it’s relationship

In keeping the cancer away.

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I have been taking Metformin for 2 years. Initially I could not tolerate the standard dosage 2 x 500 mg in the morning with food and 2 x 500 mg in the evening, again with food. I was nauseous in the morning and had to cut the dosage to 1500 mg total. I do have some minor aches in my joints (left foot) but I attribute this to regular arthritis. Recently I adjusted the dosage back to 2000 mg and tolerating it well this time. Perhaps decreasing the dosage by 25%, for example, for a period time and then checking lactic acid might be the way to go. Cheers, Phil

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He’s only on 500 XR

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Do you mean that he takes one 500 mg XR pill per day or four 500 XR pills per day? The XR stands for extended release which I presume increases the effectiveness of the Metformin thereby reducing the dosage required and maybe the possibility/frequency of side effects. Metformin (regular) is generally well tolerated. I would consult with the doctor who prescribed the Metformin and confirm if 500 mg/day is sufficient. The standard dosage is 2000 mg/day. Cheers, Phil

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He takes on Metformin XR 500 per day because of the lactic acid level he has to stop it for now.

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I take 500 twice daily ; more causes stomach distress

Bob

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Take will lots of food. When you start taking Metformin you have to ramp up slowly to avoid stomach issues. Take an extra pill every third or fourth day, then after a week or two every second day as tolerance improves. Cheers, Phil

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Armywife,

What is the relationship between Metformin and Lactic acid?

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It has been known to cause lactic acidosis in some people. Since before Metformin his numbers were normal and after it showed up. That’s why his primary is taking g him off the Metformin and we are retesting the levels. You can google metformin and lactic acidosis that’s what I did to figure out what was causing this. All his scans are clear and PSA undetectable.

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