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Advanced Prostate Cancer
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Cell Forte IP-6 & Inositol Question

Is there any concern for the high calcium amount in Cell Forte IP-6 & Inositol formulation? There is 520 mg or 52% of DV in just one scoop. High calcium is associated with risk of aggressive disease. I thought perhaps the calcium amount was calculated to just balance out the absorption inhibition from the IP6, but the mfr. Customer Service said no, it is adding calcium. They also said they do not recommend taking more than one scoop per day. Comments?

Jeff

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Jeff,

Gionannucci saw the calcium risk in terms of vitamin D inhibition over 20 years ago.

From 1998 [1]:

"Higher consumption of calcium was related to advanced prostate cancer [multivariate relative risk (RR), 2.97; ... for intakes > or = 2000 mg/day versus < 500 mg/day; ...] and metastatic prostate cancer (RR, 4.57; ...). Calcium from food sources and from supplements independently increased risk."

"High fructose intake was related to a lower risk of advanced prostate cancer (multivariate RR, 0.51 ..., for intakes > 70 versus < or = 40 g/day; ...). Fruit intake was inversely associated with risk of advanced prostate cancer (RR, 0.63; ...; for > 5 versus < or = 1 serving per day), and this association was accounted for by fructose intake. Non-fruit sources of fructose similarly predicted lower risk of advanced prostate cancer."

From 2006 [2]:

"Higher calcium intake was not appreciably associated with total or nonadvanced prostate cancer but was associated with a higher risk of advanced and fatal prostate cancer [for fatal prostate cancer, compared with men whose long-term calcium intake was 500-749 mg/d (excluding supplement use of <5 years); those with intakes of 1,500-1,999 mg/d had a RR, 1.87 ..; and those with ≥2,000 mg/d had a RR, 2.43 ...]. Dietary calcium and supplementary calcium were independently associated with an increased risk. For high-grade prostate cancer (Gleason ≥ 7), an association was observed for high versus low calcium intake (RR, 1.89 ...), but a nonsignificant, inverse association was observed for organ-confined, low-grade prostate cancer (RR, 0.79 ...). In a sample of this cohort, higher calcium intake was associated with lower circulating 1,25(OH)2 vitamin D levels. Our findings suggest that calcium intakes exceeding 1,500 mg/d may be associated with a decrease in differentiation in prostate cancer and ultimately with a higher risk of advanced and fatal prostate cancer but not with well-differentiated, organ-confined cancers."

I try to keep total calcium intake to ~500 mg & I don't see the point of >1,000 mg (how did a hunter-gatherer with sturdy bones ever get that much calcium from diet in a pre-dairy setting?)

& for 14 years, I have used fructose in my coffee.

I would have no real problem with one scoop because my diet does not contain much calcium. I would not double up on the dose, though.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/945...

[2] cebp.aacrjournals.org/conte...

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Thanks Patrick! Makes sense

Jeff

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In a period when an aging population has been bombarded with warnings about calcium deficiencies (due primarily to osteoporosis in women), many processed foods have added calcium. Since osteopenia and osteoporosis is a risk for men undergoing ADT, calcium intake is also a major issue for PCa patients. IMO, it is prudent to make sure your MO is aware of research in this area before agreeing to undertake a program of supplementation, esp. if above the 1000-1200 RDA for adult men.

Also most milk alternatives supplement with calcium (calcium carbonate) and proudly advertise that they provide 50% more calcium than dairy milk. Being mostly vegan, I use alternative milks (soon to be regulated to no longer be able to use "milk" in their product names in many states??) and opt for organic varieties since for some unknown reason thay have about a third less calcium per serving.

I agree with Patrick's view about our evolutionary calcium intake and also try to keep my calcium intake to something much less than the NIH RDA of 1000 mg/day. I shoot for the <604 mg/day low intake level used in this study:

ncbi.nlm.nih.gov/pmc/articl...

Eat Well to Be Well - cujoe

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Thanks and I do the same with the milk substitutes.

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The knee-jerk reaction to osteopenia during ADT is to throw calcium at it. But if there was no bone loss before ADT, why do doctors assume that the patient suddenly lacks sufficient dietary calcium?

Men need a small amount of estradiol [E2] for bone health (<12 pg/mL IMO). Dr. Myers approach of using a low dose E2 patch, if necessary*, makes more sense than adding calcium. And it could cut down on bisphosphonate use too.

* Castrate T means very low E2 in most cases.

-Patrick

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Patrick noting the MSKCC link posted below by Herman, stating it is binding to calcium in the body vs additive. Confusing!

Jeff

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Jeff,

I realize that it can bind to certain minerals, which is why it is always taken on an empty stomach. I don't recall calcium & magnesium being included.

My IP-6 product is calcium-magnesium-IP6, i.e. conjugated in some way, & gives the impression that the cal/mag portions become available to the body. Perhaps Nalakrats would know what the fate of the supplement is in the body?

-Patrick

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So taking a calcium/vitamin D supplement will increase the risk that my cancer will escalate? Then why do onc recommend it due to bone loss?

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Calcium is the issue, not D.

Doctors are naturally worried about the risk of serious fractures with weak bones. Perhaps that trumps all other considerations. I doubt that many men with ADT-related bone loss need additional calcium. & if they don't, adding more will not make bones stronger.

Do many oncs know that excessive calcium is associated with aggressive disease? It's old news & they should.

Note that vitamin K is needed to transport calcium to bone. These days, doctors have learned that D is needed to bring calcium from the gut to the blood, but without K, that merely increases calcium levels until the excess is ditched by the kidneys, or ends up as arterial calcification.

-Patrick

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I take 12 scoops a day in 2 divided doses, AM and PM, always mixed in water only on an empty stomach. The recommendation from Enzymatic Therapy is reasonable CYA activity.

My blood chemistry receives a comprehensive assessment every six months from my PCP and a more specialized assessment of course from my MO. Everything is in acceptable ranges except I am slightly anemic. I am on six month Lupron since my diagnosis in 2012. During the first 3 1/2 years I also took Casodex (G 8, initial PSA 19). My PCP had me evaluated in 2017 for osteoporosis (I am 77). The results indicated, in the words of my PCP, "you will never have trouble with your bones". He was a happy doc.

BTW, I am a vegan and never consume dairy products.

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That’s an excellent response, however others who consume 6 grams of calcium and 9 grams of phosphorus daily may have adverse affects on their bones and kidneys.

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Thanks, so your blood calcium is not high?

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No, it is not. Makes you wonder about DV calculations and the science behind them. I should add that Dr. Shamsuddin, who I communicate with occasionally via email, is aware of my massive dose and has never asked about it or expressed concern. We just discussed the Mayo clinic publication of the Melanoma patient and IP6. If you missed that posting here on healthunlocked, it is worth looking for or go to pubmed.gov. Dr. Shamsuddin now has a Facebook page: "IP6 Research".

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CalBear74,

I am follow a mostly vegan diet and in addition to PCa also have a blood cancer (CLL= 2Xloser). I get full blood workup (+) for the CLL every six months. About a year ago, my red blood counts were at/or below lower normal levels. I did a bit of research, analyzed my normal daily diet, and concluded that I was likely iron deficient. As a result, about six months ago I started taking a non-heme iron supplement (18 mg chelated taken with 500 mg Vit C for better absorption @ 3 to 5 x per wk) . At my last labs in December 2017, all red counts were again well above low normal range.

In doing my research, I looked at both vegan diets and CLL and found that over time both can lead to low red counts. The issue with CLL is related to blood "manufacturing" and vegan diet is related to plant-sourced iron being less readily absorbed. The good aspect of plant-sourced iron is that we limit total amount, whereas heme-iron is non-regulated; i.e., easy to get too much.

You might consider giving this a try to boost your red blood numbers.

Be Well - cujoe

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My doctor has me on a supplementary iron capsule. I will talk to him about your approach. I will mention the non-heme iron distinction. What is the brand you are using?

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Cal - Here is quick overview of the heme non-heme iron story.

globalhealingcenter.com/nat...

And here is the spiel for the Albion Ferrous Bisglycinate Chelate form I take:

bioceuticals.com.au/educati...

I use the Vitacost housebrand version.

vitacost.com/vitacost-chela...

Note: I have never been treated for my CLL (12+yrs) and am on PCa treatment vacation with <0.1 PSA. As you indicate, always prudent to review supplements, etc. with your MO. Be Well - cujoe

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I take 9 scoops/day like CalBear74. I take before meals on an empty stomach most of the time. I'm also on Lupron/Casodex [G8 (4+4) Stage-4 w/5 bone mets, initial PSA 55] and consume the Enzymatic Therapy IP6 brand.

I've had no problems with my lab work with calcium or iron issues. I do take high doses of D3/K2 to build up my D3 levels to a target of 70s as suggested by my doctors. My bone density test which was "above average for my age group" with no chance of bone fractures at this point. I going on 67-years old.

Thanks for that Facebook IP6 Research link. More research on the topic of IP6

researchgate.net/publicatio...

Personally, I would not worry about calcium issues with IP6. Low iron for some, perhaps. That was the only issue Sloan Kettering research on IP6: mskcc.org/cancer-care/integ...

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Me... I just eat two scoops of chocolate chip ice cream a day (and another scoop if my wife's not looking).

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 01/12/2019 11:54 AM EST

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I bet you did not know there was a vegan version of chocolate chip, and vanilla, and pistachio, etc. The brand, believe it or not, is Nada Moo. I buy it at Sprouts. It's excellent. Tastes like the real thing but it lacks the hormones and antibiotics the farmers love to inject.

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