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Advanced Prostate Cancer
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Enzalutamide plus BIRM any conflict?

My March 2016 diagnosis was T4 N1 M1aGleason 8 and Gleason 9 grade group 4&5

. For the past 32 monthsI have been on 3 monthly ADT injections of Triptorilin and I had 6 infusions of Docetaxel. 17 months ago I started Enzalutamide

My PSA at diagnosis was 78 but since starting Enzalutamide has been <0.1.

I used to walk a lot but the constant fatigue has been getting me down. I thought I might try BIRM to counteract the fatigue.

At my last meeting at my local oncology clinic I asked if they new of any conflict with my existing medications, I was referred to the pharmacist who had not heard of BIRM but said she would look into it. She eventually responded by email.

"Unfortunately I can’t find enough information on the pharmacokinetics of BIRM (how it is metabolised, which specific enzymes in the body metabolise it) to determine if there is an interaction with enzalutamide or not. As such, I wouldn’t recommend taking it.


I had emailed her a link to the NCBI report on BIRM which I had found on this site which I had found too complex to understand.

Can anyone advise.

5 Replies

Wise pharmacist! What is the link?


That's a mouse study. if there are clinical trials going on, you may want to wait for some safety data in humans.


I can respond. BIRM has been successfully used with many other drugs in the 1990's for HIV/AIDS. Its use for Cancer started in about 2002. Prostate Cancer was not first on the list--was mostly used for Lung, Kidney, and Colon Cancer. Then later for Breast and Prostate.

It's use is not specifically for fatigue. There are positive side effects for those doing Chemo. Less fatigue, hair loss is markedly reduced, there is no damage to nails, appetite remains steady, and neuropathy is little to none.

These are not any documented large sized studies or any organized studies. These come from a collection of thousands of people who used BIRM, while doing Chemo. Dr. Cevalos, has a collection of testimonials. going back 15 years. You can actually read some dozen + testimonials at Amazon, from those that buy BIRM there. I communicate with the Dr./inventor in Ecuador. His English is like my Spanish---so-so.

Now to the Inter-reactions with Xtandi, they are unknown. There are people on this site using both, we have heard nothing, negative. Your Pharmacist is going to find Jack on your question.

The mechanism that has been found, so far as related to cancer, is BIRM, on the Molecular Chemistry Biological level, seems to prevent cancer cells from releasing an enzyme called Hyaluronidase. We call this the Transporting Agent. It is postulated that cancer cells hitch a ride/take a taxi on this enzyme to go to other parts of the body. So it seems to stop further metastasis from one site to another. There does not seem to be much evidence of BIRM reducing PSA. Some report so. But we have reports about Fatigue reduction. But if you are looking for definitive evidence, I suggest you contact the University of Miami Medical School, and find the Team that has been funded with NIH/Dept. of Defense money, for the study of BIRM and Prostate Cancer. They are the only official USA organization that has been Gov't funded for the study of BIRM, which is USA Patented. They would/may/may not, be able to tell you, about any concerns about BIRM, and other drugs. I know that it does not affect any of the 7-8 drugs I take. And it use to be 9-10, when on a Lupron Implant and Casodex. But that is just me. And have not had to use Xtandi, or Zytiga. So I have no personal info. It is up to you to determine. There are very few people what know a lot about BIRM. I am just reporting some things I know.


1 like

Thank you very much for your responses gentlemen.


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