My Uro and my general doctors refused to prescribe metformin for me since I am not a diabetic. I was thinking of trying it as a last resort to see if it can stable the psa progression. Has anyone faced the same situation or know how and where I can get a prescription to try it for 3 months.
Thank you
I think interest in metformin has waned since two randomized controlled trials showed no effect:
ascopubs.org/doi/10.1200/JC...
urotoday.com/conference-hig...
Here's a non-journal article you may have seen already discussing the methods of study that could be employed to research metformin's ability - if any - to help people with cancer.
cancerworld.net/cutting-edg...
Why rely on outdated, non-journal info when there are two RCTs since then?
It's not a study and I didn't read it as such. I thought it was an interesting report on issues regarding the research into metformin and cancer, and since it's a non-journal article it's a little easier to read and understand. I didn't see anything in there to rely on and that's not why I thought it has some value - just the posing of a lot of questions that need examination, published by lay people with some background and knowledge in the field, and that's why I posted it. It was published later in the same year as the first study you linked. Not looking for your agreement or approval, it was just an FYI for you or anybody else who may be interested.
They didn't seem to know about those studies.
TA, are u convinced metformin will not help us?
I have not seen any benefit in the highest quality studies so far. They had relatively small sample sizes, but if there is any benefit, it is probably very small, or in yet-to-be-defined subpopulations.
There's also this:
"potential detection bias due to fewer biopsies among men receiving antidiabetic medications, which may explain the lower prostate cancer risk in men with diabetes."
jamanetwork.com/journals/ja...
I think this adequately shows why observational studies found an association between metformin use and lower risk of PC.
I am in the UK and have the same issue. I might need to get via Care Oncology protocol which costs money
Berberine does what metformin does...so I take berberine which is over the counter.
Thank you. Can you please send me a link to where you buy it? Thanks again. I am very desperate to do something
Hey Ahk1!
Amazon has a large selection of berberine.
Currumpaw
What do you think of the articles cited by Tall_Allen?
Hey dadzone43!
In the first study Metformin is paired with ADT.
In the second study Metformin is paired with Docetaxel chemo.
Metformin's ability to lower one's chances of prostate cancer was first noticed when diabetics had a lower incidence of prostate cancer despite usually poor BMI's and lifestyles. Sort of the same observations that have found that drugs are effective for other diseases than that which they were initially formulated for. Low dose Naltrexone is another as is the common aspirin which is useful in preventing metastases. Statins too.
I remember reading a study years ago that was sort of ground breaking. Rats that had a diet that supplied all necessary nutrients yet had a caloric deficit out lived rats and had less disease than rats that were given a diet sufficient in nutrients but with a caloric surplus. That was before someone's curiosity about the low prostate cancer or just cancer incidence of diabetics on Metformin led to compiling some stats from years of data.
LifeExtension which has donated over 140 million $$ to research over the years formulated a supplement, AMPK, to mimic this caloric deprivation or more accurately maybe, the positive effects of caloric deprivation. LE always cite study after study on their site that supports their supplement. I'm certain that LE helped fund some of these studies.
Daily intermittent fasting is another method that mimics caloric deprivation to reap the benefits of it.
If someone has reached the point where ADT or chemo is necessary because of their disease, how relevant will the results of that type of study be to those whose disease hasn't reached that point?
For someone that is trying to prevent recurrence why not?
The problem with studies is that there are too many factors. Genetics, stage of disease, overall health, age, time since diagnosis, diet, supplements, exposure to carcinogens--there are numerous factors and some multiply each other!
Dr. Charles, "Snuffy" Meyers and Dr. Lawrence Klotz both advise that Metformin is beneficial in preventing recurrence.
Sorry--I'm short on time. Use your search bar to solidify your own belief and opinions.
Currumpaw.
Thank you very much Currumpaw for your explanation. I can’t get metformin. I haven’t used adt yet. Failed RP and SRT. my psa is rising at .74 now. Can I use Berberine to achieve any good results to slow down the psa rising untill time for adt arrives?
Thanks again
Hey Ahk1!
Many take berberine with a meal as others do Metformin.
If you are on a statin that is also beneficial if it is a fat soluble such as Atorvastatin.
Watch the video where Dr. Klotz speaks at a urologist's conference. You might find a "hot" item of info that will interest you.
Currumpaw
thx. apples and bananas
Hey dadzone43!
I do believe that Dr. Meyers and Klotz have looked data over very carefully and in detail. I don't think I can do better. I would think that if Metformin hasn't been effective for their patients that they would advise differently.
Rather than apples and bananas, they must have found that among their patients, adding Metformin to the mix translated into better, longer outcomes? They are in the top tier of their profession.
Currumpaw
Well it is survival we all seek.
Does it have any effect on lowering the psa before you start adt for someone who is not diabetic? Thanks
Hey Ahk1!,
Stability would be nice wouldn't it? Berberine acts much the same as Metformin and many use it as a substitute.
I doubt this would work for everyone but Ruth Heidrich never had radiation or chemo despite metastases to ribs. She had breast cancer and surgery. That was it. Just surgery. She became a vegan and is a runner. Her metastases disappeared within a year.
Currumpaw
Have you done ADT and chemo ?
No, I haven’t taken anything yet
That's a real problem.
I got lucky and found a concierge doc in Chicago who costs about $2500 a year.
But smart, hooked up to a major teaching hospital, can get him on the phone usually in less than 24 hours, same day response to emails, available during off hours, and has many intellectual attributes similar to Dr. Snuffy Myers.
He is helping with my low CD4 T-Cell levels.
He isn't an Oncologist, but he is still a good standing for Dr. Myers.
Without him I likely would not have been able to continue my metformin prescription after Myers retirement.
I will soon be moving from Chicago, but this guy is a keeper. I will probably continue to visit him once a year, just like I did with Myers.
If anyone is interested in him as an internist replacement for Dr. Myers, leave me a private message.
They are still running trials in the UK with Metformin.
Ahk1, metformin is also prescribed for "Metabolic Syndrome," which is considered having 3 or more of the following associated traits:
1. Large Waist — A waistline that measures at least 35 inches (89 centimeters) for women and 40 inches (102 centimeters) for men;
2. High triglyceride level — 150 milligrams per deciliter (mg/dL), or 1.7 millimoles per liter (mmol/L), or higher of this type of fat found in blood;
3. Reduced "good" or HDL cholesterol — Less than 40 mg/dL (1.04 mmol/L) in men or less than 50 mg/dL (1.3 mmol/L) in women of high-density lipoprotein (HDL) cholesterol;
4. Increased blood pressure — 130/85 millimeters of mercury (mm Hg) or higher;
5. Elevated fasting blood sugar — 100 mg/dL (5.6 mmol/L) or higher.
Many of us on Lupron for a decade or more find ourselves qualifying.
I had to find a sympathetic doctor who would give me a prescription - I brought supporting references. And after three years my family doctor finally caved and gave me a prescription. Berberine functions in the matter very similar to metformin and is what I used in lieu of metformin until I got a prescription. Cheers, Phil
Which brand of Berberine you take please?
I used AOR (Advanced Orthomolecular Research) based in Canada. Might be available in the USA as well. Where do you live? Cheers, Phil
Long Island. Ny
You can get it from India without a prescription.
IndiaMart you can get anything and it is cheap. Example Metformin XR 500 MG under brand Cetapin XR. Faster to find a Dr who will prescribe off label. Not easy to find a Dr. If you justify it with the fact that you need to control blood sugar on ADT, you might convince one to prescribe it.
There’s plenty of info available online showing that it may be effective as an adjuvant treatment along with ADT. Perhaps if you bring some info to your MO they’ll have a change of heart.
I’ve been taking it for over 5 years now, part of the Snuffy Myers protocol, I now see Dr. Sartor along with an excellent local MO and neither has a problem with it. It’s cheap (Publix provides it free), safe and has been around for a long time.
ncbi.nlm.nih.gov/pubmed/284...
Ed
Do you have a link to Dr. Snuffy Myers protocol? He still alive although having Gleason 9 PCa. Thank you!
My PCa M.O. wouldn’t either. I’m borderline Type 2 DM so I got my family physician to prescribe it.
See Qalytude.com A doctor licensed in your state will ask you a few questions and prescribe if you are a candidate. Many use this site for life extension purposes.
Just do a quick search online with the string 'metformin online' and you will find places that will sell it to you online either with no prescription or an online consultancy.
It costs more but it is not outrageous.
According to some authors on the subject, taking metformin alone is unlikely to be helpful for very long because it addresses only one aspect of prostate cancer metabolism. To prevent cancer cells from adapting, multiple drugs that shut down all fuel sources are required.
"In diabetes, metformin (MET) decreases glucose & insulin by inhibiting hepatic gluconeogenesis. There is preclinical evidence for additional antineoplastic activity due to mTOR inhibition secondary to AMPK activation. "
Well, I cheated: I am a physician and prescribed for myself as an "off label" use. Reconsidering now that I look at the articles cited by Tall_Allen, however. May not be doing anything for me.
Hey dadzone43!
Before you trash your Metformin please read this which was published in 2015.
ncbi.nlm.nih.gov/pmc/articl...
An excerpt taken just below figure #3:
Another option is validating old drugs that inhibit cancer stem cells efficiently (Figure 4), such as metformin, which is used for diabetes. Cancer risk is reduced in patients with diabetes who receive metformin [45-49]. Metformin inhibits cancer stem cell sphere-forming in vitro and xenografts in vivo, and sensitizes many cancers, such as breast [50-53], pancreatic [54,55], and colon cancer [56], and esophageal carcinoma [57] and glioma [58] to radiotherapy and chemotherapy.
Currumpaw
Can Berberine do the same thing ?
Be careful using metformin. I took it without a doctor's consultation. After a few months, my blood test showed my B12 dropped like a rock. Googling it, I found that metformin can do that. I presume a good doctor would have warned me of that. verywellhealth.com/metformi...
That's good to know. I take an stomach acid reducer (omeprazole) and was told that I should supplement with B12, which I do. I didn't know that metformin could cause a deficiency too.
Hey LeeLiam!
Do you supplement B12 sublingually? I do and my B12 level is well within range. As we get older---do I need to finish?
A friend is the manager of the local Vitamin Shoppe. He pulled me aside one day to tell me that a customer had been taking prescription meds for heart burn for years without the expected results. The customer told him that he had found an interesting solution. His customer bought sauerkraut, the live stuff with the organisms in it from the refrigerated section of Whole Foods. He ate a forkful in the morning and another at night. In one month he no longer needed the prescription meds that often failed to control his heartburn. I have mentioned this to someone else that was having constant heartburn, Again the sauerkraut worked. Who knows?
Currumpaw
My PCP wanted me to get weekly shots but I told her I'd like to try sublingual for a few weeks. I have been doing that and they will do a blood draw tomorrow to see if it is sufficient. Based on other posts here, I'd like my B12 in the low normal range, not high normal.
Why not high normal. Mine is off the chart high
Recent discussions here on HU seem to say low levels of B12 were protective against more aggressive PC.
Hey LeeLiam!
I have taken either Twin Lab's most potent B12 or Now brand. I am a vegan.
I make blended drink with seeds, nuts Maximum Vibrance and some Solgar's Brewers Yeast which has all the amino acids. I often add some Sun Warrior which is a high quality organic protein powder. The last of many ingredients may be an entire 10 ounce package of frozen, organic blueberries. I get a good dose of some B's from the drink.
I have been slacking lately and it is time to resume my routine.
Steve Reeves, the bodybuilder and Sugar Ray Robinson, the boxer both had B12 shots during their careers to combat fatigue.
Currumpaw
It might be good for you to be a little more assertive in talking with your doctors. If two or three doctors would not prescribe Metformin for you, that does NOT mean you CAN'T get it. It just means those few doctors won't prescribe it. It may be their medical opinion that it is not a good idea, but it may be just that their medical group discourages them from prescribing "off label" uses of medications, or some other "political" reason. I got out of my Medicare HMO and went on traditional Medicare for many reasons, a minor one of the reasons was that my MO and PCP wouldn't prescribe Metformin. I went to a highly recommended family medicine doctor in another medical group who didn't hesitate for a minute to prescribe it when I explained that I knew it wasn't proven to be effective, but it was one of many "adjuvent care" steps that I take that might help, and it is well documented that it very rarely causes any problem.
Thanks for the explanation Survivor1,
Can I just take Berberine instead if they do the same thing and forget about metformin?
Ahk1, as others have said, there is not sufficient evidence to know for sure that either Metformin or berberine makes a significant difference, but many think that they help. I take both and several other supplements. Many doctors scoff at any supplements, but others think there are many supplements that can be helpful as PART of a program to try to prevent or slow prostate cancer, along with getting plenty of exercise, eating a healthy diet, reducing systemic inflammation, and generally minimizing stress in your life. I'm not confident that you will find that Metformin does much good if that's the only action you take. Many on this board also take some or all of the following supplements: turmeric (which usually contains berberin), boswelia, Omega 3, CoQ10, mushrooms (Maitake, Reishi, and Shitake), vitamin D3, quercetin, bromelian, ginger, and others. Do not just order supplements on Amazon or any other shopping site or health food store without researching the brand. Many, if not most, come from China and are contaminated. Two companies you can buy from on line that I believe are reliable and have their supplements tested by third-party labs are Pure Encapsulations and Vital Nutrients. What is your PSA currently? There is NOTHING that you can "just take" that will do the job. If your PSA is increasing to a worrisome level, you have a new part-time "job" to read about prostate cancer, find a good prostate cancer support group to join, and take these multiple actions to fight it. There is no simple answer. Good Luck and long healthy life.
Hey ImaSurvivor1!
Only 3% of turmeric is curcumin which is the active part of the root. A company has found that the root is at it's effective point when harvested late. Back adding some of the tumerone oils removed in the extraction process and some ginger, a closely related plant that works synergistically with curcumin enhances the supplement.
The Japanese have for many years been prescribing PSK, Polysaccharide K, for patients receiving chemo. PSK is Turkey Tail mushroom. Chemo not only kills cancer cells but suppresses and weakens the immune system which has to try to deal with these guys while in a weakened state--
Researchers discovered how small particles from cancer cells called extracellular vesicles cross the blood-brain barrier to make the brain more hospitable to metastatic tumors. A detailed understanding of this process could guide strategies to stop brain metastases as well as methods to deliver drugs to the brain.
How cancer vesicles breach the blood-brain barrier ...
nih.gov/news-events/nih-res...
An interesting link about PSK:
ww5.komen.org/BreastCancer/PolysaccharideKPSK.html
I take Host Defense Turkey Tail as well as their MY Community for the synergy that 17 other mushrooms add to the Turkey Tail.
Currumpaw
Thanks for the tips! I'll check into those things. Like I said to Ahk1, dealing with the recurrent prostate cancer that about 30% to 40% of prostate cancer patients get is a regular part-time job.
Yep! Like me, you have a new part-time job. From what I've read, it's important to do all you can to stop the increase in PSA soon, as once it gets above 1.0, the likelihood of metastasis is much higher.
That is the reason I am trying to find something with supplements to take before it gets to 1. Very frustrating. I don’t know what to do
I also asked my primary care doctor for a metformin prescription and was denied. I tried berberine but it seemed to cause a nasty problem with gas. Maybe I should try again.
I have no choice now but to use Berberine. I just ordered it from amazon a few minutes ago
How much did you take and when ?
Easy, just become a diabetic...
Good Luck, Good Health and Good Humor.
j-o-h-n Tuesday 11/19/2019 7:53 PM EST
Well, you've received plenty of suggestions on this thread....
I can buy metformin in Thailand OTC.
Yes and I buy it in Bombay. OTC.
Dirt cheap.
I take it for my blood sugar levels, not for MPC.
Meformin isn't totally without negative side effects. Obviously if you are a diabetic, the pluses vastly outnumber the negatives.
I take metformin off and on, I get if from a TRT clinic (Defy Medical) and they will phone a prescription in which my medical drug prescription plan will cover.
I had one A1C test where I measured 5.8% which is pre-diabetic, which I used as a predicate to get a prescription, but with the clinic I didn't really need to do this. Some believe metformin is an anti-aging drug which is one reason they will prescribe it.
I can lower my Blood glucose by lowering carb intake by a small amount, so for BG I don't strictly need to use metformin.
My local doctor was all set to prescribe meformin for me until I went off it for a month and my fasting BG was still below 100 and I ordered an oral glucose tolerance test OGTT where my 1 hour BG was 146, but my 3 hour BG was 40, dangerously low. All I can say, interesting.
All that said, the following maybe negatives for some people.
---------------------------------------------------------------
The investigators randomized 109 healthy volunteers at UAB and UK with an average age of 69. Roughly half took 1700 mg of metformin per day, while the other half took placebo pills identical in appearance. Following baseline testing, both groups completed 14 weeks of resistance training. Before and after the exercise period, both groups underwent thigh CT scans, DXA measurement, strength testing and a thigh muscle biopsy.
"DXA and CT scans showed that the placebo group had greater gains in overall lean muscle mass and thigh muscle mass," said Peterson. "CT scans and analysis of the biopsy also allowed us to determine that the quality of the muscle improved in the control group over the metformin group."
The research team originally hypothesized that metformin would improve exercise response by targeting macrophages, immune cells present in muscle.
news-medical.net/news/20191...
Metformin inhibits mitochondrial adaptations to aerobic exercise training in older adults
Metformin
Metformin
