Abiraterone acetate preferentially enriches for the gut commensal Akkermansia muciniphila
"... systemic ADT and oral AA treatments differentially impact the GI microbiota of PC patients. The findings demonstrate that systemic depletion of androgens via ADT also depletes androgen-utilizing and pro-inflammatory Corynebacterium spp. Alternatively, oral AA distinctively remodels the GI microbiota characterized most notably by promotion of the health-associated and anti-inflammatory gut commensal, A. muciniphila. Functional inferencing suggests that these changes are also associated with a shift towards increased bacterial biosynthesis of certain host vitamins relevant to PC [a coinciding increase in bacterial biosynthesis of vitamin K2 (an inhibitor of androgen dependent and independent tumor growth)].
Through further investigation and modeling of this unique microbiota–xenobiotic interaction in a host-free environment, we identify that A. muciniphila is a major determinant influencing the outcome of AA exposure on human-derived bacterial communities—a clinically relevant finding suggests that A. muciniphila may improve oral AA treatment response in PC patients."
Akkermansia muciniphila is a common "good" human gut bacterium linked to leanness and a resistance to obesity and type 2 diabetes. Ways to increase their population in your belly may include upping your intake of polyphenols and oily fish.
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noahware
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Unusual stuff for sure. We just don't know about gut biome. What is good, when it is good, how much is good. Even "bad" things are good in small amounts (what doesn't kill you makes you stronger, or something like that ).So what I do is eat lots of fruit and veggies and brown rice and let nature do its thing. Out of curiosity, I had a gut biome test. I was supposedly excellent for composition and diversity.
I had never even considered that 1) oral ADT meds might directly change the gut biome, or 2) the composition of the gut biome might directly impact the effectiveness of meds.
Biomesight. No doctor is needed. Probably crude. "Akkermansia muciniphila is a gram-negative anaerobic bacterium belonging to the phylum Verrucomicrobia."
I just downed a capsule with inulin dissolved in a little water.
The interest in akkermansia began last June when TopBanana read a review of the paper you cited & wrote to Brendan Daisley. He was kind enough to reply & this is an extract:
"... Akkermansia in the gut seems to improve a wide range of metabolic diseases and helps improve cancer treatment outcomes. Our study found that acetate (the inactive component of the cancer drug abiraterone acetate) could promote the growth of this beneficial bacteria in the gut microbiota. Though, many other studies suggest high dietary intake of polyphenol rich food is a good strategy to increase Akkermansia as well (blueberries and blackberries especially). There is a lot of interest in using akkermansia as a probiotic and I’m sure several companies are planning to release products including it. At the current time, the only supplier I know of is a US company selling it as a “medical grade” probiotic (pendulumlife.com). I have no connections to the company whatsoever. The formulation contains several other beneficial bacterium as well that were together shown in clinical trials to be beneficial for improving insulin regulation. So it is being marketed towards treating diabetes, but likely can support metabolic health in other disease states."
Pendulum did not have a standalone Akkermansia product at that time. I started a monthly membership when it cost $45 / month & canceled when I figured that I must have an established colony by now. Inulin seems to be the preferred food:
"Inulin is indigestible by the human enzymes ptyalin and amylase, which are adapted to digest starch. As a result, it passes through much of the digestive system intact. Only in the colon do bacteria metabolise inulin, with the release of significant quantities of carbon dioxide, hydrogen, and/or methane. Inulin-containing foods can be rather gassy, in particular for those unaccustomed to inulin, and these foods should be consumed in moderation at first.[citation needed]
Inulin is a soluble fiber, one of three types of dietary fiber including soluble, insoluble, and resistant starch. Soluble fiber dissolves in water to form a gelatinous material. Some soluble fibers may help lower blood cholesterol and glucose levels.[37]
Because normal digestion does not break inulin down into monosaccharides, it does not elevate blood sugar levels and may, therefore, be helpful in the management of diabetes. Inulin also stimulates the growth of bacteria in the gut.[5] Inulin passes through the stomach and duodenum undigested and is highly available to the gut bacterial flora. This makes it similar to resistant starches and other fermentable carbohydrates.[citation needed]
Some traditional diets contain over 20 g per day of inulin or fructo-oligosaccharides. The diet of the prehistoric hunter-forager in the Chihuahuan Desert has been estimated to include 135 g per day of inulin-type fructans.[38] Many foods naturally high in inulin or fructo-oligosaccharides, such as chicory, garlic, and leek, have been seen as "stimulants of good health" for centuries.[39]
Due to its resistance to digestive enzymes, inulin resists absorption during its transit through the upper gastrointestinal tract. After reaching the large intestine, inulin is converted by colonic bacteria to a gel known as a prebiotic, a food ingredient that is highly nourishing to gut microflora. As of 2013, no regulatory authority had permitted health claims in the marketing of prebiotics as a class. Inulin's health effects had been studied in small clinical trials, which showed that it causes gastrointestinal adverse effects such as bloating and flatulence, does not affect triglyceride levels or development of fatty liver, may help prevent traveler’s diarrhea, and may help increase calcium absorption in adolescents"
{Incidentally, Daisley also mentioned the importance of vitamin K2-7. He cites the EPIC-Heidelberg study: pubmed.ncbi.nlm.nih.gov/184...
Cheese lovers who are avoiding dairy now have an excuse for eating certain hard cheeses:
"Vitamin K₂ (menaquinone) concentrations were measured in a wide range of cheeses and the effects of fat content, ripening and origin of the cheeses were investigated. Moreover, the menaquinone content of cheese was compared with that of other foods known to contain vitamin K₂. It was found that cheese and curd are the most important sources of long-chain menaquinones in the Western diet and, in general, hard cheeses are richer in menaquinones than soft cheeses. However, the actual menaquinone content varies substantially and is dependent on the type of cheese, the time of ripening, the fat content and the geographic area where the cheeses are produced. Given the fact that poor vitamin K status has been mentioned as a risk factor for cardiovascular disease and mortality, while there is no clear evidence for adverse cardiovascular effects of dairy fats, cheese should be considered as a recommendable component in a heart-healthy diet."
Thanks! Also, I meant to pose this question in my original post but forgot to: does this paper (or others) suggest that the best way for abi to promote Akkermansia would be to take it WITHOUT food, as prescribed?
I know some men take the full gram w/o food, and some take 250 mg w/ food. Without really reading too deeply, the paper made me wonder if one way is better than the other, strictly as it related to promotion of beneficial bacteria. Thoughts?
Other way to grow Akkermansia might be fiber plus B420 Probiotic pubmed.ncbi.nlm.nih.gov/305... , available on Amazon. Inulin as Patrick suggested should be a good way too.
I stopped probiotics now to decrees folate levels.
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).So what I do is eat lots of fruit and veggies and brown rice and let nature do its thing. Out of curiosity, I had a gut biome test. I was supposedly excellent for composition and diversity.
High Gleason low PSA - quit ADT? 
Anyone with metastatic prostate cancer who has refused Androgen Deprivation Treatment?
