For those of you on this protocol has anyone described the size of the meal necessary to make this work effectively?
I recently switched from four pills to one because of high liver enzymes. I used to take the 4 pills around 1 AM when I got up to pee. Having a little trouble remembering to take a single pill with dinner. Sometimes (often) when I forget I will have an oil free muffin and a piece of fruit around 9 or 10 PM with the pill. Is this enough to make it effective?
The side effects of abiraterone are because of the absorbed dose. Taking less with a low fat meal gives you the same absorbed dose as the full dose without food.
Sometimes, just cutting back for a while seems to let the liver get used to it.
I switched from four pills with meals to six while fasting at least an hour before and after, only drinking kombucha while taking the six. My psa was rising slowly from belox zero to over two.by increasing my dosage two six with fasting . Just got my latest psa today it’s going down in a matter of three months to my latest psa of 1.
And I always ask about my liver enzymes and they’re fine. And I don’t always take the prescribed prednisone. Enjoy my evening scotch, one ot two. Going to be 73 in July. Was diagnosed 6 years ago. Terminal stage 4 Mets to the bone and lymp nodes.
Scout....Here is a real answer from a real person who is taking Abiraterone 250 mg with moderate fat meal . I have been doing this intermittently for 10 months.. based on PSA level..Start at PSA 10 or higher...Stop when PSA falls under 4. This was working for 8 months. Then, PSA was not falling below 4 , therefore ..For last 2 months ,I have taken Abiraterone 250 mg with moderate fat meal every day.. And here are my recent (10 days ago) Testosterone levels: Total T= 4, Free T = 0.3. Side effects: tired ness in mornings, better as day goes by and with exercise. Occasional nighttime mild "hot and cold" feeling. Liver enzymes: normal. I do not take any prednisone. To reiterate, I have not taken any Lupron like medicine for last 2 1/2 years.
PSA scheduled for tomorrow. Bone scan last week came with only 2 black spots, one on lower pelvic bone and a tiny one on T9 vertibra. Will be getting Ga68 PSMA PET CT next month.
Zytiga without Lupron? Was it easy to talk your doc into that?
dhccpa, it was a tough sell for me. But I insisted and used my personal resources to put social pressure on her.. requested vehemently and begged.. promised to do Bio marker tests every 2 weeks.My MO caved and just said.."if you want to be your own Guinea pig..that's fine. .but make sure you monitor everything closely" I checked PSA, PAP, ALP, Ca, Albumin, Hb ,Platelets ,NLR,PLR, MLR every 2 weeks besides checking total and free T every 2 weeks. Made charts and took to her . She ordered her own full Testo panel every month for 3 months. T came below 5 and free t 0.3-0.4. Finally got convinced and pleased ..said "proof is in the pudding" No more hurdles from treatment team.
That is certainly proof of the pudding. Zytiga without Lupron making you castrate T levels and verifies that the dosing at 250 is adequate. Good job LearnAll. Do you have any thoughts on the high LH levels likely? Have you checked them (LH and FSH)?
MateoBeach, its true ..my T remains below 5 with 250mg Abi with moderate fatty meal . No prednisone.
No prednisone even that is interesting and surprising.
I have not. May be I should check LH and FSH.
Learn All
I find your approach interesting... no surgery or radiation and you are willing to let PSA climb to 10. Why do you use 4 as a # to stop Abi.? Any thoughts on supplemental T ?
Scout,There are many research papers about intermittent ADT which have used PSA 10 as upper set point and PSA 4 as lower set point. I am imitating those papers.I do not have much knowledge of bipolar androgen therapy...so I fear adding supplemental T.
Are side effects on Abi. different than Lupron? I have been lead to believe side effects are from lack of Testosterone not the drugs themselves.
In first 9 months after diagnosis, I had Lupron+abiraterone and I did have severe fatigue, hot and cold waves of sensations and felt lethargic and sluggish. \With Abiraterone monotherapy, side effects are the same type but only 20 % in intensity. The best med was Bicalutamide.. which I could use for about a year and then, it did not work. So a year go, had to resort to Abiraterone monotherapy.
I'm about three and a half years in on Zytiga, for three of those years I have taken 500mg in the morning with breakfast, which consists of a fried egg on toast, plus a yoghurt. On the weekends we push the boat out and have bacon too.
The P.S.A. Has steadily fallen, the last test being 0.054. For me absorption is the key and trying to lessen the long term effects of continued medication.
I can't see how any calculation could be made for the maximum result, as I've said before, one size doesn't fit all.
I'm pleased for you that you are able to reduce your dose after the bad effects on the liver, I wish you all the best.
Phil
Thanks Phil
Are you experiencing the tiredness in the morning that Learn All mentioned?
I had been taking 1000 mg at night to eliminate the tiredness issue. Thinking it might make sense to have a midnight or bedtime snack of 300 kal. along with 250mg.
Hi, I don’t feel tiredness in the morning, after breakfast we walk our dog for about an hour, then I seize the day. Normally I ease off the pedal about 4.00 p.m. but I generally don’t doze at any point during the evening, only if I’ve overdone it a bit.
I also take prednisone and have 3 monthly jabs instead of 6 monthly, I found that helps as there is not the shock to the system.
I hope that you get a good result.
Phil
then I seize the day
Yes! that is the gift of cancer, I am packing more into a week than I previously did in a month.
Good for you, I don’t personally see it as a gift, I could do more without it.
Staying positive is a very important factor.
Your body and your mind belongs to you, this is like having a tick on a dogs back, he doesn’t want it, it just appeared. Now he needs someone to remove it, if not, it may eventually kill him.
I don’t change my diet, I don’t change my habits or my pleasures.
I really wish you the best.
Phil
I suspect no one really knows. Just be sure to monitor blood results frequently.
I haven't added Zytiga to Lupron yet, but if I do, my MO has agreed that I can the one pill with a meal method.
My father switched to 250mg dose with low fat breakfast due to non adherence with 1000mg dose. From what I know the absorption remains roughly the same so I don't know how a low dose will help with any side effects. The low dose was effective though and as my father started complying with it his T fell below 10 ng/dL for the first time.
Hello Scout , a few things , Im on the 1- 250mg abi, and 5mg prednisone on a light low fat breakfast protocol , per Dr. Szmulewitz . Normally I eat a bowl of steel cut oats , or cereal , with a handful of blueberrys , a few blackberries , rasberries , with broccoli sprouts bought from Whole Foods , and add some almond milk . Or a few times I opted for left over veggie pizza , hardly no cheeze . And a few times I has a handful of spaghetti with sauce . My favorite is a Panera breakfast sandwich which is egg white , spinach , tomato , avocado on a grain bun . I do that on Sunday on the way back from the flea market . But usually its the steel cut oatmeal . This morning I will finish a left over 99% fat free turkey breast burger . I dont know if these are all low fat but pretty close . My labs are all good . PSA is at .02 , ( zytiga ) testerone at <7 , ( Eligard) . Also I asked Dr. SZ about BAT . He was sort of elusive on his answer . There is a study about using BAT protocol while being hormone sensitive . I will see him July 1st and ask again .
There is a study about using BAT protocol while being hormone sensitive . I will see him July 1st and ask again .
Look forward to hearing his response in July
I am starting radiation at U. of C. in a few weeks. 20 sessions IMRT with Dr. Liauw
Do any of your guys have a paper to share with my oncologist for solo aberiterone? After starting to be castration resistance, I’m curious about if there is a way to make the cancer sensitive again, if possible.
Zytiga & Low Fat Breakfast
Can Abiraterone/Zytiga cause low blood sugar?
Half Dose Abiraterone 
Workable strategies for obtaining low-cost ZYTIGA (abiraterone) from outside the US. 
