Catabolic Wasting, Cachexia and Sarcopenia - Life Extension Foundation, Section Update: 03/2021

[cujoe]

As most men with PCa are oldER and may be on some form of testosterone-blocking treatment, like ADT, odds are they are also struggling with the muscle-wasting and weight issues that comes with both oldER age and loss of T. This article from LEF is a very comprehensive overview of both Cachexia and Sarcopenia. (The first is related to some disease state and the second a common result of advancing age.)

Life Extension Foundation, Science & Research, Health Protocols A-Z, Catabolic Wasting, Cachexia and Sarcopenia, Contributor(s): Maureen Williams, ND; Shayna Sandhaus, PhD, Last Section Update: 03/2021

lifeextension.com/protocols...?

As I returned to daily gym use after a 2+ year absence due to C O V I D, I have just switched from total plant protein post-workout supplementation to a combo using the more complete Whey Protein Isolate. I also started supplementing with a moderate amount of Creatine Monohydrate - in powder form to add to smoothies and in capsule form for taking pre-workouts. Soon after starting the Creatine, i did note a significant rise in my creatinine at my next blood lab. What got my attention was the big drop-off in my eGFR rate, which has never been below 90 (~%) and indicative of excellent kidney function for an old guy like me. With a bit of sleuthing, I found that the simplified eGFR calculation (without the optional Serum Cystatin C lab) using the formula linked below, so when my historically low serum creatinine was boosted by supplementation, it made my kidney function suddenly look considerably worse. (than it really was!)

Medscape - eGFR using CKD-EPI (2021 update)

reference.medscape.com/calc...

I have continued with the Creatine at something around +/- 4 grams total per day and my subsequent labs have come back with a >90 eGFR results. I mention all this, so that others who start an aggressive Creatine supplementation routine know they might also have a similar apparent drop in kidney function. Here is a case study of just such a kidney function misdiagnosis due to Creatine supplementation and what Examine.com has to say about the issue:

How the use of creatine supplements can elevate serum creatinine in the absence of underlying kidney pathology, BMJ Case Rep. 2014; 2014: bcr2014204754. Published online 2014 Sep 19

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

Examine, Creatine, FAQ, Is creatine safe for your kidneys?

examine.com/supplements/cre...

Anyone boosting protein intake, amino acids, or using any sort of "growth hormone" should do so in consideration of the possible contributory effects to their PCa. One of the reasons I have come to prefer my mostly WFPB-diet is that it has kept protein intake at a moderate-to-low level (compared to a SAD diet) and keeps methionine well down. (Methionine-restriction is a well-documented strategy to slow cancer progression.) So, I'll be closely monitoring for any changes due to my current protein boost for any negative outcomes related to PCa.

We are what we "eat", so, as Mom probably told you many times during your youth, be careful what you put in your mouth.

Keep It S&W,

Ciao - K9 terror

PS All of the personal information is n=1 anecdotal in nature and may not be applicable to anyone else. That's my story and I'm stickin to it.

[MateoBeach]

The Life Extension article on cachexia and sarcopenia etc. is excellent. I have crawled out of my own deep hole of sarcopenia over the last two years employing many of these ideas.

Selumetinib is extremely interesting, lowering inflammatory mediator IL-6 and promoting muscle/strength gains. Will look into that more in depth. Pablo

[cujoe in reply to MateoBeach]

MB - I'm crawling right along with you. The temporary elevated T is definitely a hormonal asset to get me back to pre-COVID even-steven. Ciao - K9

[cigafred]

In addition to its overall addition to my knowledge, this paper provides me with something to convince hospital doctors that my high levels of creatinine can be due to creatine taken after workouts. I only take 3/4 gram, but before I began to self-catheterize for blockage from gross hematuria the ER docs would refuse to release me until many hours later when the creatinine receded. "Creatine and creatinine are not the same thing" I was told, despite my claim of causation.

[KocoPr]

Good post! Got to love LEF.org.

I'm with Mateobeach on selumetinib. going down this rabbit hole lol!

Clinical Pharmacokinetics and Pharmacodynamics of Selumetinib

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

selumetinib

[PCaWarrior]

The person took 32 grams of creatine ethyl ester 5x a week. Creatine monohydrate is the commonly used form. I've used it for 30 years. No issues but I only use 5 grams a day. My eGFR is usually in the 80s and 90s. The high was ">99".

In the figure, CEE is creatine ethyl ester. CRT is creatine monohydrate. CEE causes dramatic increases in serum creatinine. This study used a loading dose of 20 grams a day for one week followed by 6 weeks of 5 grams a day (notice the high bump in creatinine during the first week and the slow decay afterward). Loading creatine is an old bodybuilding practice that isn't used very often today. The study average was about 7 grams a day vs. the 21 grams a day that the case study subject ingested. He was "loading" permanently and the advice to stop his CEE was sound. I'm wondering about his incredibly high diastolic BP. Systolic is normal. Creatine doesn't raise BP per studies. But I don't recall seeing a study of CEE. Or any study of any form using this type of dose.

Note that non-vegetarians get around 2 grams a day from red meat. Vegetarians get almost nothing.

Creatine has been studied for PCa therapeutic action. It is part of the ATP energy cycle. More is likely needed for older adults to help prevent sarcopenia.

The body of evidence tells me that whey protein is a positive for PCa therapy and also to prevent sarcopenia. I eat 100 grams a day minimum to go along with my 5 grams of creatine.

CEE vs CM