Treatment and Prevention strategies for cognitive function in men being treated for advanced prostate cancer. Mild cognitive impairment (“brain fog” chemo-brain”) is common and widely recognized in those being treated with ADT and androgen signaling drugs, as well as with taxane chemotherapy. I am highlighting 3 possible therapeutic strategies that may help ameliorate or improve treatment-caused cognitive impairment. One is a prescription. The other two are OTC supplements. These are, as always, on top of not instead of, optimal complete nutritional, good sleep hygiene, moderate to no alcohol intake, and exercise, lots of exercise both physical and mental. Be safe and well and treasure every day. Paul/MB
1) Estradiol Patches during ADT and ARSI therapies. Also effectively supports ADT by helping suppress the hypothalamic-piruitary-testicular axis (LHRH inhibition). Also alleviates the adverse side effects of ADT and castrate androgen levels, including hot flashes as well as MCI, depression and fatigue.
Typically 0.025 - 0.10 mg per day biweekly patches hile on ADT. Much higher doses can achieve castrate testosterone levels as a monotherapy per the PATCH trial. Did not increase adverse cardiovascular events as oral estrogens can (DES). Use the PATCH Trial results to convince your doctor(s).
2) Theracurmin. Theracurmin is a proprietary form of Curcumin that is micro-sized particles to provide much better bioavailability. There are several brands that license this from the Japanese company that makes it for non prescription supplements. Its effects on MCI are demonstrated in a RCT below. Another specialized (lipidated) form of bioavailable curcumin, called Longvida, has also demonstrated beneficial effects in MCI. Not sure which may be better of the two.
3) Magnesium-l-Threonate (MagT). This is a formulation of Magnesium supplementation that can cross the blood-brain-barrier and increase magnesium levels in the brain much better than other forms of magnesium supplementation. Soft evidence, mostly animal, is suggesting that it can improve memory and cognitive function. It also reduces neuro-inflammation such as that modulated by TNF-a, and protects against oxidative stress. It also appears to reduce chronic pain, reduce anxiety and improve sleep. There is one RCT in older humans with a Mag-T supplement linked last below. While the jury may still be out about the benefits in humans, it may be worth considering on a personal trial basis as I am doing now.
Neurocognitive impairment associated with traditional and novel androgen receptor signaling inhibitors ± androgen deprivation therapy: a pharmacovigilance study
nature.com/articles/s41391-...
pubmed.ncbi.nlm.nih.gov/374...
Estrogen/ Estradiol Supports and Protects Brain and Spinal Function
journals.physiology.org/doi...
Memory and Brain Amyloid and Tau Effects of a Bioavailable Form of Curcumin in Non-Demented Adults: A Double-Blind, Placebo-Controlled 18-Month Trial
pubmed.ncbi.nlm.nih.gov/292...
Evidence of Benefits to Mood and Working Memory from Lipidated Curcumin in Healthy Older People
pubmed.ncbi.nlm.nih.gov/325...
Enhancement of Learning and Memory by Elevating Brain Magnesium
sciencedirect.com/science/a...
Magnesium L-threonate prevents and restores memory deficits associated with neuropathic pain by inhibition of TNF-α
pubmed.ncbi.nlm.nih.gov/240...
Efficacy and Safety of MMFS-01, a Synapse Density Enhancer, for Treating Cognitive Impairment in Older Adults: A Randomized, Double-Blind, Placebo-Controlled Trial