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Am I messing up my hormonal status with supplementation ??

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 Posted 7/25/2012 10:38:40 AM
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Thank you for the reply DDye. My new value will probably comes to a surprise to him and I will see what he will say. In general, while being an extremely experienced practitioner I found him a bit skeptic over the PSA obsession and several aggressive approaches mainly in the US. I have had regular DREs with the last one about a month ago without any particular concern: prostate small and soft. Main concern was then with the high post void and I am doubling the tamsulosin dosage before re-checking in few weeks.

Can you recommend the best urology specialized forum and site? Maybe you can also check with one of the urology specialist in the LEF medical board.


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 Posted 7/27/2012 5:42:45 PM
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To Albedo:

www.prostate-cancer.org has some good links and resources.

Stephen B. Strum, MD is a urologist who wrote Life Extension's prostate cancer information http://www.lef.org/protocols/cancer/prostate_cancer_01.htm and this book: http://www.lef.org/Vitamins-Supplements/Item33670/A-Primer-on-Prostate-Cancer.html


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 Posted 7/28/2012 2:01:18 AM
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DDye, thank you for the links. I am just ending reading Dr Strum's article in the LEF's Disease Prevention book. It is quite detailed and I like the "military" as well the scientific and compassionate approach. As I travel to US quite regularly, I might be consulting, if i recollect well he is doing it in the Seattle (WA) area, right? But first I will be checking here what they will be saying.
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 Posted 7/28/2012 5:27:30 AM
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Thank you for the reply Beefster and sharing your experience.

However, I tend not to agree and I think I will take a long time before playing with substances supposed to alter my hormonal balance at least until I see clear what is happening:

  • an aggravation of BPH? I have also a high urea/creatinine ratio in the urine, pointing to potential obstruction (hence urea reabsorb)
  • an infection due to urine retention? It will also rise PSA.
  • a possible mistake in the measurement?
  • and of course PC …?
Of course I am not doing a causative link but I am very suspicious that, barring the above, my supplementation is showing something. To be positive (!) an early diagnostic as every one of us has cancer cells which the body keeps normally at bay.

A big concern is IFG-1 going off range! Dr Strum cites refs where higher IGF-1 are associated to 4x risks of developing PC. To your point, “Gene expression of IGF-1 and its receptor are inhibited by 5-alpha- reductase inhibitor such as Proscar” hence my considering it and I feel you are right using it even at low doses as recommend by your doctor. I recollect studies of synergistic effects with tamsulosin for BPH treatment but also understand the side effects.


I am 56 with a genetic higher risk (23andme) to PC hence … caution !
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 Posted 7/30/2012 4:17:23 AM
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Albedo, Dr Strum is in Ashland, Oregon.

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 Posted 7/30/2012 6:51:02 AM
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Thank you DDye!
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 Posted 9/17/2012 5:03:41 AM
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PSA (2.3) back to *normal* values, i.e. previous to the spike (likely caused, as told by one of my urologists, by a flare of inflammation). DHT and IGF-1 lowered and hrCRP dramatically lowered likely due to my aggressive anti-inflammatory diet. DHEA stopped and slightly lowered protein intake. Happy I did not go immediately to the biopsy.

Unfortunately post void (PVR) is very high to abut 500mL despite 0.8 mg/d of the alpha-blocker tamsulosin but good on flow. I am scared to death to be heading to a TURP for side effects but on the other side very concerned PVR is damaging my bladder due to BPH. Should an 5-alpha reductase be tried with tamsulosin prior to try the surgery? Experience please !! I keep supplementing with saw palmetto, betasitosterol, stinging nettle, pigeum, lycopene, etc ...


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 Posted 9/17/2012 8:56:41 PM
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Albedo,
Before you settle on TURP, ask your doctor if you're a candidate for TUBD. That is If there is no malignancy, and it's just urine flow obstruction. The latter will allow you to regain urine flow normalcy while saving the gland. There is always hope that other things you and your doctor are trying may cure the hyperplasia, and with an intact gland, hopefully be cured.

-Tom


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 Posted 9/23/2012 2:24:15 AM
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Tom

Thank you for pointing me to TUBD. I will surely ask my urologist as I am due to retest my post void in a couple of months. From the small research I did the procedure seems to be valuable in younger patients to avoid or delay TURP, but is unlikely to achieve longer term effectiveness and seems not widely accepted.

Taking apart the open prostatectomy (incision in the abdomen, normally for large prostates) and focusing on the trans urethral procedures, TURP seems the gold standard (also allows sampling for pathology).

Next to TURP and TUBD and to complete the 4-letters acronyms therapies you have:

TUNA (Transuretral Needle Ablation) - using small needles in the prostate via cystoscopy delivering radio frequency which makes tissue necrosis.

TUMT (Transuretral Microwave Thermotherapy) - delivering heat and also generating tissue necrosis.

TUIP (Transurethral Incision of Prostate) - making smaller cuts in the bladder neck thus reducing the gland pressure on the urethra.

Then you have laser based procedures such as the  Nd:YAG laser vaporization and more recenty the greenlight photosensitive vaporization. It seems greenlaser has similar success as TURP with less hospital stay and bleeding (but cannot take samples for analysis).

Also, as I learned in this forum, you have the Gat-Goren process for BPH, not yet available in my my Country.

Therefore there are many options available and I will surely go for a second option before deciding (if I ever get there) as technology advances very rapidly.

I also would like to probe on using pharmaceuticals to reduce the size of the prostate such as finasteride (with or without tamsulosin) which looks to me also good before TURP or others.

Finally, from my research, I did not find, so far, how to link my high post void residual either on a prostate induced conditions (as obstruction due to BPH) or a possible bladder dysfuntion. Nobody could advise on this yet which bothers me....


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 Posted 9/23/2012 4:24:20 AM
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from THIS LINK it talks about other causes:

...High PVRs can be caused by bladder outlet obstruction (BBO), bladder hypocontractility or acontractility or, in rare cases, a large bladder diverticulum. BOO can stem from prostatic enlargement, poor sphincter relaxation (dyssynergia), urethral or meatal blockage, or less common causes, such as a bladder stone. Poor bladder contractility can result from neurogenic, myogenic, psychogenic, or pharmacologic causes."

For some men finasteride has its own set of side effects, mood disorders (depression, aggression), and erectile dysfunction.

do you think there may be some interactions going on with all the supplements you're taking?


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