More info:
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https://integrativeoncology-essentia...ation-therapy/
For the prevention of chemotherapy-induced peripheral neuropathy(studied with oxaliplatin and paclitaxel)
DOSE: Mix 15 grams of powdered glutamine in a small glass (6-8 ounces) of water or juice. Drink. Repeat every 12 hours (schedule: morning and evening)
Start this regimen on the day of oxaliplatin infusion and continue for seven days thereafter. Repeat with each infusion.
This is based on a study that showed a significant reduction in chemotherapy-induced peripheral neuropathy among patients receiving this regimen versus no glutamine:
After all 6 cycles of chemotherapy, 48% of patients in the glutamine group had no peripheral neuropathy (PN) versus only 27% in the non-glutamine group.
After all 6 cycles of chemotherapy, 12% of the patients in the glutamine group had moderate-to-severe PN versus 32% in the non-glutamine group.
Glutamine supplementation significantly improved cold intolerance and lessened the interference to activities of daily living.
Chemotherapy dose-reductions were less frequently needed in the glutamine patients (7%) versus those not taking glutamine (27%)
There were no differences found in the response to chemotherapy or survival between the two groups.
How Does Glutamine Reduce Mucositis and Esophagitis?
Glutamine has been shown to reduce the degree of mucositis through:
anti-inflammatory mechanisms (inhibition of one of the main switches that turn on inflammation, NF-kappaB)
inhibition of bacterial toxins
increased tissue healing (increased fibroblast and collagen synthesis.)
How Does Glutamine Reduce Chemotherapy-Induced Peripheral Neuropathy?
We don’t know exactly, however it is believed that glutamine may exert its neuroprotective effects by upregulation of nerve growth factor. In animal studies, supplementation with glutamine appears to increase NGF.
Under certain circumstances, cancer cells consume glutamine at a much higher rate than they consume glucose.
Is Glutamine Safe To Give To Patients With Cancer?
This is an area of controversy, as it is well-known that under certain circumstances cancer cells use glutamine for energy even more voraciously than glucose.
However, no human study, have ever shown that glutamine increased tumor growth rates or decreased the efficacy of other cancer therapies.
Over the last 20 years, 36 clinical studies have demonstrated the tolerance, safety and effects of glutamine (oral and IV) in patients undergoing chemotherapy and/or radiation therapy. In each of these studies, researchers have reported that glutamine supplementation in cancer patients improves their metabolism and clinical situation without increasing tumor growth.
Potential Side Effects and Drug Interactions:
Generally, very well-tolerated and is considered safe for use by most people for the duration of cancer care (chemotherapy and/or radiation therapy) in doses up to 40 grams per day (adults.)
Do not use glutamine if you:
Have kidney failure, kidney dysfunction, or if your kidney function is impaired or abnormal.
Have liver failure, liver dysfunction, or if your liver function is impaired or abnormal.
Have ever been diagnosed with or had a period of hepatic encephalopathy (liver function that affects your mental, emotional, or cognitive state).
Have a history of mental illness, especially bipolar depression (manic depression), mania, or hypomania.
Have a history of seizure disorders, such as epilepsy or are taking medications to control a seizure disorder.
Have a history of allergic reaction to monosodium glutamate (MSG), a flavoring agent sometimes used in the preparation of Chinese food in restaurants.
Are taking or have been prescribed to take a medication called lactulose.
Adverse drug-glutamine interactions are not common, but (as with any supplement) always check with your physician before starting glutamine.
Read about side effects and potential drug interactions here: WebMD
Additional References:
Examine.com (glutamine scientific references)
Oral Cancer Foundation (mucositis information)
National Cancer Institute (mucositis information)
American Cancer Society (peripheral neuropathy)
Cancer.Net/ASCO (peripheral neuropathy)
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Acetyl-L-Carnitine Increases The Risk and Severity Of Taxane Induced Neuropathy:
Contrary to promising results from earlier studies (preclinical and smaller human studies), a large randomized trial found that patients who received acetyl-L-carnitine (3,000 mg per day) during their taxane-based chemotherapy for breast cancer actually developed neuropathy more frequently and had more severe neuropathy compared with those who took a placebo.
The bottom line: Don’t take acetyl-L-carnitine to reduce the risk of taxane-induced neuropathy…it doesn’t work.
This is yet another study that makes the same point as I made above, that we need to be cautious in our adoption of new therapies before they have been proven safe.
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Discussion re: supplements for neuropathy:
http://www.earthclinic.com/cures/neuropathy.html
Some prefer R Lipoic Acid over the Alpha Lipoic Acid because of bioavailability, I saw that 1 person recc taking B complex 3 hrs before or after the ALA Says "it causes them to be used up quicker otherwise". Many supplementing with B12 speciifically.
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Spoke with employee at Health Food Store, whoi said Phosphatidyl Serine Complex would cause the alpha lipoic acid to be more effective as would lecithin in preventing/treating neuropathy
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Discussion re: glutamine oat:
https://csn.cancer.org/node/219148
"From a population of 108 oxaliplatin-treated patients referred for neurological assessment in 2002–2008"
Under Good News:
"A total of 86 patients with MCRC treated at Taipei Veterans General Hospital were enrolled."
So that's roughly less than 200 people. That's really not a huge sampling of cancer patients IMO.
I am by no means saying that glutamine can not be helpful. Below is some information that is not just an abstract from a medical study. I hope that some of you find it helpful.
~source of my information
Neuropathy, Arthralgia, and Myalgia
Several small studies support that taking glutamine may reduce the occurrence and severity of neuropathy, arthralgia, and myalgia among people who are taking chemotherapy medications that can cause these side effects. Most of these studies are not randomized, controlled trials, so they only suggest glutamine can help, but do not prove it will work to prevent and manage neuropathy, arthralgia, and myalgia. On a positive note, glutamine has a very good record of safety. As long as a person does not have contraindications to using glutamine (see contraindications below), it is generally well tolerated and safe. When using glutamine to try to prevent and diminish the severity of these side effects, keep the following key points in mind:
The effective dose appears to be 10 grams of glutamine powder, dissolved in water, taken three times per day.
For best results, glutamine should be used both as a preventive treatment before neuropathy, arthralgia, and myalgia have developed, as well as after these symptoms have developed, to minimize the severity of these side effects.
.
Some of these potential interactions are theoretical, which means they may occur, but are not proven to occur. For this reason, be sure to discuss your individual situation with your health care team before you use glutamine during cancer treatment. Glutamine is generally safe for most individuals with cancer, but only you and your doctor, working together, can decide if glutamine is safe for you.
One additional concern with glutamine is the quality of the product. Independent researchers have confirmed that some glutamine products do not contain the ingredients as claimed on the product label or may be contaminated with other ingredients. If you do use glutamine, go with a good quality, pharmaceutical grade product such as Glutasolve by Nestle Nutrition (formerly Novartis Nutrition), Sympt-X by Baxter Healthcare, or Dymatize Pro Line Glutamine.
~end
** many of us do have livers that have been affected.
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From:
https://www.caring.com/articles/peri...he-natural-way
If you are diabetic or have had chemotherapy, you may also want to consider taking alpha lipoic acid. You can find this powerful antioxidant at your local health food store. Studies show that 600 mg per day can be beneficial in reducing the symptoms of PN. (Remember to always monitor your blood sugars if you are diabetic. Sometimes these natural medicines can drop your blood glucose levels.)
CoQ10 can be effective in managing the symptoms of PN. It is also good for heart and brain.
Omega-3 fatty acids found in cold water fish and flaxseed are “food” for the nervous system. When our nerve cells are well nourished, they are more capable of transmitting healthy nerve signals. In addition, Omega-3 fatty acids reduce inflammation in all tissues of the body.
St. John’s wort is an herb which is good for nerve injuries, especially to the fingers and toes. It can reduce burning or shooting pain. It has also been shown to be effective for mild depression. (Do not use if you are taking antidepressant medication.) Big bonus: it is anti-viral.
my note: think I heard St John's Wort
is contraindicated with chemo******
Passionflower is an herb which can be useful for restlessness, agitation, and muscle twitching, and spasms. It helps with nervousness as well. It is not appropriate for pregnant women.
Oat seed has been beneficial for some people with numbness and weakness of their limbs. It is a mineral-rich herb and very safe.
Nettle is a nourishing herb that is rich in minerals. It is particularly good for PN with a “stinging” sensation. Be patient. It takes a couple weeks to work. It is also anti-inflammatory and effective in reducing for hayfever and allergies.
Ginkgo biloba is useful for PN symptoms due to poor circulation. Use caution with medications which increase bleeding like aspirin or ibuprofen. Never take ginkgo with the drug Coumadin (warfarin.)
If you are one of the many people who deal with the symptoms of PN, I hope this information will be helpful. Have a happy and healthy holiday season.
Take care of your (whole) self—
Amy Bader, ND
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Good article discussing the controversy of nutritional supps during chemo and radiation:
http://www.todaysdietitian.com/newar...0510p26.shtml:
In part:
Cancer experts seem to be split into two camps on the antioxidant issue. One side believes taking antioxidants during cancer treatment may interfere with chemotherapy and radiation by reducing their efficacy. Radiation and some chemotherapy agents work by generating free radicals that kill rapidly dividing cancer cells. Since antioxidants scavenge free radicals, the thinking is that they may interfere with these cancer treatments.
The other side of the argument is that oxidation supports the growth of malignant cells, which may conflict with treatment. Thus, antioxidants may counter the harmful effects of oxidation in the malignancy process, boost the effects of the cancer therapy, and protect patients from the therapy’s toxic side effects.
Supportive Evidence
In some circles, there is mounting support for using antioxidants during cancer therapy. Block, who spoke at the Sixth Annual Nutrition and Health Conference in Chicago in May 2009, concedes that there is controversy about whether antioxidants protect normal cells or cancer cells. But he believes antioxidants should be administered with chemotherapy because oxidative stress initiates and promotes cancer cells; cancer patients often have low levels of antioxidants, which increases their susceptibility to side effects; and oxidative stress promotes cytotoxicity and serious side effects.
To provide evidence-based science on this issue, Block conducted two systematic reviews. As discussed in a May 2007 issue of Cancer Treatment Reviews, his research team conducted a systematic review of published studies examining the effects of antioxidant supplements in chemotherapy, with 19 out of 845 studies meeting all evaluation criteria for the review. The researchers concluded there is no evidence supporting the theory that antioxidant supplements interfere with the therapeutic effects of chemotherapy agents. The review found that antioxidants may help increase survival rates, tumor response, and patients’ ability to tolerate treatment. Some of the antioxidants used in the trials included glutathione, vitamin A, vitamin C, vitamin E, ellagic acid, selenium, and beta-carotene.
In the second systematic review examining the impact of antioxidant supplementation on chemotherapeutic toxicity, 33 out of 965 studies met the inclusion criteria. Antioxidants evaluated were glutathione, melatonin, vitamin A, an antioxidant mixture, N-acetylcysteine, vitamin E, selenium, L-carnitine, Coenzyme Q10, and ellagic acid. The majority of the studies (23 out of 33) found evidence of decreased toxicities from the concurrent use of antioxidants with chemotherapy. Nine studies reported no difference in toxicities between the two groups. Only one study on vitamin A reported a significant increase in toxicity in the antioxidant group. Five studies reported that the antioxidant group completed more full doses of chemotherapy or had less dose reduction than control groups. The review findings were published in the International Journal of Cancer in 2008.
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From:
http://yaletownnaturopathic.com/how-...-chemotherapy/
L-Glutamine:
Glutamine is an amino acid that can be used to help support the health of nerves during and after chemotherapy1,2,3. In my experience this is particularly helpful with some of the intense chemotherapy regimens given to patients battling colon cancer. I have also found it to be more helpful when it is used to prevent neuropathy rather than waiting until the neuropathy has developed and then deciding to use it.
There is currently a controversy about the use of glutamine in cancer patients. Cancer cells uptake glutamine and it is metabolized by the cancer for a number of different pathways. Some people look at this information and jump to the conclusion that glutamine feeds the cancer. Yes, glutamine does feed cancer but glutamine also feeds every cell in the body. If the cancer does not get glutamine from the blood stream then it will cause muscles to waste away and get the amino acid from those tissues. The cancer will always find a way to get glutamine whether you supplement with it or not. The simplistic point of view that we should avoid everything that has potential to “feed cancer” is seriously flawed because our immune system desperately needs these same molecules as well. When it comes to the use of glutamine during chemotherapy, the benefits certainly outweigh the risks and this is particularly evident when we consider the health of the nerves.
B-Vitamins:
During chemotherapy the body often becomes rapidly depleted in water soluble B-vitamins11. It is critical to make sure that you are adequately supplied with B-Vitamins prior to and during chemotherapy to adequately support the nerves. The vitamins that are most critical to prevent neuropathy are B1 (Benfotiamine) and B12 (Methylcobalamin)4,5. The dosage of these nutrients makes a big difference and many of the low quality brands have completely insufficient doses. I have no idea why many of the popular low quality brands decided to put the same dose of all B-Vitamins (eg. 50mg of each B-Vitamin). Just because they share the letter “B” in their name does not mean that the metabolic requirement for each one is the same. Each B vitamin has a completely different function in the body so clearly some will be needed in greater quantities than others.
In my practice I regularly give B12 injections to patients who are undergoing any taxol chemotherapy. B12 is not an antioxidant and there are no realistic concerns about giving these shots regularly. Often the absorption of B-vitamins are impaired in cancer patients so oral supplementation is insufficient to achieve the desired doses. I have found that when given weekly these shots can dramatically support the health of the nerves. It is important to point out that you do not have to have a blood test which shows low B12 levels to justify the use of B12 injections. Vitamin B12 is a water soluble vitamin so if your levels are high then the excess will just be excreted in your urine. It is not uncommon for me to give these injections to patients who actually have high levels in their blood and their symptoms improve as a result. A test that demonstrates adequate amounts of B12 floating in your blood in no way indicates how effectively your body is actually utilizing the B12. It seems that many people during chemotherapy have a functional deficiency of B12 during chemotherapy, even if the actual concentration in the blood is normal or high.
Alpha Lipoic Acid (ALA):
This natural support has been shown to be a helpful nerve support with certain chemotherapies5. It is critical to recognize that ALA is not safe with all chemotherapies. You must have professional guidance when implementing any of these neurological supports into a cancer treatment plan. ALA helps to prevent neurological damage by supporting the health of the mitochondria. Every cell in the body has mitochondria which are responsible for generating energy and these delicate structures are often damaged by chemotherapy. The ALA helps to directly protect these components within nerve cells which can help to prevent neurological damage.
I have found ALA to be particularly helpful in cases where patients had diabetic neuropathy prior to starting chemotherapy. Clearly in these cases additional supports are needed because the nerves will be inherently vulnerable to any additional stressors. ALA has been extensively studied in the context of diabetic neuropathy and has consistently demonstrated a positive effect in numerous studies6. This is an example of a natural therapy where the quality of the supplement makes a big difference. It can be administered orally or through an IV. If it is given orally then it must be the pure R form to be effective. If it is a racemic mixture then it will not be effective. When it is administered through an IV it must not be mixed with anything else and the entire line and bag must be completely protected from UV rays. Often the bag and line is wrapped in tin foil to prevent UV degradation of the ALA.
Cryotherapy on hands and feet during chemotherapy:
One of the most basic physiological concepts is how blood flow changes when the body is exposed to extreme temperatures. When our tissues are exposed to cold temperatures the blood vessels in the periphery (arms, hands, legs and feet) constrict dramatically to reduce blood flow to the peripheral regions of the body. The blood is shunted to the internal organs so that your core body temperature is preserved and this allows vital organs to continue to function optimally in cold temperatures. When the body is exposed to very warm temperatures then the opposite happens. The blood vessels in the periphery open up and blood is drawn away from the internal organs to the periphery of the body. This prevents vital organs from overheating and it allows heat to escape on the periphery of the body in the form of sweat.
The concept behind cryotherapy during chemotherapy is that if cold is applied to peripheral tissues then there will be less blood flow to the nerve endings that are vulnerable to the effects of chemotherapy. By this same logic it should also deliver more chemotherapy to the cancer (which is more often located in these internal organs rather than on the hands/toes) by fundamentally changing the flow of blood in the body. This concept makes perfect sense on the physiological level and I would recommend this to anyone who is particularly concerned about neuropathy developing in their hands or feet. There is an abundance of research that supports the use of this therapy on the hands or feet to prevent nail toxicity and peripheral neuropathy7,8,9. In circumstances where patients wish to also preserve taste while reducing the risk of oral mucositis, it can be helpful to chew ice cubes during the infusion10. Of course this should not be done in cases of oral cancers but it is a helpful way to preserve taste by reduce blood flow to the tongue and mouth. This is a simple approach that in my opinion every patient should consider adding to their treatment plan.
Summary:
When used appropriately these neurological supports can be used in a synergistic manner to powerfully support nerve health. The sooner that these supports are used, the better chance of nerve recovery. The therapies that were discussed in detail here are only a fraction of the available therapies. Acupuncture, phosphatidyl-serine, acetyl-L-carnitine and glutathione are also used in specific circumstances to support nerve health. All of these supports must be used properly if you expect to have any positive results. In order to develop an effective nerve support protocol you must have professional guidance from a Naturopathic doctor who has experience supporting patients through chemotherapy.
Dr. Adam McLeod is a Naturopathic Doctor (ND), BSc. (Hon) Molecular biology, Motivational Speaker and International Best Selling Author. He currently practices at his clinic in Vancouver, British Columbia where he focuses on integrative oncology.
http://www.yaletownnaturopathic.com
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Article re: cautioning clearing use of these supps with oncologist:
https://books.google.com/books?id=nW...0chemo&f=false
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Called and spoke with a pharmacist to ask if there is any contraindication in taking Glutamine, Alpha Lipoic Acid, and Phosphatidyl Serine Complex while doing Taxol. She checked her resources which she felt were limited looking at Walgreens data base. Nothing conclusive there--nothing directly contraindicated, cited study saying antioxidants can protect cancer cells but nothing like these supps would increase toxicity, etc.
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Accupuncture helping some people with neuropathy
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Selenium might help--could start few Brazil nuts/day
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