111 replies to this topic

[albedo]

Even is this thread seems of no interest considering the lack of replies ...

PSA (2.3) back to *normal* values, i.e. previous to the spike. 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 ...

[albedo]

I just went through the (bipolar) TURP process and started recovery. Read almost everything I could before deciding and hope it has been worth. So far so good.

[Lufega]

Keep it updated. This information will be extremely valuable to someone else in your position some day.

[albedo]

OK let me give a small update:

STATUS

• TURP (bipolar) done 20 days ago
• Main reason: huge post void residual (PVR) which increased over 6 years from 200ml to 800-900ml and no effect of large doses of tamsulosin (2x0.4mg). Prior to TURP I had a cystoscopy and pressure-flow study (both strongly recommended prior to decide)
• Surgery went very well, prostate was small (norm is around 30g), surgeon very well experimented and cautious (2000+ interventions)
• So far one complication: had to be re catheterized the very same day they removed the 3 ways surgery cath as I could not urinate at all (was very anxious I think)
• 20 days after, I am drinking a lot (2-3l fluids), taking normal dose of tamsulosin in the evening (0.4mg) (will soon try to stop this under medical recommendation) and distigmine bromide (5mg) in the morning (not every day, 1 every 2-3 days)
• Can void 350-450ml typically at night (going 3-4 times) but also during day, this looks good. Had peaks at 500ml and even 600ml.
• Regarding stream I am waiting to see the TURP effect after doc agreed to stop the tamsulosin but it does not look bad.
• Scheduled for first control, in particular the PVR, in 2 weeks.

LESSONS LEARNED (so far):

• Research, look for experienced surgeon and ask opinions before deciding on the procedure. Very good source of information are the Guidelines of both EUA and AUA.
• Try to relax if you are anxious (easier said than done, I was given an anxiolitic after removal of the surgery cath) but if I managed, you will also do!
• Stay close to an ER for say the first week if you need by any chance a new cath. This helps also with anxiety.
• Have at hand a laxative if you got constipated. Plums worked great for me but had to take a glycerin suppository one day I was completely blocked.
• Of course drink a lot (in total I am taking 2-3l fluids, mainly water, no caffeine, 1-2 couples of green tea)
• Have a perfect diet (take proteins and foods rich in Vitamin A) and watch supplements in case you take them; avoid herbs and blood thinning substances for a while to speed healing of the scar. I am still taking probiotics, moderate doses of Vitamic C, Magnesium, Zinc, Vitamin D and ask doc first.
• Keep constant talk with doctor.
• Expect blood in the urine. I still have after 3 weeks mostly when seating, passing a stool but almost invisible after staying in bed (e.g. at night). Remember that also a very little blood make it impressive. Do not panic, it is normal. Doc confirmed.
• For recovery expect nothing at short term. Think about weeks and months, not days. From what I read, it is going to take 6-8 weeks with full recovery only after 3-4months. Take it really easy with work. Expect sex only after 1-2 months.

Edited by albedo, 15 February 2013 - 08:49 PM.

[albedo]

Recovering well. Visible blood in the urine (at the start of stream) disappeared when entering the 4th week after surgery. I am now at the end of 5th week. Stream good without the tamsulosin. PVR measured at 250mL and more than halved from previous measurements, hence not perfect, hopefully I will improve a bit, maybe never completely, but at least I am protecting my bladder.

Histology has shown low grade PIN (LGPIN), some atypical adenomatous hyperplasia (AAH) and low inflammation.

All this looked OK to urologist as not high grade PIN (HGPIN). However, I wonder if/which actions could be considered as prevention. I am thinking mainly to a nutritional anti inflammatory approach (e.g. Zyflamend, Curcumin, ...) and chemio prevention (Selenium? others?). Low dose finasteride? Anyone out there trying something? E.g. see for this Dr. Katz's book "Guide To Prostate Health" and trial with Zyflamend at Columbia.

However, while HGPIN would definitively require more testing, LGPIN seems not increasing PCa risk. See the (excellent) review article of Harvard Medical School.

These are interesting excerpts on scope from Medscape (http://emedicine.med...780-overview#a1)

".... Prostate cancer develops within 1-2 years in an estimated 30% of men with multiple cores containing HGPIN and in perhaps even more men with ASAP. Indeed, the presence of HGPIN or ASAP cells in multiple areas has such a high predictive value for prostate adenocarcinoma that the existence of these cells alerts the pathologist to search for any areas in the biopsy sample that might harbor carcinoma. However, the presence of HGPIN or ASAP does not necessarily imply that prostate cancer is inevitable; although these conditions may progress to invasive cancer, HGPIN and ASAP remain stable for years in many patients and regress in some individuals...."

"...Many pathologists do not report the presence of LGPIN...."

"...Epidemiologic studies suggest that the major dietary factor associated with prostate cancer is fat intake. An additional component is total energy (caloric) intake (regardless of source). Obesity and a high-fat diet have been shown to correlate with the development of prostate cancer, as do genetic and many other, unknown factors. De Marzo and associates have suggested that proliferative inflammatory atrophy, which may represent regenerative epithelium in response to environmental insults, may precede the development of PIN and early carcinoma.[17] These lesions may arise in the setting of inflammation and exposure to dietary toxins, such as the carcinogens that have been identified in charred meat...."

"...Drug therapy is ordinarily not recommended for patients with HGPIN or ASAP unless multiple biopsy cores demonstrate HGPIN..."

"...There is no current evidence of an association between diet and HGPIN or ASAP. However, because dietary factors have been implicated in the development of prostate cancer, patients are advised to consume a diet low in fat, particularly animal fat, and high in fruits, vegetables, and fiber. Patients should avoid taking in more calories than they expend, as obesity is associated with an increased risk of developing prostate cancer. No dietary supplements, such as selenium and lycopene, have shown any benefit. (See Prostate Cancer and Nutrition for more information on this topic.)..."

I hope this helps! Please comment!

[triffid113]

Should I continue with (low dose) DHEA? Should I try 7-Keto? One expert advice I once got was to supplement DHEA when both DHEA and testosterone are deficient.

Maybe try liquid DHEA since it is absorbed through the mucus membrane in the mouth avoiding the liver for quicker utilization by the body.

Warning! Warning Will Robinson!

DHEA tastes like sh*t! I ordered a sublingual DHEA and couldn't finish it. And, fyi, a liquid is just going to go down your stomach. You need a slow dissolving sublingual to keep it in your mouth long enough to absorb it through the skin of your tongue.

[triffid113]

Even is this thread seems of no interest considering the lack of replies ...

PSA (2.3) back to *normal* values, i.e. previous to the spike. 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 ...

idk, idk...
I just wanted to tell you not to neglect the most basic 5-alpha-reductase inhibitor -- zinc!

Zinc is high on my personal radar because allergies destroy skin which it takes a hugh amount of zinc to repair (like 75-150mg/day). So, I get zinc deficiency symptoms (including thyroid issues) during allergy season. Your TSH should be < 2.0: http://www.lef.org/p..._testing_02.htm If it is not, consider whether it might be due to a zinc deficiency -- a deficiency in the most basic 5-alpha-reductase inhibitor.

[albedo]

Even is this thread seems of no interest considering the lack of replies ...

PSA (2.3) back to *normal* values, i.e. previous to the spike. 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 ...

idk, idk...
I just wanted to tell you not to neglect the most basic 5-alpha-reductase inhibitor -- zinc!

Zinc is high on my personal radar because allergies destroy skin which it takes a hugh amount of zinc to repair (like 75-150mg/day). So, I get zinc deficiency symptoms (including thyroid issues) during allergy season. Your TSH should be < 2.0: http://www.lef.org/p..._testing_02.htm If it is not, consider whether it might be due to a zinc deficiency -- a deficiency in the most basic 5-alpha-reductase inhibitor.

Thank you. I take zinz which across supplements should be around 25mg/d. Yes I do know it is an important nuttrition for the prostate health. I lalso checked blood levels (normal) but not sure what that would actually means. TSH is 2.7, T3 free is 2.9 and T4 free is 1.7. I had to go through a (bipolar) TURP as posted elsewhere for my PVR So far so good. They found a low grade PIN as posted elwhere, with 2.7 PSA, and will increse my antiinflammatory dieting/supplement. See also http://www.ncbi.nlm....pubmed/14663472

[albedo]

An update and positive outcome ....

I had (bipolar) TURP in January and recovered well w/o complications.

At 1-month check up with ultrasound, my PVR was still high but 50% lower than before TURP. I re-tested at 3 months from surgery, keep reading ...

I think I found a method to probably void the PVR: standing and after the first urge and urination, I bend my upper body almost 90 deg and also apply a gentle pressure on the pelvic region above the penis. I then return straight and gently strain to further void. For some reason (rising liquid level in the bladder and triggering some nervous reflex??) I am able to void a little more, impossible otherwise. Repeating several times I feel I can void almost all my PVR. Doing this process before going to bed, non only I have no nocturia but have very small urine in the morning. Hopefully this can be a good simple way to help bladder shrinking and further help after the TURP (done because of PVR). Is this method working? Keep reading ....

At 3 months from surgery I did my second test to check PVR and the maneuver described above.

I arrived to doc with full bladder. At urge, I could void w/o difficulty 630 mL with a Qmax of 26-27 mL/sec and normal profile which is very good. At the ultrasound a PVR of about 280-300 could be measured ... mhhh ... I then applied my method and could void an additional 420mL. Doc measured again PVR which was happily at <20mL which confirmed basically what was previously just an impression. The method seems working. Looks like I unintentionally re-discovered what is known as the Credè's maneuver which can be used to void bladder. I intend to repeat it at least 2x/day in the hope to "re-educate" bladder. I am also checking for a specific physiotherapy for the bladder.

Hopefully things are going to improve even further.

Barring long terms complications, still possible, so far the (bipolar) TURP has been a success and based on my experience I could recommended it in similar conditions (mine was not obvious as pretty asymptomatic) provided the caveat of doctor experience and a previous pressure-flow and cystoscopy support to diagnostic.

Other actions are in the pipeline to check PSA at 6 months, lower inflammation with nutrition intervention and supplementation. Continuous monitoring (including PSA, I do not believe the absurdity of several recent panels recommending not to screen) and not dropping guard are key. However, I feel equally important not being obsessed and living happily !!

I hope this helps.

[albedo]

IMO, the following suggests me doing something also regarding LGPIN described in my previous posts:

Is low-grade prostatic intraepithelial neoplasia a risk factor for cancer?

INTRODUCTION:

High-grade prostatic intraepithelial neoplasia (HGPIN) is generally accepted to be a precursor lesion of prostate cancer. The likely outcome of isolated low-grade PIN (LGPIN) lesions in prostate biopsies remains unclear. A follow-up study of 106 patients with LGPIN- and HGPIN lesions was performed.

MATERIALS AND METHODS:

In a 2-y period, 207 men were diagnosed with isolated PIN on standard systematic sextant biopsy of the prostate. In total, 104 patients had LGPIN and 103 had HGPIN. No patients had ever received androgen deprivation therapy, chemotherapy or radiation therapy. In all, 106 patients who underwent repeat second or third sextant biopsies were analysed in the study; 30% of these patients received a selenium-vitamin E supplement for at least 6 months.

RESULTS:

In total, 43 had LGPIN and 63 HGPIN on the first biopsy. The mean age was 63.5 y (range 46-77) in the LGPIN group and 64.9 y in the HGPIN group. The mean total PSA was 6.96 ng/ml (range 0.59-34.13) in the LGPIN group and 8.44 ng/ml (range 0.59-35.3) in the HGPIN group. In the LGPIN group, 30% of the patients had cancer in at least one of the repeat biopsy cores. In the HGPIN group, 27% had cancer in at least one of the repeat biopsy cores. The mean total PSA of patients who had cancer in repeat biopsies with LGPIN was 7.84 ng/ml (range 2.92-34.13). The mean total PSA of the patients who had cancer in repeat biopsy in the HGPIN was 6.73 ng/ml (range 0.56-25). There was no significant difference in PSA and pathological stage between those patients who did and those who did not receive selenium-vitamin E supplements.

CONCLUSIONS:

These data are intriguing since the risk of finding prostate carcinoma on repeat sextant biopsy in the LGPIN group is 30%. This is higher than commonly reported. The importance of recognising and re-biopsying HGPIN was confirmed. If chemoprevention could be shown to be effective, it might be beneficial not only in HGPIN but also in LGPIN. The possible activity of chemopreventive agents and their combination with iso-flavonoids needs further investigation.

http://www.ncbi.nlm....pubmed/14663472

Edited by albedo, 17 May 2013 - 08:24 PM.

[albedo]

At 5 months from (bipolar) TURP my PSA was at 0.8 (3x less than prior to surgery). Beside the terribly low DHEA-S, hormones were OK (posted elsewhere full results). Decided not acting on DHEA!

I also continued my physiotherapy. Therapist first introduces a special probe in the rectum and checks a real time curve on the screen showing my ability to relax or contract the sphincter as an indirect test of the same ability to relax/contract urethra prior to urination, relaxation being a prerequisite to a better voiding. I have a little challenge to get the curve on the screen flat at the start (you can imaginge the stressful position) but with little time and talking I noticed I can be trained to do so. Message is to take time, relax, image to "open the door" before any attempt to void. When relaxed and stream starts apply gentle pressure to increase voiding. Key is also to regularly go; suggestion is every 2-3 hours in my case, do not wait for the urge. Keep drinking 1.5L liquids per day. With my "procedure" as described I feel I can void almost entirely.

Comparing to few months ago, I did a new PVR test last week at 9 months from TURP. This time I was unhappy. I drank more than normal before going to doctor. An emergency with another patient made that I had to wait longer time before my visit, resulting in increased stress. At ultrasound my bladder had ~600mL. I first went and voided ~300mL and then tried to void the rest using my procedure. I could not relax at all and despite trying nothing much was going out (maybe 50mL). Result: my PVR after the process was as high as 250-300mL (competing to <20mL last time). As I learned from my physiotherapy, relaxation is key and applying gentle pressure while urinating. Doc decided to see me again in a couple of months with empty bladder this time (voided at home). I think this is important. Immediately when back home after the visit I was relaxed and emptied very well. I should have a personal ultrasound device to test by myself! Oh, a confounding factor might be I stop all medication before the new test (distigmine bromide).

Sorry for this diary, I hope this helps others….

[Braziliandude]

Well,I ve been having some problems with my prostate and psa also...but mine was cause by that poison finasteride, on the top of that I have problems with libido, and mal function of the genitals, seriously, what the fuck has happened to me??

[albedo]

Short update if this is still of interest.

I just had my urologist check up at 1 year from surgery. PSA was 0.8 last June (6 months post-surgery).

Overall it looks pretty good !

Test was done after I fully voided (with my "procedure") and taking time without stress (at home and at the location restroom). Relaxing really looks key in my case and points to many, many years of bad habit. Full voiding was after about 2L drinking during past 10 hours and including all liquids, probably going 6-7 times prior to test.

Firstly my feeling was of being "light". Before the ultrasound, the doctor pressed just under the umbilici and asked if I had feeling to urinate. I said no and he noticed he can press without encountering much resistance indicating a good voiding. Ultrasound confirmed this with PVR or ~30 mL. She also looked at kidneys and did a DRE. Everything looked normal. Flow looks good.

In conclusion, TURP still looks was a good decision, side effect acceptable (retrograde ejaculation) and physiotherapy helped to learn how to relax and fully void, at east try, when going.

Still trying eating well, keeping my supplementation deck, focusing on lowering inflammation, and exercising. No DHEA unfortunately as level is very low (fully new panel in 6 months) but not willing to take risks.

[johnross47]

It's very much of interest. I'm currently on CISC and although it has provided a great deal of relief after becoming progressively less and less able to pee normally, with residual volumes sometimes as high as 1100, close to emergencies, I do feel it is not a good long term solution. I recently moved house and have a new doctor who seems unhappy with the situation so I may be offered other options soon.

[albedo]

It's very much of interest. I'm currently on CISC and although it has provided a great deal of relief after becoming progressively less and less able to pee normally, with residual volumes sometimes as high as 1100, close to emergencies, I do feel it is not a good long term solution. I recently moved house and have a new doctor who seems unhappy with the situation so I may be offered other options soon.

Thank you John. I am happy this can be of help and you are still interested. I am also very much interested to learn from your experience.
When I did my research prior to opting for the (bipolar) TURP triggered by my high PVR I came across CISC and remember the following study which you might find of interest:
http://onlinelibrary...5574.x/abstract
I am not allowed to post the full study (just 5 pages), please get to a library for a download, I found it a good read.

[johnross47]

It's very much of interest. I'm currently on CISC and although it has provided a great deal of relief after becoming progressively less and less able to pee normally, with residual volumes sometimes as high as 1100, close to emergencies, I do feel it is not a good long term solution. I recently moved house and have a new doctor who seems unhappy with the situation so I may be offered other options soon.

Thank you John. I am happy this can be of help and you are still interested. I am also very much interested to learn from your experience.
When I did my research prior to opting for the (bipolar) TURP triggered by my high PVR I came across CISC and remember the following study which you might find of interest:
http://onlinelibrary...5574.x/abstract
I am not allowed to post the full study (just 5 pages), please get to a library for a download, I found it a good read.

My new doctor referred me to the specialists in my new local area and things now seem to be moving ahead. I had an early appointment and they are just waiting for a PSA test to come back. They expect to move on to cystoscopy, which the previous lot never bothered to do; left me dependent on catheters without ever taking a look inside.

[albedo]

I have rediscovered this (pretty old) evidence on beneficial effects of glycine and other amino acids on benign prostatic hypertrophy (BPH) and wonder if there are more recent studies and if you have some experience:

"A combination of the amino acids glutamic acid, alanine, and glycine (390 mg capsules- 2 caps three times a day for two weeks, then 1 cap three times a day thereafter) was found to be effective in BPH treatment, with significant improvement in nocturia (56% treated patients, 15% placebo), urgency (66% treated, 11% placebo), frequency (43% treated, 15% placebo), and delayed micturition (50% treated, 0% placebo) in a double-blind, placebo- controlled study of 45 men.37 The mechanism for this improvement has not been elucidated."

http://www.thorne.co...text/1/1/18.pdf

(37) Dumrau F. Benign prostatic hyperplasia: amino acid therapy for symptomatic relief. Am J Geriatr 1962;10:426-430.

[albedo]

This is a well done video on a very reasonable approch you could have when you discover your PSA got suddenly high:

 

https://www.youtube....eature=youtu.be

[12 String]

This is a well done video on a very reasonable approch you could have when you discover your PSA got suddenly high:

 

https://www.youtube....eature=youtu.be

Good video. I have marginally high psa and monitor it even though I know that the man who invented the test thinks it is useless for detecting aggressive prostrate cancer

http://www.healthbea...is-is-good-new/

 

I didn't know about the MRI step in the video. That really changes everything.

[albedo]

Yes 12 String, I was following the discussion. Thank you for the link. IMHO and also having discussed with my urologist I feel a reasonable use of the test, mainly when oriented to see trends in the long term (velocity, doubling time etc .) is very much worth.

[albedo]

A short update at >2.5 years from surgery....

 

Overall this has been so far a success.  I am off of medications but did continue with prostate health supplementation and keep caring to lower inflammation with diet and supplementation. I take care (as learned during my physiotherapy) to use my time and void completely with my "procedure" to the point I think there is nothing or very little in my bladder and do this every 2-3 hours, in particular before going to bed, having no need to wake up during the night. I keep regular testing, as posted here, and particularly check PSA (values, velocity, ..), hormonal levels (particularly testosterone and DHT), hs-CRP, free fatty acids. My last June test has even shown a decrease in PSA over one year and complete this with urologist visit, DRE prostate exam (digital rectal exam) and PVR (post void residual). I am now 60. I expect my prostate will still continue to grow (hence watching DHT in particular) but trying to delay any possible worsening of BPH (or worse) as far as possible.

 

I hope this helps others!

Edited by albedo, 14 August 2015 - 10:20 AM.

[Bryan_S]

Bryan_S,

 

Sorry, a bit off topic and will move elsewhere to discuss if necessary, do you mind sharing what mediation you take for your BPH and some historic of PSA before and after NR and now the Magnolia extract? Have you ever tested your level of dihydrotestosterone (DHT)? Maybe you went also through some recording of the IPSS score?

 

I ask because I also have mild BPH as posted elsewhere. I was on tamsulosin (even up to 800mgc/d) and even if my prostate was normal, it was nevertheless slightly obstructive to the cystoscopy. To reduce the post void residual, hence trying to avoid worsening my bladder condition (or anticipating possible worse problems with kidneys) I decided to go through, successfully, a (bipolar) TURP surgery more than 2.5 years ago. I reported my experience in the link posted above. The NR potential effect is totally unexpected to me but reinforces me in continuing and possibly increase my NR dosage (now 100mg). I wonder if the magnolia extract could also be beneficial to me and will think about it (the PCa possible prevention via the pro-apoptosis action of honokiol is interesting). However for the time being I move nothing as pretty happy of my last June tests also showing, pleasantly, a lowering of PSA to 0.86.

 

 

albedo,

 

This is as good as any other place to talk. Was diagnosed 2005'ish, nothing obstructive was found in my cystoscopy. They also set up some flow rate experiment to measure the rate at which I void. My urologist was also concerned about my kidneys and there is some marker showing some reduced capacity. They also routinely perform a Prostate-Specific Antigen test at every visit but I don't have the comparative data in front of me. My urologist prescribed tamsulosin under the name Flomax. Awful stuff with sexual side effects but when you need to void you'll do almost anything to find relief. When Tadalafil "Cialis" became available he moved me into that before my insurance even recognized it as a BPH medication. Expensive stuff back then but it worked as effectively as Flomax without the problems. As I mentioned after about 3 days off the medication I'd go into a considerable amount of bladder discomfort and this didn't happen when my medication ran out this last time. 

 

I cant tell you the Nicotinamide Riboside is doing the trick. As I mentioned after One and 1/2 years taking the stuff you'd think I would have noticed a BPH benefit sooner but I cant rule it out. I recently added the Honokiol, Pterostilbene and Grape Seed Extract so these are the likely trio giving me some benefit. The fact that there are some Honokiol studies suggesting a benefit could be had by BPH suffers suggests they are trying to isolate the mechanism as a drug target path.

 

Its also possible that because Honokiol (Magnolia Extract) and Pterostilbene are Sirtuin activators they've had a synergistic effect with the Nicotinamide Riboside. Sirtuins are NAD consumers performing modifications to your epigenome and in doing so deplete the available NAD pool so its advisable to boost NAD levels to support them. As resveratrol_guy pointed out I'm likely already at the limits of oral NR effectiveness. That was my feeling also and why I started exploring the Sirtuin activators as the next logical path.

 

I'm going to give this a few more weeks without my medication and see what happens.

[albedo]

Flow rate, PSA, IPSS score... everything was fine for my urologist beside the PVR (post void residual). That was huge and totaly asymtomatic. Tamsulosin worked as a dream in my case to increase flow w/o sexual side effects but was totally noneffective to hep me fully voiding. And still today after my surgery I am trying to "recondition" (likely naively) my bladder by relaxing and "taking my time" to void. I might also re-consider and taking it again. But so far I am happy how things turned around. For the record I also used distigmine bromide immediately post-surgery but was quickly taken off as considered not necessary (I think it is used in case of severe retention). My recommendation would be to also keep checking with your doctor your PVR which I am pretty sure she/he already does.

 

Your hypothesis on NR and Honokiol for BPH is surprising and interesting and would like to explore more. Btw I also taking (some) Pterostilbene and Grape Seed Extract.

[Bryan_S]

 

 

Btw I also taking (some) Pterostilbene and Grape Seed Extract.

 

Blood pressure was my reason I expect yours as well.

[albedo]

I have blood pressure well under control so I never looked at this aspect. Pterostilbene and GSE simply because they are included in synergy in a resveratrol formulation I am supplementing for various possible health promoting reasons potentially blood pressure too.

Edited by albedo, 15 August 2015 - 09:32 AM.

[albedo]

 

 

 

Btw I also taking (some) Pterostilbene and Grape Seed Extract.

 

Blood pressure was my reason I expect yours as well.

 

 

I forgot to add that, as you were taking tamsulosin (I suppose 400 mcg/d), you should have noticed some blood pressure lowering. It is a common side effect.

 

[albedo]

...

 

... Now as too blatter function, I am pretty certain this improved. Amount of bathroom visits has gone down and volume up.

 

Stefan

 

Stefan, I moved this into here from the NR thread (http://www.longecity...ndpost&p=740505). Can you develop a bit more on it and how you realize it. Have you consulted with a doctor, were you waking up at night, have you any LUTS (lower urinary tract symptoms) discomfort? This is very interesting and beside a potential effect of NR it is interesting by its own.
 

Edited by albedo, 16 August 2015 - 02:10 PM.

[stefan_001]

Hello Albedo, Sure I can.

- indeed If I would drink later in the evening as would wake up in the night to go to bathroom. This happens less. At some point I decided to track the volume of urine when I would go to the bathroom in the night and I was concerned it was getting less and less. It was however roughly stable. Now I would say it has become 15-20% more.
- I always went to bathroom regularly and it would be quite a challenge if I could not find one so to say. That has become a lot less. Life has become easier.

Reading the threads I am now thinking that perhaps there is less residual urine in my blatter but there is also another influence that gives better control on whatever muscles there are to hold.

Brian I think I read somewhere that you somewhat recent also changed the dosing pattern for NR, so more frequent during the day. Perhaps that has an influence? If something should improve I guess it only happens when there is a NR boost. With a single boost a day there is limited time for "repairs" and the rest of the day is still mostly as usual. Multiple boosts increase periods of "repair" time - till a point comes that repairs are more than normal detoriation.

Stefan

Ps last time I did a PSA score was 5 years ago. That is not too smart......Time for a checkup

Edited by stefan_001, 16 August 2015 - 07:18 PM.

[albedo]

Thank you Stefan. IMO a useful baseline would be to have your urologist measuring how fast you void (flow meter) and measure (typically by echography) a post void residual. Typically you arrive to the doc with you full bladder, test pre-void, void measuring flux and test post-void. In any case the feeling and your own test showing you are able to void more is a very positive sign!

[Bryan_S]

Brian I think I read somewhere that you somewhat recent also changed the dosing pattern for NR, so more frequent during the day. Perhaps that has an influence? If something should improve I guess it only happens when there is a NR boost. With a single boost a day there is limited time for "repairs" and the rest of the day is still mostly as usual. Multiple boosts increase periods of "repair" time - till a point comes that repairs are more than normal detoriation.

 

Yes I did and it's possible this made a difference.

 

OK here is my most complete list:

My recent regiment starts with setting aside 8 125mg capsules of Nicotinamide Riboside for the day ahead. At the start of my day I take 2 125mg capsules of Nicotinamide Riboside under my tongue. I followup with my sirtuin activators 200mg of Honokiol Magnolia Bark and 50mg of Pterostilbene. To this I add 500mg of Grape seed extract. I followup with another 125 mg of Nicotinamide Riboside about every hour until my 1000mg is gone.

 

At the end of the day, before bed I take 4 1000mg gel caps of Garlic oil, 200mg of Honokiol Magnolia Bark and 50mg of Pterostilbene. To this I add 500mg of Grape seed extract and 2000mg of Niacinamide. I also take some B12. If I've been on my feet thru the day I may take some sodium naproxen 440mg. Another drug I've been taking less of recently is omeprazole 40 mg for acid reflux.

 

On the sublingual dosing of Nicotinamide Riboside, I use the HPN brand 125mg capsules we run in the LongeCity Group Buy. They use a vegetable based excipient and I am not afraid of accidentally inhaling it like another venders brand I tried. Knowing how your NR is processed is important. Some Excipients used in the encapsulation process should not be placed under the tongue.

 

Quote

"Silica dust is a known carcinogen, lung irritant, and a central nervous system toxin. What is Silica dust see link. Guys I take my NR under the tongue like many of you. I trialled one of these other venders product and ACTUALLY THOUGHT I WAS GOING TO COUGH UP A LUNG. This is why HPN uses a plant based excipient. So again buyer beware, swallowing a capsule undisturbed is completely different than emptying its contents under your tongue. Now, knowing and researching what some of these excipients are I don't want them in my body period."

 

Why under the tongue: Sublingual and Buccal Medication Administration

The digestive system is a tough place for a lot of molecules to endure and survive until absorption and I'm going to give my Nicotinamide Riboside the most uninterrupted path to the blood stream. Plus its expensive and I want as much of it working as possible.

 

As I'd mentioned before I don't know what's alleviating my BPH symptoms. I did get my BPH prescription refilled last weekend just incase whatever's working stops. Today marks the 14th day I haven't taken my medication and normally I would have been in pretty bad discomfort by the 3rd day. So I'm enjoying a good stream while I void but I'm also paranoid the good times will end so I have my back-up medication incase.

 

Of the supplements I take most were selected as anti-inflammatories to assist in my ankle and foot recovery. The only exceptions were my BPH medication now discontinued, omeprazole for heart burn and Grape seed extract for blood-pressure.

 

Of the supplements I think are helping I'd put the Honokiol Magnolia Bark near the top. Honokiol is a SIRT3 activator with some interesting properties. I can't be certain but of the supplements listed above I've run some associative word searches on each supplement on google. The one that returned the most information was "Honokiol BPH" and it returned some hits associated with targeting smooth muscle contraction in the prostate. I make no such claims and cant be sure whats working so this is pure speculation at this time on my part.

 

In the first article link on Honokiol as a SIRT3 activator they talk about cardiac hypertrophy. This is in no way associated with benign prostatic hyperplasia. The 2 conditions look similar and each tissue begins to work incorrectly because of its enlarging size but thats where the similarity ends. The cells behave differently in each enlarging tissue. 

 

 

So if its not working the same way as it did in cardiac hypertrophy whats it doing? Search the term "Honokiol apoptosis" and you'll get a virtual laundry list. Now most of those links are associated with cancer studies. Also see search term "Honokiol Cancer" but generally in this framework Apoptosis is induced by NAD depletion. I don't think that is the case because I'm taking it with a NAD booster. 

 

Now again guys I just started digesting this stuff and I've barely scratched the surface. My feeling is the Nicotinamide Riboside as a NAD booster and Honokiol as a SIRT3 activator are a synergistic combination. We also know sirtuins are major NAD+ consumers so if you push the production of SIRT3 you'd be wise to increase your NAD+ pool in order for the sirtuins to work.

 

Thats one theory and given the variables listed above in my supplementation I have to consider when the benefit was noticed and what changes I made just prior to that benefit. 

 

The changes I made were in my NR dosing (spreading it out thru the day) and I added Honokiol/Magnolia Bark, Pterostilbene and Grape seed extract on May 11th of 2015. So I cant say any of this happened overnight because It took 90-days until I noticed anything. I wouldn't have noticed anything at all but I missed renewing my BPH prescription and didn't notice a problem this time. (it happened recently before back in Feb-April and I noticed a problem right away)

 

The possibility is also it just took a 19-months for the NR to work. Or its one or more of the other supplements. God forbid, tomorrow I could also be back the way I was, so I'm keeping my fingers crossed.

Edited by Bryan_S, 18 August 2015 - 05:58 AM.