Dr. Amy Nett: That’s a tricky one because, I mean, steroids, unfortunately, as you know, they’re going to be increasing the glucose. I’m not sure if something like berberine would be helpful. There’s a product they can get by Designs for Health called GlucoSupreme … Oh, Sherry said he is taking basically boswellia, CBD, and turmeric. Those are all great supplements to be included there. Berberine or GlucoSupreme, which is going to be a combination of, I think, gymnema, cinnamon, and a number of different herbs that may help with blood sugar control, you can try that. To be honest, I don’t know if they’re going to be enough to sort of override the effects that the steroids are having because you need the steroids in this case, and so unfortunately that’s just in there, and I think a ketogenic diet is probably one of the best approaches.
One question would be is, in order to get into … and Sherry is saying, “Is there another therapeutic diet you would recommend to help control growth?” I’m not a specialist in cancer, and I know that there are some functional integrative medicine doctors who really specialize in cancer. As far as I know, ketogenic diet probably would be the most appropriate. I think one of the questions would be, how deep into ketosis is he getting? Are you using keto monitoring and could you use something like more MCT oil or leucine or these strategies to get deeper into ketosis? Is he maybe eating more protein than is appropriate? Do you need to increase the fat, and in particular, like, the MCT, medium-chain triglyceride intake so that you can get deeper into ketosis? Whether that’s going for straight MCT oil, you could use coconut oil, but I think I’ll you’ll get a bigger therapeutic benefit from going with straight MCT. I don’t know if you’ve tried exogenous ketones, again, just to get potentially deeper into ketosis, because I don’t know if you’re monitoring grams of protein. If just a low-carbohydrate diet, I know some patients will go a little too high on protein and that prevents them from getting deeper into ketosis.
Sherry says, “He notices an increase in seizure activity with aged cheese, nuts, and dark chocolate. He’s tried exogenous ketones, but the salt has some cross-reaction with some medications.”
Okay, so what about … can you do, like, an MCT oil or leucine powder to help him get deeper into ketosis? Are you measuring ketones to see what his levels are? Like, using the Precision Xtra monitor and doing fingersticks to check ketone levels? One other thing, too, with nuts, macadamia nuts are good for ketosis. Ketogenic diets, sometimes some of other nuts will end up having just a little more in the way of protein, but I see some people having trouble staying into ketosis with walnuts in there, etc., because again you get a little more protein, I think, and some people are just a lot more sensitive to that. Ketones are being measured and you might want to work on.
Sherry says, “I don’t have his numbers in front of me right now. I’m wondering if he is being triggered by arginine.”
You think arginine is causing the seizure activity? I don’t know about that. I don’t know that aged cheese is high in arginine. Nuts and dark chocolate are.
Sherry says, “There are some studies showing arginine effects on tumor DNA.”
Oh, interesting, I didn’t know that. Yes, I’d be really curious about … I don’t know if we’re able to post studies in the Facebook group, or something we can take a look at that. I’m not familiar with the effects of arginine on tumor growth, so I would be really curious. Aged cheese, though, I think cheese is actually relatively lower in arginine and higher in lysine, I thought, but again, not certain on that. I know I’m not sure about arginine influencing either tumor activity or seizures. The aged cheese could be a histamine issue, but again I don’t know that histamine would necessarily trigger seizure activities, I’m not sure … and Sherry says she will look for the links and post them. That would be awesome.
I would think he can take a look at the ketogenic number, like, see how far he’s getting into ketosis, and it might be that instead of aiming for like a mild ketosis, there might be therapeutic benefit for him in terms of trying to get that glucose low by getting deeper into ketosis, and unfortunately, that means, like, a really, really high-fat diet, even with just minimal protein, unfortunately, so you might just have to watch that and be really aggressive in terms of that ketosis. And I know MCT oil for some people, you have to really build up to it, otherwise, you get that gastrointestinal side effects, and there is also the MCT oil powder that people seem to tolerate a little bit better in terms of the GI side.
I would play around with getting deeper into ketosis and maybe adding berberine or GlucoSupreme to see if that can help again. I think it’s going to be really hard to override the steroids to lower inflammation. I don’t know if increasing … depending on the amount of turmeric or meriva you have him on, if you can go up on some of those anti-inflammatories, the CBD and meriva, to see if that can help lower inflammation and then help decrease the need for steroids. Sherry says, “I know this is a hard one.” I completely agree. This is a really hard one. So yes, let us know how it goes because I think we could probably all learn from this one, so good luck with that and keep us posted.