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Multiple Myeloma Diet- Liver Enzymes, Inflammation

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Regarding your question about multiple myeloma diet and liver enzymes, or I should say, a diet to bring down liver enzymes when they are high, I have linked an article below…

Hello David, thank you for posting this web on your own journey with dealing with MM, i think it was divine intervention that brought me here. My questions are actually for a loved one about his multiple myeloma diet. 

 Firstly, thank you for bringing up the benefit of a MM specialist.  The person i am speaking for does not have a specialist only an oncologists,  who has been seeing him for over 1 year now.
He will actually be getting a 2nd opinion because it seems that his body is not responding well now to Revlimid- his liver enzymes has been trending up and so he had to stop Revlimid 25mg for 1 session and was started on Vemlidy 25mg, it brought down the enzymes but once he started regimen again with Revlimid his enzymes now went up again, do you think the felxitarian diet will help him with this and help his liver? 
 
His doctor diagnosed him with Smoldering Multiple Myeloma (SMM) so he is not in late stage yet but now his current therapy is affecting his liver. 
 
Secondly, do you have any tips to help with insomnia? He has been taken off dexamethasone but still has trouble sleeping and uses Ambian everyday to be able to get at least 4hrs sleep. Thank you.

Hi Henry, 

 I’m glad that PeopleBeatingCancer.org is helping you. 
 
Regarding your question about multiple myeloma diet and liver enzymes, or I should say, a diet to bring down liver enzymes when they are high, I have linked an article below. More importantly, I have posted two articles about a nutritional supplement called curcumin. 
 
According to research, curcumin lowers high liver enzymes as well as enhances the efficacy of Revlimid. Your loved one MM patient will get a sort of two-fer by supplementing with curcumin. 
 
As for your question about sleep, my sleep enhancing techniques are the same as discussed in other articles. 
  • Exercise earlier in the day,
  • No food before bed,
  • Read before bed,
  • Low-dose melatonin occasionally 
I don’t think my sleep inducing practices are revolutionary but they help. 
 
Let me know if you have any questions. 
 
Thanks, 
 
David Emerson
  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:


Diets for Elevated Liver Enzymes

“If you have high liver enzymes, you likely have too much fat in the liver. The fatty liver disease diet is like the Mediterranean diet, an eating plan that includes fruits, vegetables, nuts, whole grains, fatty fish and olive oil. It also limits meat, sugar and refined grains

Causes of High Liver Enzymes

When the liver is injured, it releases several substances, two of which are enzymes called aspartate transaminase and alanine transaminase, explains the American Academy of Family Physicians. The most common causes of high liver enzymes are alcoholic liver disease and nonalcoholic fatty liver disease (NAFLD). Less common causes include certain medications, hepatitis B, hepatitis C and a hereditary condition called hemochromatosis…
If the enzymes are only mildly elevated, usually no symptoms of NAFLD are present, says the American Academy of Family Physicians. However, sufferers sometimes manifest weakness, nausea, fatigue, loss of appetite, abdominal pain and weight loss, notes Harvard Health Publishing.
The disease has no drug treatment, so doctors focus on preventing further fat accumulation in the liver by addressing the underlying causes, which are diabetes, high blood lipids and obesity, states Harvard Health Publishing.
While remediation goals include controlling blood sugar and lipids, a key treatment goal is to promote weight loss, an objective accomplished through exercise and diet, notes the Mayo Clinic. A 10 percent weight loss is desirable, but smaller reductions can also improve risk factors.

Efficacy of curcumin/turmeric on liver enzymes in patients with non-alcoholic fatty liver disease: A systematic review of randomized controlled trials 

Background: Several studies reported that curcumin supplementation could improve non-alcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the efficacy of curcumin/turmeric supplementation on liver enzymes in patients with NAFLD.

Methods: PubMed, Scopus, Web of Science and Google Scholar were systematically searched until December 2017. We included randomized controlled trials (RCTs) which examined effect of curcumin/turmeric supplementation on NAFLD in adult participants. Main outcome was alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Potential risks of bias (ROB) were assessed by using Cochrane ROB tool.

Results: All included studies showed low ROB in most of item of Cochrane ROB tool. Meta-analysis of 4 randomized controlled trials including 228 subjects showed a trend toward significant reduction of ALT blood concentrations in subgroup with ≥1000 mg/day curcumin supplementation (-11.36 IU/L, 95% CI: -22.75 to 0.02; I 2:51%). Meta-analysis showed a significant reduction of AST in studies with 8-weeks administration (-9.22 IU/L, 95% CI: -12.77 to -5.67; I 2: 49%).

Conclusion: This review suggests that curcumin/turmeric might have a favorable effect on NAFLD in higher dosage. Further high-quality studies with large-scale and higher dosage are warranted..

Background: Curcumin, the active component of the Curcuma longa plant, has been shown to potentiate the effect of the immunomodulatory drugs (IMiDs) thalidomide and Bortezomib against human myeloma cell lines and a nude mice model.  

Its effect on the other IMid, lenalidomide, has not been evaluated. This study aims to investigate the mechanism of action of curcumin and its potential ability to positively interact with lenalidomide.

Method: we designed an in-vitro study to investigate the cytotoxic and chemo-sensitising effects of curcumin alone and in combination with lenalidomide on the human myeloma H929 cell line.

Results: Incubation of H929 cells with curcumin (30mM) or lenalidomide (2.5 mM) for 3 days resulted in 26.35% (±1.06) and 30.81%(±2.98) apoptotic cells respectively. When 30 mM curcumin was combined with 2.5 mM lenalidomide, 50.4% (±3.37) apoptotic cells were detected by flow cytometry and the increase was significant compared to either curcumin alone or lenalidomide alone (anova = 0.0026). Furthermore, gene analysis studies show that curcumin enhances the cytotoxic effect of lenalidomide via suppression of the cereblon and multi-drug resistant genes.

Conclusion: Curcumin exerts a cytotoxic effect additive to that of lenalidomide on H929 myeloma cells, and it also enhances the chemo-sensitizing effects of this agent.

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2 comments
Kathryn Guillaum says a few months ago

The one problem I don’t have is insomnia. I sleep well most of the time. The weird part, I think, is what I attribute my good sleeping to. I take an aspirin every night. It seems to relax my inflammation from everyday activity so that I can be comfortable enough to fall asleep. If I need a little more incentive to sleep, I do exercise breathing ( not intense, just enough to pay attention to ). About 10 cycles ? but I don’t count. Inhale through nose slowly, hold for 4 seconds, exhale through mouth slowly; repeat.

Reply
    David Emerson says a few months ago

    Hi Kathryn- I am envious- my sleep is only so-so-

    Reply
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