Combination therapy with various antioxidants - My 1st post here.

[TJPD]

Hi Guys - I'm new here

I  am 60 years old, fit and healthy and you can see my experience of Peyronies in my signature.

Before this I had good erections and a penis I was more than happy with. It was a shock how it just appeared overnight.

I've been to my urologist and they believe I am still in the acute phase - they recommended VIT.E and a VED and will see me again in a months time.

I'm after a second opinion and wondered is anyone familiar with "Rationale of combination therapy with antioxidants in medical management of Peyronie's disease: results of clinical application". by Gianni Paulis,1,2 Andrea Paulis,3 Gennaro Romano,4 Davide Barletta,5 and Andrea Fabian.

This paper can be found National Library of Medicine website.

I'm self medicating Silymarin (milk thistle) + Ginkgo Biloba + vitamin E + propolis + bilberry + CoQ10 at the doses mentioned in their trials.

I unfortunately do not have access to topical diclofenac or pentoxifylline injections.

My questions are, is taking this amount antioxidants safe and has anyone else tried this method?

Thank you in advance.

TJPD.





 

[Mikel7]

Thank you for filling out your signature line and I'm assuming that you have read our survival guide -->Survival Guide .

I have not read that article in question but I assume it is based on reducing inflammation and promoting healing of the tissues and blood flow.  Peyronies is in itself a healing disorder that is fueled by inflamation. It can be minor and cause little damage or just the opposite. Also damage from a fracture can initiate this process or completely heal on it's own.

Treating it with the supplements you are taking is debatable and I am sure will not harm you. Anything topical will not penetrate to make any improvements.  It is up to you to assess if this is helping or not. I would recommend the VED therapy along with gentle traction. Also taking Cialis or similar will combat inflammation and improve blood flow. I would also take some measurements as a baseline just in case things change.

[TJPD]

Hi Mikel -

Thank you very much for taking the time to reply, it is very much appreciated... I also appreciate your solid advice - I'll be sure to take it all on board.... regarding the Cialis - am I correct to think that low doses such as 2.5mg or 5mg?

[Mikel7]

Yes the usual starting dose is the 2.5mg which is well tolerated.  

[projectpd]

Hi TJPD,

Yes it really is a shock. For me, it used to be the only part of my body I wasn't unconfident about, I literally thought it was much better than any in porn, and then suddenly it was the opposite.  Too short, narrow and weird looking! And painful.  I should have taken more care of it.  But, from what I understand your situation is very fortunate, because you have somehow been able to take all this action so quickly. As in the acute phase, is in which perhaps the long term changes are only beginning, and most amenable to intervention.

There are several of these small studies by Gianni Pauli et al, I've read mostly only criticism of them on this forum, but, I do like:

 that the full text is made available for free, when they are often about £30 or more;
 that he states the exact amounts used;
 that the agents studied are mostly readily available, and affordable.

 It's not as if he's promoting some secret proprietary invention. But, one of the studies did use a particular product containing these, but there's no suggestion that you would only likely obtain a benefit if using this one.


Diclofenac:

4% spray gel /one application per day (2 pump strokes = 16 mg of diclofenac sodium)

This is one you were unsure about, but here in the UK, you can buy diclofenac as Voltarol gel in "pound shops" (cheapest general shops) in any high street  ie. everyday items costing one or a few £1s. or the most popular pharmacy, Boots.  If not the spray, but the gel probably wouldn't sell if it couldn't penetrate skin, and therefore, would not work at all.

"Molecular size is probably the main determinant of flux across the skin (i.e. the amount of drug that can penetrate the skin per unit of time)Citation66. Diclofenac is a small molecule (296 g/molCitation67)

The drug must be water solubleCitation68, yet also have adequate lipophilicity to penetrate through the lipid matrix of the stratum corneumCitation1,Citation56. Diclofenac is a weak organic acid (pKa 3.9Citation69) and thus amphiphilic, with both lipophilic and hydrophilic properties that allow it to access all tissues including the stratum corneum and other skin tissues, but also cell membranes such as in the synovial lining of jointsCitation33,Citation50,Citation63. "

From <https://www.tandfonline.com/doi/full/10.1080/03007995.2017.1352497>


Pentox:

100 mg (perilesional injection) twice a month

This is usually in tablet form, I don't know, how to acquire in injectable form!
The idea of injecting Pentox, though, seems to me, quite a leap, from the other , likely harmless (on the contrary, likely very healthy in general ) natural supplements that you can easily just take as a pill or drink, to injecting a drug in the penis, but then, his data is suggesting a benefit.  This one isn't a natural substance, and because of side effects, it makes some sense to do this locally, with the rationale to minimise systemic dose.

Interestingly, this actually has even lower molecular weight (278) than Diclofenac, and there have been studies on it, formulated as a gel or microemulsion. Considering whether we should be able to formulate it ourselves for transdermal use,  I'd personally prefer that to injecting, as apart from the hassle, and pain, I'd be worried I might hit a nerve or blood vessel, and/or trigger off an inflammatory/fibrotic cascade at the injection site, even if only a small one.  The most probably capable (BUT not necessarily only one ) agent is DMSO, which has a reputation for being able to transport substances through the skin like nothing else can, and particularly when molecular weight under 400.


Silymarin (milk thistle) :

200 mg/orally/twice daily

From <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5530853/>

This dose used seems very low.  Most supplements you can buy are in the 4000-6000mg range, at least 10 times higher.  And, not advocating in any way, any particular commercial source (it's easy to source), but some info about doses and precautions are here
Milk Thistle: What it Does, Benefits, Dosage | Holland & Barrett (hollandandbarrett.com)
So I personally wouldn't worry, or I'd be worried that 200 isn't enough, but of course everyone's individual case and genetics is very unique. it's always an option to at least gradually taper up over time as long as there are no adverse effects.


Ginkgo Biloba

250 mg/orally/once daily

This is from a leaf of an ancient Oriental  tree species.  I think it's usually been regarded only as beneficial in some ways for health in typical doses, eg. For blood circulation, and in the brain. Again extremely low compared to the ones that have been selling. There is one on bay claiming 30,000mg equivalent dose.
Or, the molecular weight is only 326, so it seems within a range that transdermal might also be an option.


Bilberry

160 mg/orally/once

This is literally the fruit , bilberries. Again available supplements are vastly more than this, claiming equivalent up to 10,000mg.


vitamin E

400 IU/ orally/twice daily

Personally this is one I would definitely have a concern about. Typically when you see "Vitamin E" with no qualifications, it refers to a "bog-standard" (ie. cheapest) vit E , as unlike Silymarin and Ginkgo , is synthetic and comprised of a mix of mostly NON-bio-identical tocopherols (and no tocotrienols).  "Vitamin E" is one of the vitamins , like vitamin A, where it has been claimed that supplementation may  increase the risk of cancer. And this could be the reason.
I posted about this in the past, as there are then still debates about the benefits or harms of tocotrienols vs tocopherols, and their exact composition (alpha, beta, delta, gamma) which leave far behind , the primitive issue of natural vs synthetic.

Propolis:

600 mg/orally/once daily

It's a bee hive nutrient/product,  can't really imagine this being a concern . Amounts on ebay include 1000mg .


CoQ10:

This one doesn't seem to be studied in Pauli's study, but in the study he references, [30], were it was 300mg.  1000mg seems to be the highest dose available of the ones on ebay. It's a natural substance , that's generally supposed to have multiple benefits, but normal precautions apply I guess. There are some debates as to the best form of this to take though.