Q: My sister has advanced hormone receptive breast cancer with extensive liver mets. We’d like to try DCA, my only concern is as her liver isn’t in a great way is it safe to take? My worry is liver failure. Unfortunately, we can’t get it via IV in the UK. I’d be greateful for any information. Kind regards, Reena T. A: Hello, Reena! Is your sister on Tamoxifen? (If yes, read this article - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312350/. Tamoxifen + DCA can have a synergistic effect) From our narrow knowledge, we haven't encountered anyone who took DCA and experienced liver problems. However, I would approach this treatment option with relative caution and maybe try lower than medium doses due to existing liver damage. There have been no deaths related to DCA usage and you can find all of the side effects in this article: https://www.dcaguide.org/dca-safety-and-side-effects.This is what we've the article mentions regarding DCA and liver function: ▪ Mild liver enzyme (AST, ALT, GGT) elevation, without symptoms. A majority of medications can cause mild liver enzyme changes in the blood. DCA can cause minimal liver AST,ALT, GGT elevations (about 50 – 60 U/l) for 1 % of the patients. These little alterations should not cause any worries. A more acute and bigger liver enzyme increase can be caused by antibiotics, Tyenol/Paracetamol (acetaminophen), certain types of medicinal herbs and birth control pills. (Ref.) ▪ DCA and the liver. In case of liver failure and severe jaundice don’t use high doses of DCA, because Sodium dichloroacetate is metabolised in the liver. In situations like these, DCA should be administered intravenously and not through the mouth. If the patient experiences AST and ALT or bilirubin elevation by 150% from the upper reference norm, a pause should be made (Ref.)" If I was in your situation, I would check her liver function with liver enzyme blood test. I wouldn't take DCA if AST or ALT were higher than 100 U/l. Elevated Bilirubin can also be a red flag in this situation. All in all, she could use the oral form DCA orally, just in lower quantities, such as 10 - 20 mg/kg DCA daily. I/V DCA injections are difficult to find in the UK and are mostly given in Canada and Germany. We hope we shed some light on your question.
Q: Taking DCA 2 week on with 1 week off I understand... How long term can a person take the DCA, 6 months, years ? Kreuzman. A: Dear Mr. Kreuzman, thank you for your question. There are no official guidelines on how long DCA can be taken. Regarding safety, there have been documented reports of people taking DCA for more than 4 years (https://www.dcaguide.org/news/dca-and-cancer-melanoma-long-time-remission-and-stabilisation-case-presentation-101258). In some clinical studies, children have taken DCA for even longer periods of time. If someone has stage IV cancer which has spread, then DCA and other regimens should be taken as long as possible to keep cancer stabilized or cured. How long can a person take Sodium dichloroacetate also heavily depends on how well the patient tolerates the DCA protocol, whether there is any preexisting liver failure or previous nerve injury. Diabetes can also cause nerve damage, therefore, preexisting diabetic neuropathy should be treated as much as possible before continuing the Sodium dichloroacetate treatment. Some people take it for years to keep themselves in remission. Our suggestions for longer time periods would be: • Stop taking DCA if you experience side effects. You can resume once they resolve. • Stop taking DCA if you have severe chronic liver failure, acute hepatitis, chemotherapy-associated liver injury. You can resume DCA once the liver is in better function. • Stop taking DCA if you experience abnormal liver enzyme (AST, ALT, GGT) elevation 2.5 times from the upper limit of normal levels. Take 1) silymarin or milk thistle, 2) essential phospholipids. Take a break till the liver enzymes return to normal levels. • Take DCA till you treat cancer or you want to maintain remission. Please don't forget to take the neuroprotective supplements such as Vitamin B1, Alpha-Lipoic acid and, if possible, Acetyl-L-Carnitine.