#safety

I have not taken this supplement together with the DCA as an optional 3rd supplement. I have read that this acetyl L Carnitine could also cause weight loss. I would love to gain weight … Your opinion on this ?

Q: Hello, I learned about your existence via the DCA company as I forwarded a question to them that they aren’t entitled to answer. I hope you might enlighten me on my query. I had half a lung removed since being diagnosed with a lung tumour (Dec 2018). I refused chemotherapy, radiotherapy and started DCA as part of a natural alternative therapy via food and other healthy disciplines. I have been taking DCA for 3 months now, my weight is 51 kg and I took one DCA tablet daily in the morning until a few weeks ago. To lower the side effect of trembling and coordination (I had some). I take benfotiamine (300mg/day) and Alpha lipoic acid 3x200mg/day. My first scan at the beginning of April was clear the next one in July showed a lymph node 24mm in the top part lung, the doctor thought my cancer wanted to re-emerge in the lymph system. I’m not followed by an oncologist as he dropped my case since I refused chemo and radiotherapy. France is very traditional and even hostile towards my sort of attitude. I have had no new scan since and carry on doubling the dose: one tablet in the morning, one tablet in the evening. Two weeks on and one week off. My monthly blood tests are rather very satisfying and carried out by my general practitioner. I have not taken this supplement together with the DCA as an optional 3rd supplement. I have read that this acetyl L carnitine could also cause weight loss. I would love to gain weight ... Your opinion on this ? Thanks for whatever advice you can give and light you can shed on my query. Yours, Josiane. A: Dear Mrs. Josiane, Thank you for your e-mail. You can surely take the DCA protocol without Acetyl L-Carnitine (ALC). In our honest opinion, it is the least important neuroprotective supplement in comparison to Vitamin B1 and Alpha-lipoic acid. Nevertheless, there are some studies proving that Acetyl L-Carnitine could help avoiding DCA side effects of the nerve system. (Ref1.), (Ref2.), (Ref3.) There is limited evidence that Acetyl L-Carnitine provides significant weight loss, in fact, there is still no significant evidence that it could cause measurable weight loss. There were no differences in weight loss between women who took ALC and those who didn‘t. (Ref.1) , (Ref2.) Acetyl L-Carnitine is nothing to be afraid of. It is found in animal products and is consumed by people every day. If you are vegetarian, taking a little bit of Acetyl L-Carnitine could even prove beneficial for you since you get a reduced amount of it from your diet. However, if you're too uncomfortable consuming it, take smaller doses or avoid using it altogether. The stress and negative feelings that come with it are too big of a price to pay for the benefits. On the other hand, if you feel more relaxed about Acetyl L-Carnitine - please take it as recommended in our articles or by…

We are still going to give DCA as this is our last hope, but we are also going to give some vitamins specifically for the liver. Should we give these vitamins or not? Is there any recommended dosage for Silymarin?

Q: Cancer took the most part of the liver (3/4), but still not completely gone. We are still going to give DCA as this is our last hope, but we are also going to give some vitamins specifically for the liver. Should we give these vitamins or not? On your website, it seems like it is encouraged to give. Is there any recommended dosage for Silymarin? I found this supplement below in Turkey, they recommend 1 capsule a day, and it has 80% Silymarin, but I couldn't be sure if it is enough in our case. Kurtulus. A: Dear Kurtulus, thank you for reaching us out. Adult dosage in terms of hepatoprotection is 420 mg/day of Silymarin extract (standardized to 70-80% Silymarin). I would advise to take three 140 mg capsules a day. Take one with breakfast, second one with lunch and the last one with dinner. You can also take Essential phospholipids (EPL) to help speed up liver recovery from light or heavy damage. The recommended dosage is 900-1800 mg/day. Take three 300 or 600 mg capsules daily with your meals. These supplements are extremely safe and have virtually no drug interactions. They are also used in a healthcare setting to aid liver recovery. However, you need to take them at least 2-6 months straight for the effect to be evident. You can take Silymarin and Essential phospholipids separately or together for swift and positive response. It‘s up for you to decide.

I live in Alberta, I can‘t seem to find Vitamin B1 or any of the other recommended supplements suggested. Does anyone know where I can get these from in Alberta Canada ?

Q: I live in Alberta, I can‘t seem to find Vitamin B1 or any of the other recommended supplements suggested. Does anyone know where I can get these from in Alberta Canada ? Debbie. A: Dear Debbie, thank you for your email. Unfortunately, we cannot recommend any specific brand of the protective supplements. You‘ll need to decide which kind suits your budget and needs the best. Your best bet would be to use the Canadian Amazon shop to find these products. It's up to you to make the decision on what you like and trust, we believe that there are many quality supplement brands out there. 1) Vitamin B1: https://www.amazon.ca/s?k=Vitamin+B1&ref=nb_sb_noss_2. (buy Benfotiamine if possible), 2) Alpha-lipoic acid: https://www.amazon.ca/s?k=Alpha+lipoic+acid&ref=nb_sb_noss_2., 3) Acetyl L-Carnitine: https://www.amazon.ca/s?k=Acetyl+L-Carnitine.&ref=nb_sb_noss. Like mentioned previously, if you have the opportunity, try taking Benfotiamine as your primary choice of Vitamin B1. It seems to have a stronger neuroprotective effect than Thiamine against DCA adverse reactions. You will also need to take two times lower doses of Vitamin B1.

Is your group still in existence? Do you have any information on DCA quality since 2018? Have you discovered who is behind “Certified DCA”, whether it is really a pharmaceutical grade product, and whether its purity is as they claim?

Q: Is your group still in existence? Do you have any information on DCA quality since 2018? Have you discovered who is behind "Certified DCA", whether it is really a pharmaceutical grade product, and whether its purity is as they claim? Elizabeth A: Dear Elizabeth, thank you for your email. Yes, our group is still in existence. However, due to the Covid-19 pandemic, we have been less active lately. We are still following the global situation on DCA manufacturing. Unfortunately, a lot of Sodium dichloroacetate suppliers have remained completely the same or have taken a step back in terms of the quality of their services. Many popular DCA suppliers have abandoned this molecule due to the recent inactivity of clinical trials with Sodium dichloroacetate. This was partly caused by the Corona virus pandemic, since all the attention and funding were redirected towards solving the Covid-19 crisis. Nevertheless, the situation should come back to normal in half a year. We noticed that a lot of previously great DCA sellers have developed problems with their sites, customer service quality and delivering the products on time. Regarding the claims by Certified DCA. Firstly, Sodium dichloroacetate is not registered as a licensed medicine, therefore a pharmaceutical grade product of DCA cannot officially exist. Such claims are false. Secondly, the quality of their product has not changed since the last time we reviewed them. Therefore, we didn't feel the need to update their product review. Lately, their site has been down and it’s not possible to order a new batch of their production. We’ll try to check them whenever it will be possible. Best regards, DCA Guide

I have a question about DCA, next week I start with immune therapy because I have lung cancer. Is it safe and can I still use DCA?

Q: Dear Sir or Madam, I have a question about DCA, next week I start with immune therapy because I have lung cancer. Is it safe and can I still use DCA? Best regards, Alfredo. A: Dear Alfredo, thank you for your letter. We are getting similar questions often, therefore, we will try to explain DCA and immunotherapy in greater detail. In most cases, using Sodium dichloroacetate with checkpoint inhibitors such as pembrolizumab (Keytruda), atezolizumab (Tecentriq) and other similar drugs is a great option. It does not look that DCA could be unsafe with any type of immunotherapies. (Ref.) Immunotherapy helps the person’s own immune system fight against tumors. This class of medications is especially useful when the cancer develops resistance against conventional chemotherapy treatment. It also allows the immunity to bypass the special proteins that cancer cells develop as “camouflage” to continue growing and expanding. As the cancer progresses, it continues to develop an acidic environment around it. Lactic acid is considered an important factor in driving cell invasion, angiogenesis and immune suppression. Unfortunately, this process disables the immune system from fully engaging in tumor eradication. Furthermore, it diminishes the effectiveness of immunotherapy. The mechanism can be seen in the scheme below. (Ref.) It is proven that DCA successfully inhibits aerobic glycolysis in cancer. This decreases the massive amount of lactate secreted by the tumor cells and prevents acidosis. The surrounding extracellular space remains in normal pH, thus the immune system can recognize and destroy tumors more effectively. Considering everything, if you aim to efficiently treat cancer, Sodium dichloroacetate and immunotherapy can go hand in hand. These are the key points that you should keep in mind when using DCA alongside immunotherapy: • You should be free from peripheral neuropathy caused by previous chemotherapy treatment, • If you develop rare neurological complications from immunotherapy such as Guillan-Barre syndrome, encephalitis or any type of neuropathies, please stop DCA treatment until the side effects resolve, • Avoid using DCA, Vitamin B1 and Alpha-lipoic acid during your stay at the hospital while you’re receiving immunotherapy, you can resume DCA and supplements 2 days after you’re released from the healthcare setting, • If you’re receiving cytotoxic chemotherapy, such as platinum based compounds (cisplatin, carboplatin, oxaliplatin) or taxanes (paclitaxel, docetaxel) – avoid using DCA and Alpha-lipoic acid 3 days before hospitalisation and 7 days after receiving chemotherapy infusions. After that time period, if you haven’t developed chemotherapy induced peripheral neuropathy, you can continue using the DCA protocol as usual. Remember, DCA fights cancer on its own and can be used as monotherapy, but when it is incorporated with immunotherapy, the combination should work even stronger. (Ref.) Hope you find this information useful. Best regards, DCA Guide

Can we use along with Keytruda/Pembrolizumab ?

Q: Can we use along with Keytruda/Pembrolizumab ? Jon D. A: Hello, Jon. Yes, DCA can be safely used with Keytruda (Pembrolizumab) as no drug-drug interactions are expected. (Ref.) As far as we heard from our own experience, there haven't been any bad interactions between Sodium dichloroacetate and biological therapy. Also, based on research and cancer biology facts, it seems that DCA and immunotherapy can go hand in hand. (Ref.) You can find more details in the previous answer that analyses Sodium dichloroacetate and immunotherapy in-depth. (32)

My Dr. Gave me DCA capsules… 333 mg capsules to take 2-2x a day… I tried to take them, would get sick & throw up immediately… do you have any idea why this would be happening?

Q: My Dr. Gave me DCA capsules... 333 mg capsules to take 2-2x a day... I tried to take them, would get sick & throw up immediately... do you have any idea why this would be happening? Thank you...Sincerely. Troy B. A: Hello, Troy. The situation is rather strange. It could be due to the fact that your doctor was prescribing you with impure DCA. DCA can irritate the stomach mucosa. However, we've got the subject covered in our article: https://www.dcaguide.org/methods-and-supplements-for-preventing-dca-side-effects "On rare occasions, Sodium dichloroacetate administration can result in heartburn or nausea. If this is the case, try taking DCA after you eat a little bit of food and drink some fluids to avoid taking the medication on an empty stomach. If that didn't resolve the problem, you should try taking medications that lower gastric acid secretion - Proton pump inhibitors. Any type of PPI is acceptable provided the fact that they don't have any major differences. ▪ Pantoprazole / Omeprazole / Esomeprazole (take one 40mg tablet per day, at the same time. Take it at least 30 minutes before your meal and DCA.) For convenience purposes, we recommend using Pantoprazole because it doesn't seem to have any poor interactions with other medications. However, any other Proton pump inhibitors should have the same effect. Let us know if you have any more questions.

Should we continue and disregard once a day diarrhea? We are taking it low as far as the dosage calculator is concerned.

Q: Hi, we have purchased DCA and from the first day there was diarrhea this is the second day so it‘s two days once a day, should we consider the dose of capsules 333 a high dosage? This man has had tumor on his vocal cords, which were removed as well as a part of his larynx . So now he was advised to follow chemo, which he won't cause doctors said his tests revealed that something wasn‘t right, probably spread after surgery. Should we continue and disregard once a day diarrhea? We are taking it low as far as the dosage calculator is concerned. Thank you in advance. Victoria A: Hello, Victoria. This is the first time we've heard that someone would develop diarrhea after taking DCA. Diarrhea is not a documented side effect of Sodium dichloroacetate. In extremely rare cases, diarrhea could be a result of an allergic reaction. However, symptoms like itchiness, hives, shortness of breath, cough, swollen face should also be present. On top of that, allergic reactions to DCA are extremely rare. Personally, we have never encountered them. We have followed hundreds cases of people who are taking DCA, yet we have never observed that Sodium dichloroacetate would cause loose stools. It is most likely caused by other reasons and should be investigated by his doctor. DCA dose size should not impact the intensity of diarrhea, therefore, he can take more than just one 333 mg capsule. On the other hand, one of the things that some people experience in their digestive system while on DCA is stomach irritation. Sodium dichloroacetate powder is a little bit acidic, however, most manufacturers use buffers in their product to make it neutral. Using capsules or taking DCA with/after food also quickly fixes this problem. Maybe it's just bad food, too much coffee, too much spices, stress or his overall condition ? Did the man have any kind of chemotherapy lately ? Oncological drugs often cause loose stools. We would advise you to take a short break (about 3 days) from taking DCA and then start again. Observe if the diarrhea returns. He should also take plenty of clear fluids, at least 8 glasses of water or tea. Eating frequently in small amounts of low fiber food should also help. For example, bananas, rice, noodles, white bread, skinned chicken or turkey, fish. If all of this fails, try taking Imodium (Loperamide). Start with 4 mg initially and afterwards give him 2 mg after each loose bowel movement. Hope this helps.

Hello. So is dcalab.com selling verified high purity DCA by an independent lab? Is it safe to take?

Q: Hello. So is dcalab.com selling verified high purity DCA by an independent lab? Is it safe to take? Thanks. Dan A: Hello, Dan. As far as we know, their DCA is of high quality. Over >99% pure. Their product has also been used in a couple of clinical trials with patients: 1) A pilot study done by Prof. F. Comhaire in Belgium on treating myalgic encephalopathy/chronic fatigue syndrome (ME/CFS) with Sodium dichloroacetate (link), 2) A phase II clinical trial done by the University of Edinburgh using DCA as a possible treatment for endometriosis-associated pain (link). There is a quality comparison analysis on our site where we compare the most popular DCA suppliers. You can find a detailed quality analysis of each brand. The method of anionic and gas chromatography was used to get the results: https://www.dcaguide.org/dca-quality-analysis. We gave the maximum rating to two suppliers: -DCA Lab (they're an independent laboratory that specializes solely on high quality synthesis of Sodium dichloroacetate), -Sigma-Aldrich (they're a big company in Germany who manufactures a lot of chemical compounds. Their DCA is also of high quality. However, it is often hard to place an order). DCA LAB is also listed on www.molbase.com, which states that their product is 99.9% pure. Based on this information, we believe that DCALab.com offers high purity Sodium Dichloroacetate that is verified. They also have great customer support. Nevertheless, DCA is safe to take in most of the cases. On the other hand, 95-97% pure DCA can have synthesis byproducts such as Sodium monochloroacetate, which can be toxic. Therefore, we advise you to choose a verified supplier and to avoid online shops like https://www.alibaba.com/ for your own safety.

Can you take DCA with high dose IV Vitamin C treatments?

Q: Can you take this with high dose IV Vitamin C treatments? Daniel A: Hello, Daniel. We have followed hundreds of cases where people take DCA to treat their tumors and we noticed that a lot of people take Vitamin C additionally to their anti-cancer regimen. You should avoid self-medicating with high doses of Vitamin C perorally, because it will not enable you to achieve the concentrations needed to have any effect. The only way to do this correctly, is to have someone give you Vitamin C through intravenous injections. However, please be cautious. There are dangers. The biggest concerning side effect of high dose Vitamin C is oxalate crystal formation in the kidneys. This can happen after frequent Vitamin C administration in large quantities. We have found these rare cases in medical journals. One man has been taking huge doses of Vitamin C for a couple of years orally for thyroid cancer relapse prevention and after 2 years he experienced kidney damage due to oxalate crystal formation as a side product from Vitamin C. You should keep this risk in mind and stay alert. Regarding your question about DCA and high dose IV Vitamin C - we haven't heard any interactions and we firmly believe that this shouldn't cause a problem. Both treatments should be well tolerated and have no interactions with one another.

I would like to purchase from DCA Lab as it is quite a good price compared to others, however I want to make sure that it is ok for human consumption?

Q: Hello, I would like to purchase from DCA Lab as it is quite a good price compared to others. However I want to make sure that it is ok for human consumption. I heard some places use toluene or other chemicals to purify which is of course dangerous to humans and I just want to make sure that even though they are cheaper it can be used for humans and if you guys have experience with this company and others using their products. Thank you, Farzad A: Hello, Farzad. DCA is mostly sold as a lab chemical worldwide, because it is currently not registered as a drug or a food supplement. However, this could happen any time soon. It is considered as an alternative cancer treatment in Canada for example. You can read more in this document: http://www.oicc.ca/uploads/dca-health-professional.pdf. Regarding your question about DCA Lab, we have never asked them if they use toluene or other harmful chemicals. Nevertheless, we do believe that they have developed a safe technology, which enables them to synthesize great quality material. Their products are used in clinical trials with patients, therefore, it‘s safe to assume that they are legitimate. We know dozens of people who are taking their Sodium dichloroacetate and we have never heard that anyone experienced any complaints related to harmful chemicals in their products. Please also check this analysis we have made about the available DCA products to get a better idea on the global situation: https://www.dcaguide.org/dca-quality-analysis. In the analysis, look at the anion and gas chromatography tests. They confirm that no toluene has been detected in DCA Lab products. Every DCA seller should provide a certificate of analysis, which proves the purity of their product. DCA Lab is one of suppliers that provide CoA‘s with their production. Sigma-Aldrich and Tocris also produce exceptional quality Sodium dichloroacetate. Please consider them also. Avoid buying Sodium dichloroacetate that could have large quantities of impurities as these could be toxic if used for a longer period of time.

What is the beginning daily dosage of DCA for a person weighing 220lbs ? How much Vitimin B1 and how often?

Q: What is the beginning daily dosage of DCA for a person weighing 220lbs? (BMI ideal weight 183-185bs)? How much Vitimin B1 and how often? Thank you, Charles. A: Hello, Charles. All of your answers are also answered in these pages: DCA dosage and usage (Long guide) and Methods and supplements for preventing DCA side effects . However, we will give you additional clarification on your specific situation. For someone who is 220 lbs, first try out 15 mg/kg. This mean should start with 1500 mg daily. For the first cycle (two weeks on, one week off) take 1500 mg of DCA (750 mg after or with breakfast and 750 mg after or with dinner). Take this for two weeks and then stop taking DCA for one week. Then, if you feel okay after the first cycle, move on to a larger dose: 25 mg / kg. Take DCA 1000 mg two times a day: 1000 mg with breakfast, 1000 mg with dinner. Don‘t forget to take Vitamin B1 (thiamine) three times a day: 100 mg in the morning, then 100 mg with lunch and 100 mg at dinner. If you can get hold of benfotiamine (a better version of Vitamin B1), take it in the same fashion, but 150 mg in three divided doses. It would be great if you could add Alpha-lipoic acid to your plan. Alpha-lipoic acid - take 300 mg with breakfast, 300 mg with lunch and 300 mg with dinner (total 900 mg daily). As with Vitamin B1, take it every day with no breaks. Consider adding L-Carnitine to your DCA regimen. Your total plan should look like: 1) DCA 1000 mg two times a day: 1000 mg with breakfast, 1000 mg with dinner. Take it daily for two full weeks, then take a break of one week. Repeat. 2) Vitamin B1 (Thiamine) - take 100 mg with breakfast, 100 mg with lunch and 100 mg with dinner. Benfotiamine is an even better form of Vit. B1 if you find it (then take 150 mg divided in three parts daily). Take every day, with no breaks. 3) Alpha-lipoic acid - take 300 mg with breakfast, 300 mg with lunch and 300 mg with dinner (total 900 mg daily). Take every day, with no breaks.

For stage 4 it recommends DCA to be taken constantly. Does this mean without breaks ? For how long ?

Q: For stage 4 it recommends DCA to be taken constantly. Does this mean without breaks? For how long? I'd guess until markers are normal and there is no need to continue. Or do you recommend continuing as a preventative? Please clarify. Thanks, Dana A: Dear Dana, it means that you still need to take breaks, otherwise peripheral neuropathy can ''kick-in" more swiftly and prevent you from using DCA for cancer prevention as soon as you‘re in remission. If one has stage IV cancer, the treatments that are given by the oncologist should also be continued. Most of the time, it will be chemotherapy, target therapy or immunotherapy. DCA goes well with most of these treatments, however, it goes especially well with target therapy and immunotherapy. A lot of cancers develop some sort of resistance to chemotherapy after its given frequently. Please understand that the main goal of treating stage IV cancer is transforming it into a chronic disease and prevent it from causing further harm through metastastis and growth. To achieve this, someone with stage IV cancer should constantly take some kind of anti-cancer treatment and monitor his health as well as tumors as a routine. Therefore, take DCA as a single agent or in combination with other methods to prevent cancer from spreading and getting larger. This means taking it for the rest of your life. Sometimes you develop any side effects such as peripheral neuropathy, which will make you to take a pause until they resolve. After they‘re gone, resume the DCA protocol. Cancer markers are one of the main ways to follow the progress / regress of the tumor advancement. The most accurate tumor markers that correlate with the size of the tumor are – 1) CA-125 (for ovarian cancer), 2) PSA (for prostate cancer) and 3) CEA (for colon cancer). You can repeat them every 3 months to see how well is the cancer responding to treatment. If they drop, it means that the malignancy is shrinking. One must also have imaging scans performed, to see if tumors are decreasing or increasing in size and to make sure if all the metastasis are gone. If you achieve remission, you can lower your DCA doses. DCA can be used as a preventative for cancer relapse if desired. Most of the cases take in doses lower than before, at least 50-80 % of the original dose that helped you achieve remission. Don’t forget that you can combine DCA with other natural methods or regimens that prevent cancer.

Does anyone know if Kisqali (ribociclib) is compatible with DCA? Or even complimentary? Do you know of any clinics/practices in Australia competent in administering this drug?

Q: Hello, my dear wife has been struggling with breast cancer and this site has been a great ray of hope. She has recently been put on a drug called Kisqali (ribociclib). Does anyone know if it is compatible with DCA? Or even complimentary? Do you know of any clinics/practices in Australia competent in administering this drug? I look forward very much to hearing from you. Richard. A: Hello, Richard. Unfortunately, Ribociclib (Kisqali) is quite a new therapy against breast cancer and we have found no studies, which discuss of combining it with DCA. However, we've reviewed the pharmacodynamics and pharmacokinetics of Ribociclib and it doesn't look like it should interact badly with Sodium dichloroacetate. In fact, as mentioned before, we have no bad experiences of combining DCA with targeted therapies. Please read carefully our work at DCA Information and learn all you need before administering DCA to your wife. Everything should be fine. Just don't overdose the DCA and remember that the protective supplements that we recommend with the DCA protocol are obligatory. DCA + Kisqali shouldn't cause any problems when used together. In fact, they could both provide benefits. Another therapy for breast cancer, Tamoxifen, has a synergistic effect with DCA. If you want real professional help, please contact Dr. Akbar Khan. He has a cancer center in Canada. He's one of the most famous oncologists who uses DCA with other conventional cancer treatments. We doubt that there is someone better in this field than him.

How long term can a person take the DCA, 6 months, years ?

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.

Regarding using DCA, is there any side effect concerning kidneys, would it result in kidney failure, what dosage should we use as he is at the last stage?

Q: Dear Sir /Madam, My father is stage 4 cancer, he has a mass of 6cm in the stomach, metastases 6-7 masses in liver, and some other parts. we were told that it was too late for chemothreapy and / or for operation. So while we are searching for alternatives, we found out DCA and wanted to try as our last chance. He is given very little short time. we already ordered the drug and would like to start using it as soon as possible but we have one important question: our father has aproblem with his kidneys as they are half functioning, this is one of the key reasons they would not apply chemothreapy to him since it can result to kidney failure on top of the cancer and spend his last days going to dialysis, so regarding using DCA is there any side effect concerning kidneys, would it result in kidney failure, what dosage should we use as he is at the last stage? Kurtulus. A: Dear Kurtulus, thank you for your question. We can confirm that DCA is safe to use with kidney failure. The main metabolism occurs in the liver and 99% of the drug metabolites are excreted through feces. We know patients that had severe chronic kidney disease and creatinine levels of 300-400 μmol/l (3.39-4.52 mg/dL) and have taken DCA without any problems. Regarding the question about renal toxicity. We haven't found scientific evidence that DCA could damage the kidneys: ''The drug does not alter renal concentrating ability or amino acid excretion. It slightly increases urinary lactate and pyruvate excretion, probably by inhibiting the specific tubular reabsorption of these anions. Of note, in the phase Ib clinical trial for GBM, the researchers have observed no other toxicity from DCA, including abnormalities in cardiac function, renal function, or liver tests.'' This means that there is no available evidence of Sodium dichloroacetate damaging the kidneys. In fact, there is one in vivo research which states that DCA pretreatment could even help protect the renal function from some chemotherapy toxicity when used in together (Dichloroacetate Prevents Cisplatin-Induced Nephrotoxicity without Compromising Cisplatin Anticancer Properties). *Important! This doesn't apply if the patient has Polycystic kidney disease. One should avoid DCA when suffering from this condition as DCA could in theory aggravate the condition. Regarding the question about dosing in such a situation. Your best option would be: •take 50 mg/kg I/V DCA injections. If intravenous DCA is not available, then take Sodium dichloroacetate by mouth, •take 12,5 mg/kg DCA powder for 14 days, make a 7 day break. If the patient tolerates the medication well without side effects, you can continue slowly try increasing the dosage to 20 mg/kg and 25 mg/kg after a while. Don't forget to take breaks (administrate DCA on 14 days on, 7 days off schedule), neuroprotective supplements and don't forget that DCA shouldn't be if severe liver failure is present.

Could you kindly specify what blood tests should be done and frequency of testing once the treatment has begun?

Q: Could you kindly specify what blood tests should be done and frequency of testing once the treatment has begun. I have been doing the CEA every 3 months, which is on a continual rise. My Dr knows nothing about DCA, but is willing to work with me if she is aware of what should be checked regularly. Keith A: Dear Keith, thank you for your question. In short, you should monitor your complete blood count, your liver enzyme levels (AST, ALT, GGT), bilirubin, CRP (C reactive protein), creatinine, urea, electrolyte levels and CEA. •Liver enzymes are important to monitor your liver function. Rarely, but they can get elevated from the DCA and the other natural treatments that you‘re getting. They can also rise if you take too much paracetamol/acetaminophen (Tylenol), antibiotics or other drugs that can cause a liver reaction. Cytotoxic chemotherapy can as well cause liver injury and the elevation of liver enzymes as well as bilirubin. 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. Then you can resume DCA. •CEA is a tumor marker that is most useful for tracking the dynamics of cancer. The increase of CEA might indicate that the tumor is growing while the decrease of CEA might indicate that the tumor is decreasing in size. Have a regular check every 3 months to see whether the cancer is responding to therapy, also check if stabilisation is achieved. This is how your papers should look like. • Full blood exam / Complete blood count. It is a basic blood test that should be done in every hospital or clinic setting. 1) Reduced HGB (hemoglobin) could mean that you have iron deficiency anemia, other types of anemia or chronic bleeding. 2) Reduced WBC (white blood cells) and neutrophils are often encountered 1-3 weeks after cytotoxic chemotherapy and could indicate suppressed bone marrow function. This could lead to increased susceptibility to infections as well as fever. 3) Low platelet count (below

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