Juicer/recipe recommendations?

NomadicMike · February 2013

I've been looking at juicers for the last week - mainly because my sister had really gotten into it and she was encouraging me and got my interest going. I considered the Vitamix, Blendtec, and Nutribullet. Because I live in a motorhome and counter space is a premium I went with the Nutribullet.

I like it so far. Seems like it was decently made (for $100 anyway), it's quieter than my 'regular' blender and it's easy to clean. It's definitely a way to get more fiber and greens in my diet.

I do kinda wish that it ground up nuts a little better - it gets them down to about a mm in size, which is small enough to make it a 'smoothie', but I'm wondering if the Vitamix and Blendtec would do a better job since they're so much more powerful.

Anyone have any or all three of these machines? Also, any recipies you'd recommend or certain ingredients to encourage or avoid? A lot of the ingredients in the recipies that came with the machine include banana and oranges, which I thought I read somewhere to try to cut down on for RCC.

NanoSecond · February 2013

Juicer

Hi Mike,

The Vitamix was recommended to me as the best. It may also be the most expensive.

But I don't use any of them.

Please email me at: n.feldman@videopost.com

I have done lots of research on what I dub a "proper diet" and "appropriate" supplements that one might wish to consider taking to reduce the side effects from TKI's and to help miminize or prevent mets, etc. In it I explain the science and rationale behind what I am doing. I have been taking the maximum dosage of Sutent (50mg/day) since August and have had no significant side effects (yet).

I am also (so far) showing "dramatic" (positive) response in fighting my bone mets.

It is a long .pdf document which is why you need to email me - so I can email it back to you (or anyone else interested).

Best wishes,

-NanoSecond (Neil)

todd121 · February 2013

Food

Bananas are high in potassium, and those of us that are kidney compromised need to be a bit careful of too much potassium. Finding out how much is too much has been a challenge. You may not have as much to worry about because you have nearly 1 2/3 kidneys.

I think oranges are ok. They told me to avoid citrus when I was healing because of the acidity and it could easily make you nauseous when constipated. However, I think oranges are fine once you've returned to "normal".

Grapefruit, on the other hand, many of us on certain meds need to avoid. I'm taking afinitor (everolimus) as part of an adjuvant drug study and there's something called CYP3A4 (I hope I got that right) that affects how much drug the body takes up (or not). I think it might be a liver enzyme. (Anybody that wants to pipe in and correct me here, I would appreciate it). In any case, I've been told to avoid grapefruit and I believe blood oranges because they have some effect on this enzyme.

Todd

NanoSecond · February 2013

todd121 said:
Food
Bananas are high in potassium, and those of us that are kidney compromised need to be a bit careful of too much potassium. Finding out how much is too much has been a challenge. You may not have as much to worry about because you have nearly 1 2/3 kidneys.

I think oranges are ok. They told me to avoid citrus when I was healing because of the acidity and it could easily make you nauseous when constipated. However, I think oranges are fine once you've returned to "normal".

Grapefruit, on the other hand, many of us on certain meds need to avoid. I'm taking afinitor (everolimus) as part of an adjuvant drug study and there's something called CYP3A4 (I hope I got that right) that affects how much drug the body takes up (or not). I think it might be a liver enzyme. (Anybody that wants to pipe in and correct me here, I would appreciate it). In any case, I've been told to avoid grapefruit and I believe blood oranges because they have some effect on this enzyme.

Todd

Drug and Food/Supplement Interactions

OK, since you have asked, this is from my "guide":

The mechanism for that to occur relates to how most pharmaceutical drugs, including Sutent, are metabolized in the gut. Sutent is a substrate (that is, a chemical that is acted on by an enzyme) for the enzyme known as Cytochrome P450 3A4 (CYP3A4). However, other drugs or foods may also be substrates for CYP3A4. If so, they may compete with Sutent for the amount of CYP3A4 enzyme that is available. If these substances use up a lot of the CYP3A4 enzyme then the Sutent may not get metabolized properly. Instead Sutent may remain in the blood stream at an abnormally high level. This could possibly lead to some very severe side effects.

Any supplements (or other medications or foods) that increase (or “induce”) the activity of this enzyme (such as St. John's Wort) will decrease the concentration of Sutent getting into the bloodstream. The increased activity of CYP3A4 will cause Sutent to be metabolized too quickly, resulting in less of it being available to fight angiogenesis (blood vessel creation). In contrast, anything that decreases (“inhibits”) the activity of this enzyme (such as grapefruit, grapefruit juice, or green tea) will increase the concentration of Sutent staying in the bloodstream. That result could become dangerous.

My general rule is that I do not take any drug or food inhibitors that increase the activity of the CYP3A4 enzyme (i.e. decrease the amount of Sutent getting into my system). On the other hand I still do take some supplements that "might" be inducers and could serve to increase the Sutent level. This is only because, so far at least, I have not had any significant side effects to deal with. However, I still will not drink any green tea or eat any grapefruit or grapefruit products while on Sutent. These items are too potentially harmful to mess with.

Some other CYP3A4 inducers to avoid can be found here:

http://www.gistsupport.org/treatments-for-gist/sutent/sunitinib-sutent-basics-for-gist.php#6

There are also a few other potential interactions to consider. Variation in the CYP3A5 enzyme may also affect Sutent levels. However, none of the supplements I use happen to impact this enzyme. The gene ABCB1, which stimulates the protein p-glycoprotein, can also impact Sutent concentrations. P-glycoprotein helps cancer cells ship medications out through the cell membrane. Note that Curcumin and Quercetin are two supplements that may inhibit p-glycoprotein, which, in turn, could increase the concentration of Sutent in tumor cells.

This information plus much more available if you email directly at: n.feldman@videopost.com

Texas_wedge · February 2013

NanoSecond said:
Drug and Food/Supplement Interactions
OK, since you have asked, this is from my "guide":

The mechanism for that to occur relates to how most pharmaceutical drugs, including Sutent, are metabolized in the gut. Sutent is a substrate (that is, a chemical that is acted on by an enzyme) for the enzyme known as Cytochrome P450 3A4 (CYP3A4). However, other drugs or foods may also be substrates for CYP3A4. If so, they may compete with Sutent for the amount of CYP3A4 enzyme that is available. If these substances use up a lot of the CYP3A4 enzyme then the Sutent may not get metabolized properly. Instead Sutent may remain in the blood stream at an abnormally high level. This could possibly lead to some very severe side effects.

Any supplements (or other medications or foods) that increase (or “induce”) the activity of this enzyme (such as St. John's Wort) will decrease the concentration of Sutent getting into the bloodstream. The increased activity of CYP3A4 will cause Sutent to be metabolized too quickly, resulting in less of it being available to fight angiogenesis (blood vessel creation). In contrast, anything that decreases (“inhibits”) the activity of this enzyme (such as grapefruit, grapefruit juice, or green tea) will increase the concentration of Sutent staying in the bloodstream. That result could become dangerous.

My general rule is that I do not take any drug or food inhibitors that increase the activity of the CYP3A4 enzyme (i.e. decrease the amount of Sutent getting into my system). On the other hand I still do take some supplements that "might" be inducers and could serve to increase the Sutent level. This is only because, so far at least, I have not had any significant side effects to deal with. However, I still will not drink any green tea or eat any grapefruit or grapefruit products while on Sutent. These items are too potentially harmful to mess with.

Some other CYP3A4 inducers to avoid can be found here:

http://www.gistsupport.org/treatments-for-gist/sutent/sunitinib-sutent-basics-for-gist.php#6

There are also a few other potential interactions to consider. Variation in the CYP3A5 enzyme may also affect Sutent levels. However, none of the supplements I use happen to impact this enzyme. The gene ABCB1, which stimulates the protein p-glycoprotein, can also impact Sutent concentrations. P-glycoprotein helps cancer cells ship medications out through the cell membrane. Note that Curcumin and Quercetin are two supplements that may inhibit p-glycoprotein, which, in turn, could increase the concentration of Sutent in tumor cells.

This information plus much more available if you email directly at: n.feldman@videopost.com

Green tea

Neil, I thought the effect of green tea was still just educated guesswork and not actually established re human subjects. Has this speculation advanced any further?

NanoSecond · February 2013

Texas_wedge said:
Green tea
Neil, I thought the effect of green tea was still just educated guesswork and not actually established re human subjects. Has this speculation advanced any further?

Green Tea

Tex,

Yes, technically you are correct. There has not been any new data (that I am aware of) other than the studies you and I are both familiar with.

However, this is one of those where I ruled it out just to be able to focus on all the other supplements I am taking. Early on, before I knew how well I was responding to Sutent + Xgeva, I was so paranoid about interfering with Sutent (because I had no side effects), that I just crossed it off my list. And then I forgot about it.

I take it you still are drinking it with no ill effect? If so, I should revise my caveat on that one.

rae_rae · February 2013

NanoSecond said:
Green Tea
Tex,

Yes, technically you are correct. There has not been any new data (that I am aware of) other than the studies you and I are both familiar with.

However, this is one of those where I ruled it out just to be able to focus on all the other supplements I am taking. Early on, before I knew how well I was responding to Sutent + Xgeva, I was so paranoid about interfering with Sutent (because I had no side effects), that I just crossed it off my list. And then I forgot about it.

I take it you still are drinking it with no ill effect? If so, I should revise my caveat on that one.

Vitamix
I love my vitamix! Very powerful and you can make nut butter in a few minutes. Expensive but a good investment!

todd121 · February 2013

NanoSecond said:
Drug and Food/Supplement Interactions
OK, since you have asked, this is from my "guide":

The mechanism for that to occur relates to how most pharmaceutical drugs, including Sutent, are metabolized in the gut. Sutent is a substrate (that is, a chemical that is acted on by an enzyme) for the enzyme known as Cytochrome P450 3A4 (CYP3A4). However, other drugs or foods may also be substrates for CYP3A4. If so, they may compete with Sutent for the amount of CYP3A4 enzyme that is available. If these substances use up a lot of the CYP3A4 enzyme then the Sutent may not get metabolized properly. Instead Sutent may remain in the blood stream at an abnormally high level. This could possibly lead to some very severe side effects.

Any supplements (or other medications or foods) that increase (or “induce”) the activity of this enzyme (such as St. John's Wort) will decrease the concentration of Sutent getting into the bloodstream. The increased activity of CYP3A4 will cause Sutent to be metabolized too quickly, resulting in less of it being available to fight angiogenesis (blood vessel creation). In contrast, anything that decreases (“inhibits”) the activity of this enzyme (such as grapefruit, grapefruit juice, or green tea) will increase the concentration of Sutent staying in the bloodstream. That result could become dangerous.

My general rule is that I do not take any drug or food inhibitors that increase the activity of the CYP3A4 enzyme (i.e. decrease the amount of Sutent getting into my system). On the other hand I still do take some supplements that "might" be inducers and could serve to increase the Sutent level. This is only because, so far at least, I have not had any significant side effects to deal with. However, I still will not drink any green tea or eat any grapefruit or grapefruit products while on Sutent. These items are too potentially harmful to mess with.

Some other CYP3A4 inducers to avoid can be found here:

http://www.gistsupport.org/treatments-for-gist/sutent/sunitinib-sutent-basics-for-gist.php#6

There are also a few other potential interactions to consider. Variation in the CYP3A5 enzyme may also affect Sutent levels. However, none of the supplements I use happen to impact this enzyme. The gene ABCB1, which stimulates the protein p-glycoprotein, can also impact Sutent concentrations. P-glycoprotein helps cancer cells ship medications out through the cell membrane. Note that Curcumin and Quercetin are two supplements that may inhibit p-glycoprotein, which, in turn, could increase the concentration of Sutent in tumor cells.

This information plus much more available if you email directly at: n.feldman@videopost.com

CYP3A4

Hi Neil,

Thanks for the explanation. Even though everolimus works in a different manner than sutent and the other anti-angiogenesis drugs, its uptake seems to be affected by the same enzyme.

In addition to avoiding grapefruit and st. johns wort (didn't see green tea on that list), I was given a long list of drugs for my doctor NOT to prescribe. There were some common antibiotics on that list.

By the way, the GIST website seems to have been re-organized and that link above wouldn't work. I tried searching around but couldn't find the page you were referring to.

My doctor has strongly discouraged me from taking pretty much any supplements. I'm supposing he's worried about these kinds of interactions (or perhaps he's just worried about the supplements screwing around with their data when they collect and analyze my blood). I'll have to ask him about this next time. I was really only taking vitamin D3 and a fish/borage/flax seed oil and a low-dose aspirin (which I was encouraged to take even by my nephrologist). He asked me to stop them while I was on the drug.

Todd

NanoSecond · February 2013

todd121 said:
CYP3A4
Hi Neil,

Thanks for the explanation. Even though everolimus works in a different manner than sutent and the other anti-angiogenesis drugs, its uptake seems to be affected by the same enzyme.

In addition to avoiding grapefruit and st. johns wort (didn't see green tea on that list), I was given a long list of drugs for my doctor NOT to prescribe. There were some common antibiotics on that list.

By the way, the GIST website seems to have been re-organized and that link above wouldn't work. I tried searching around but couldn't find the page you were referring to.

My doctor has strongly discouraged me from taking pretty much any supplements. I'm supposing he's worried about these kinds of interactions (or perhaps he's just worried about the supplements screwing around with their data when they collect and analyze my blood). I'll have to ask him about this next time. I was really only taking vitamin D3 and a fish/borage/flax seed oil and a low-dose aspirin (which I was encouraged to take even by my nephrologist). He asked me to stop them while I was on the drug.

Todd

CYP3A4

Hi Todd,

Thanks for the heads up on the link. I will check it out and get you the right one.

Yes, many oncs discourage their patients from taking supplements or even considering changing their diet. Fortunately mine is not that way.

I always encourage anyone interested in following a similar approach to mine to do it with their doctors full approval. So, perhaps if you sit down and fully explain just who is ultimately in charge making your decisions he may become more open to consider this approach.

That is why I have done so much research on my own. I always try to come fully prepared with the best science and evidence at my disposal whenever I discuss what I propose to do next with my onc. On several occasions he has told me, "you know I am learning a lot from you". I never expected to hear that.

Never forget that only you can be your own best advocate.

todd121 · February 2013

NanoSecond said:
CYP3A4
Hi Todd,

Thanks for the heads up on the link. I will check it out and get you the right one.

Yes, many oncs discourage their patients from taking supplements or even considering changing their diet. Fortunately mine is not that way.

I always encourage anyone interested in following a similar approach to mine to do it with their doctors full approval. So, perhaps if you sit down and fully explain just who is ultimately in charge making your decisions he may become more open to consider this approach.

That is why I have done so much research on my own. I always try to come fully prepared with the best science and evidence at my disposal whenever I discuss what I propose to do next with my onc. On several occasions he has told me, "you know I am learning a lot from you". I never expected to hear that.

Never forget that only you can be your own best advocate.

Good Doctor

Sounds like you have a good one. My uncle is like this. He's very open to discussing things and listening and he's very scientific and wants to see data, and he looks at the data and makes a decision. He listens.

Glad you have found a good doc.

I think mine would listen if I brought data/scientific facts with me. I'm pretty weak in all of this biochemistry. I read the explanations and studies, and the terminology often blows me away. I read a phrase and think "that has two possible meanings. which is it?". I've emailed my uncle, and he explains it. Then I understand. It's mainly just a lack of familiarity with a lot of specialized lingo.

My doc is very smart. He's one of those child prodigy types. UCLA med school at 17. If I'm going to change his mind, I should be well armed.

Todd

one putt · February 2013

JUICERS

Mike I highly recommend the vitamix. With its powerful motor you could grind a cell phone so nuts should be no problem. It's also a great multi-tasker.

Texas_wedge · February 2013

one putt said:
JUICERS
Mike I highly recommend the vitamix. With its powerful motor you could grind a cell phone so nuts should be no problem. It's also a great multi-tasker.

Vitamix

Isn't it just - so versatile - you can make great hot soups with it too. [ Do you find, as I do, that it's a good idea to clean it as soon as possible after use? I find it more laborious to clean if I leave it for a while, even full of water to soak. ]

Texas_wedge · February 2013

NanoSecond said:
Green Tea
Tex,

Yes, technically you are correct. There has not been any new data (that I am aware of) other than the studies you and I are both familiar with.

However, this is one of those where I ruled it out just to be able to focus on all the other supplements I am taking. Early on, before I knew how well I was responding to Sutent + Xgeva, I was so paranoid about interfering with Sutent (because I had no side effects), that I just crossed it off my list. And then I forgot about it.

I take it you still are drinking it with no ill effect? If so, I should revise my caveat on that one.

Green tea

Funnily enough, Neil, my situation is similar to yours (must be the chRCC!) insofar as my docs tend to say they learn from me also, and my lovely young onc is very good at following up on things she doesn't already know about.

However, she's actually very well-(in)formed and it was her advice that I should give up green tea until the hash has been settled on that matter (if ever). So, reluctantly, I don't drink green tea at present. Had she not made the suggestion to err on the safe side I would have gone on drinking it - just a mug or two a day, but would have increased that in due course, I think. So, annoyingly, I can't contribute to the evidence and maybe your caveat should remain in place.

Texas_wedge · February 2013

rae_rae said:
Vitamix
I love my vitamix! Very powerful and you can make nut butter in a few minutes. Expensive but a good investment!

Vitamix

Rae, I think I prefer your recipe to John's (although I think I'd be even more reluctant to grind my nuts than my cell phone!).

one putt · February 2013

MR. vs. MRS.

Tex, I always clean the vitamix immediately after using while Alice likes to wait. We used to have "discussions" about this until my bride explained her rationale for waiting. It seems it makes it easier(quicker) to make herself another frozen margarita. Hardly seems fair, we get the Votrient, while she gets the frozen margarita.

angec · February 2013

NanoSecond said:
Juicer
Hi Mike,

The Vitamix was recommended to me as the best. It may also be the most expensive.

But I don't use any of them.

Please email me at: n.feldman@videopost.com

I have done lots of research on what I dub a "proper diet" and "appropriate" supplements that one might wish to consider taking to reduce the side effects from TKI's and to help miminize or prevent mets, etc. In it I explain the science and rationale behind what I am doing. I have been taking the maximum dosage of Sutent (50mg/day) since August and have had no significant side effects (yet).

I am also (so far) showing "dramatic" (positive) response in fighting my bone mets.

It is a long .pdf document which is why you need to email me - so I can email it back to you (or anyone else interested).

Best wishes,

-NanoSecond (Neil)

Hi Nano, how are you? Would

Hi Nano, how are you? Would love to see the document if you can kindly email to me. angemccoy@yahoo.com.. thanks much!

angec · February 2013

one putt said:
MR. vs. MRS.
Tex, I always clean the vitamix immediately after using while Alice likes to wait. We used to have "discussions" about this until my bride explained her rationale for waiting. It seems it makes it easier(quicker) to make herself another frozen margarita. Hardly seems fair, we get the Votrient, while she gets the frozen margarita.

Ha! Take it from me, Alice

Ha! Take it from me, Alice NEEDS the Margarita.. in fact, I need one also!!!

NanoSecond · February 2013

angec said:
Hi Nano, how are you? Would
Hi Nano, how are you? Would love to see the document if you can kindly email to me. angemccoy@yahoo.com.. thanks much!

Guide

It is on its way to you through cyber-space.

Juicer/recipe recommendations?

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