Hi Beth,

Hi Beth,

You are right that increasing absorption of a TKI does render a higher 
dose, and for me, yes this caused more side effects on Sprycel, but my side 
effects in hindsight were an auto-immune reaction.  Here is the thing about 
lemon juice, vinegar, coke or anything that increases stomach acid, it is 
possible, as gleened from personal annecdotes and my personal experience, 
that Sprycel, and possibly other TKI's, actually cause a reduction in 
stomach acid over time reducing the amount of absorption of a dose that 
would otherwise be affective on our CML.  There are still so many unknowns 
about these drugs.  Whether that is the case or not, at a point where a 
dose is no longer affective, doctors have simply increased the dose, rather 
than trying to increase the absorption!  I personally think that there is 
more control over how much you are absorbing and the toxicity of a drug by 
simply restoring your ability to absorb a medication rather than increasing 
the dose.  If you are taking, let's say, 100mg of a drug daily, increasing 
the absorbtion by intentionally increasing acidity still can never give you 
more than 100mg, but if you increase that dose to 140mg, on any given day 
you could absorb more...up to the full 140mg, as the acidity level is 
natually affected in your stomach by what you eat.  Sort of like why a 
particular food will give you heartburn on one day but not another...due to 
natural fluctuations in stomach acid.   This is just my thought on this.  

As an interesting side note, when this vinegar topic came up here last 
year, I had noticed that not only was my sprycel dose not as affective but 
that every time I ate I got stomach pain and indigestion.  On an 
experiment, I tried lemon juice to ease the indigestion and stomach pain 
and it worked.  There is much anecdotal evidence of this online as an 
indigestion aide.  So to take my experiment one step further, I started 
swigging lemon juice before my meals, and it completely put an end to my 
indigestion!

As far as wound healing...yes...this was my experience also on all of the 
TKI drugs, wounds do not heal well or quickly!  In the case of Sprycel, my 
skin was extremely dry and did not heal well from any type of wound, 
surgical or injury. I also noticed that I had an absorbtion problem from 
medication patches...in my case estrogen...it simply did not absorb well.  
I also had a more extreme reaction to chlorine when I was doing pool 
therapy, but found that using a heavy mosturizer prior to contact kept me 
from breaking out in an itchy rash.  Wounds will eventually heal but must 
be safeguarded, with extreme vigilence, from infection due to the slower 
healing time.  Hang in there!

Hope my thoughts are able to help in some way.

Peg


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