1. < Prostate Cancer

Testosterone Replacement Therapy after RALP

Posted by jeb0505 @jeb0505, Sep 16 1:38pm

I get so many mixed messages about Testosterone Replacement Therapy, i've read contradicting information from different clinics/hospitals, etc., so it's hard to know where to begin.

My question is for those who have spoken to their doctor about this, and especially for those who are now taking TRT after surgery. First- what has your doctor said about taking TRT after surgery, and Second - have you been given any alternatives to TRT?

My T level prior to finding out I had cancer was sub 300 ng/dL, when on Test, my levels were raised to about 700 to 800 ng/dL... Following my diagnosis, i stopped taking T, and i could definitely notice a change for the worse. After surgery, it's noticable worse. By me, my wife, even friends notice a change in "me"... I talked to my doc about it, and he suggested waiting for 'at least 1 year after surgery'... well, surgery was in May, and i am seriously dealing with side effects.

Any help from those who have had similar experiences, is appreciated.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

jeffmarc | @jeffmarc | Sep 27 6:54pm
In reply to @stevecando54 "we both about the same, age included. I get firmagon once a month and take Abiraterone..." + (show)
@stevecando54

we both about the same, age included. I get firmagon once a month and take Abiraterone daily. Been on this for the last 18 months. Have the fatigue since the beginning. I will say I don't believe it has gotten worse over time but I sure know I have it. You just have to do the best you can to keep moving. Having it every day at times wears me down. I sometimes have to fight through it so I don't fall into that hole. I consider a good day when I keep my head on straight and have a good time, fatigue be damned. Welcome to the site, so many here that share, and I wish you the best on your journey. Best to all

Jump to this post

The reason they give you prednisone with Zytiga is to replace the cortisol lost by taking Zytiga.

Low cortisol can be a problem. According to a web search low cortisol causes this.

‘Low cortisol levels can cause any of the following symptoms: Fatigue and morning sluggishness. Depression. Anxiety.”

It’s possible you can talk to your doctor into increasing your prednisone from 5mg to 7.5mg or 10mg to see if that relieves some of the fatigue problems. Some doctors actually give their patients 10 mg of prednisone with Zytiga. Can’t hurt to ask.

REPLY
1 reply
stevecando54 | @stevecando54 | Sep 28 4:16am
In reply to @jeffmarc "The reason they give you prednisone with Zytiga is to replace the cortisol lost by taking..." + (show)
@jeffmarc

The reason they give you prednisone with Zytiga is to replace the cortisol lost by taking Zytiga.

Low cortisol can be a problem. According to a web search low cortisol causes this.

‘Low cortisol levels can cause any of the following symptoms: Fatigue and morning sluggishness. Depression. Anxiety.”

It’s possible you can talk to your doctor into increasing your prednisone from 5mg to 7.5mg or 10mg to see if that relieves some of the fatigue problems. Some doctors actually give their patients 10 mg of prednisone with Zytiga. Can’t hurt to ask.

Jump to this post

I've been on 10mg of prednisone since the beginning. I will talk with my oncologist next month about this. Does cortisol levels show up in blood work? I get tested for quite a few every month, I look at them but don't understand a lot of them. Of the list you mentioned the only one I could cross off is anxiety, otherwise the list fits me. Thanks for the info. Best to all

REPLY
2 replies
tuckerp | @tuckerp | Sep 28 8:20am
In reply to @stevecando54 "I've been on 10mg of prednisone since the beginning. I will talk with my oncologist next..." + (show)
@stevecando54

I've been on 10mg of prednisone since the beginning. I will talk with my oncologist next month about this. Does cortisol levels show up in blood work? I get tested for quite a few every month, I look at them but don't understand a lot of them. Of the list you mentioned the only one I could cross off is anxiety, otherwise the list fits me. Thanks for the info. Best to all

Jump to this post

I suffer from Polymyalgia Rheumatica. (PMR) an autoimmune disease. As with many autoimmunes steroids are used to treat it. Your symptoms fit steroid use. The test for cortisol is ACTH but the test is useless for testing cortisol until you get down to about 2-3mg of prednisone. Prednisone is an anti inflammatory and immune suppressant. Besides the list jeffmarc gave it raises blood pressure, raises cholesterol, raises A1C, causes gastric issues, floaters in the eyes, and bone density issues. Physical features such as moon face, thin skin, and weight gain. The worst thing is that after 2 weeks your body stops making cortisol. Prednisone is supplying it. You cannot live without cortisol. The bodies adrenal system will have to slowly restart while you taper off prednisone. The length of time and dosage of prednisone can effect this restart. You will go into extreme pain if you taper to quickly. Prednisone will fix a lot of issues but it is the devils tic tac. Google "prednisone and cortisol".

REPLY
jeffmarc | @jeffmarc | Sep 28 10:51am
In reply to @stevecando54 "I've been on 10mg of prednisone since the beginning. I will talk with my oncologist next..." + (show)
@stevecando54

I've been on 10mg of prednisone since the beginning. I will talk with my oncologist next month about this. Does cortisol levels show up in blood work? I get tested for quite a few every month, I look at them but don't understand a lot of them. Of the list you mentioned the only one I could cross off is anxiety, otherwise the list fits me. Thanks for the info. Best to all

Jump to this post

The reason I recommended more prednisone was because I thought your problem was fatigue. now that I review what you said I do not see that mentioned.

I’m not sure what changes you are referring to. I was speaking to someone yesterday who has major fatigue, problems, and hard time getting out of bed in the morning. he’s on 5 mg and a shortage of cortisol could be causing his problems, and more prednisone might fix it.

Not knowing the details of “changes in me” Makes it difficult to suggest anything. Maybe in your case you’re taking too much prednisone.

You definitely have to talk to your doctor and try to resolve this. You might consider getting a palliative care doctor. They work with people to resolve conflict with medicine they are taking that are causing them medical problems.

REPLY
1 reply
stevecando54 | @stevecando54 | Sep 29 4:57am
In reply to @jeffmarc "The reason I recommended more prednisone was because I thought your problem was fatigue. now that..." + (show)
@jeffmarc

The reason I recommended more prednisone was because I thought your problem was fatigue. now that I review what you said I do not see that mentioned.

I’m not sure what changes you are referring to. I was speaking to someone yesterday who has major fatigue, problems, and hard time getting out of bed in the morning. he’s on 5 mg and a shortage of cortisol could be causing his problems, and more prednisone might fix it.

Not knowing the details of “changes in me” Makes it difficult to suggest anything. Maybe in your case you’re taking too much prednisone.

You definitely have to talk to your doctor and try to resolve this. You might consider getting a palliative care doctor. They work with people to resolve conflict with medicine they are taking that are causing them medical problems.

Jump to this post

This site has been so good to me. These last few posts got me to thinking about my meds and side effects. Some how I forgot I get a Xgeva treatment each month for bone strength. Side effects include shortness of breath and fatigue. Bingo, I finally realize where my sides are coming from. I was on monthly for one year, now I just started getting quarterly. Hoping they back off some over time. I've been pushing through for the last 18 months but at times it gets rough with no let up. This site has been a blessing to me with so many caring and sharing people on here, I thank all you. Best to all.

REPLY
View MoreView Less
Please sign in or register to post a reply.