Most of the fatigue comes from being in a low-testosterone state, not the specific ADT drug. I lift 4 days a week and rarely feel it in the gym, but yard work — especially in the heat — can bring on rapid fatigue. I’ve learned to pace myself with house or yard chores, go slow and easy, and stay hydrated. My personal experience is that both exercise and diet play a role — I’ve cut way back on sugar, can’t drink alcohol at all, and the fatigue can be random. Sometimes it just hits out of nowhere and then passes.