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ADT, Hot Flashes and Ashwagandha: Is it safe?

Posted by slowdo @slowdo, 1 day ago

I have received 3, three-month Lupron shots and radiation therapy for Gleason 3+4 prostate cancer. After the final shot in June, my PSA was < 0.01ng/mL (undetectable). Still going through major hot flashes. As I understand it, the hot flashes will slowly get better as the testosterone level rises, but I would prefer months to years for improvement. Ashwagandha moderately boosts testosterone, and has other anti-cancer effects. Sources always stress not to take ashwagandha during ADT, but never mention AFTER therapy. So, the basic question is... is it safe to consume ashwagandha at this stage in my treatment?

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slowdo | @slowdo | 12 hours ago
In reply to @brianjarvis "@slowdo If you’re tracking testosterone (T) levels, that will indicate when treatments have ended. > what..." + (show)
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@slowdo If you’re tracking testosterone (T) levels, that will indicate when treatments have ended.
> what was your T level before starting ADT?; what is your T level now? (If T levels are still low, that may explain why you’re still suffering major hot flashes and poor sleep quality.)

Your PSA should increase slightly once the ADT leaves your system and T levels begin to rise significantly. I would wait until then before considering a testosterone boost,

Actually, a 2.0ng/ml rise in PSA above nadir (called the Phoenix Criteria) is the clinical definition of biochemical recurrence (BCR) following initial radiation. That’s a number you don’t want to reach. (See attached chart showing my PSA at the start, during, and since radiation. If my PSA ever exceeds 1.0ng/dL, we’ll start discussing next steps well before a 2.0ng/ml rise in PSA has occurred.)

In addition to regular testing of Total PSA going forward, you’ll want them to also test and track:
> Free PSA
> PSA Velocity
> PSA Doubling Time

> A separate question: Did you have a DEXA scan prior to starting ADT?

Also, they should be checking all of your other bloodwork (i.e., CBC & CMP) to ensure that the radiation treatments haven’t caused any other issues.

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@brianjarvis
Wow! That's a lot of data to digest right now, so I'll reply again later. Just want to say thank you for your time posting this.

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