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ADT fatigue- How bad can it get for some men?
I started Firmagon 4 months ago, and am just beginning radiation this week. Localized 4+3, PSA at diagnosis was 28, now down to 0.66. Testosterone is <10.
All I want to do is lay down on the floor and crawl into fetal position, I am so fatigued. I can microwave a dinner, or do dishes, but in 10 minutes I want to go back to bed. I'm 73, was reasonably energetic (not a jock, though)... but i do have a history of bad depression fatigue in past.
The oncologist has checked everything blood and thyroid-wise, no real red flags.
Can the low T cause fatigue this severe? If I only do a year of Firmagon might I have a reasonable hope of energy in the future? Cause I can hang in there if this is the price of healing.... but it should would help to hear a "yep, been there, done that" from somebody.
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I had 44 IMRT treatments and completed 18 months of Orgovyx 4 weeks ago. Exercise reduces fatigue. I exercise a little over an hour weekdays: a combination of aerobic, stretching, and resistance. It hasn't eliminated fatigue, but it gives me some hours of relief most days. If you stop moving, eventually you won't be able to move...the old "use it or lose it" cliche. Dr. Robert Newton of Australia has a helpful YouTube video on types of exercises recommended. ADT can reduce muscle mass significantly; exercise reduces that effect.
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3 ReactionsFor Mr Datasourse. I would ask your doctor why the need for a full year of Firmagon? Localized 4+3 is usually 4-6 months. And then ask him about expected recovery times. For me, 5 months of Firmagon and 5 months later my testosterone is still undetectable. So 10 months total, so far. For you, if you are “on” it for a year, you may be “on” it for 18 months or longer. ADT only does one thing very well and that’s fight prostate cancer. There are so many other things that it negatively impacts. You alone will be the decider on how far into this you want to go. When the bad outweighs, the good you’ll know what to do. Always remember that you are the one steering the ship.
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2 Reactions@jeffmarc
What is your Testosterone level for not having a fatigue problem?
On ADT at 72, I too felt very fatigued. I restarted exercising and getting in the sunshine. This helped tremendously!
Best o’ luck to you!
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4 Reactions@ava11
I’ve been on ADT for eight years. I was on Zytiga Which reduces your testosterone even lower for 2 1/2 years.
My testosterone is normally below five.
For some reason, I just don’t get the fatigue. I’ve always been pretty hyper, however. Maybe it makes me normal instead of fatigued.
@jeffmarc Yes. I am only 2.5 months into but so far I get a night sweat now and then. No fatigue.
@dhasper
The Embrlabs.com Wave 2 Device works really well to stop the night Hot sweats. It pretty much stop them for me. At one of the online meetings I was on Tuesday one of the guys messaged me saying it was working great for him using the instructions I sent him. It works for a lot of people also. If you’re gonna be on ADT for a long time, it can be worth getting one.
If you do get one, send me a message and I can send you the instructions for how to optimize it. I’ve been using them for five years and I’ve worked closely with the company. I was even in one of their TV ads.
@xahnegrey40 Thank you. That’s what I say fuck it. Let’s get with it.
Exercise and good nutrition help with SA a lot. My husband exercises every day and likes those series :
There are actually 12 weeks for every level (I provided a link for medium level, week 1 as an example - there are other levels too).
Mr. Surf hates going to the Gym , he likes outdoor sports , so this "do it yourself" program which can be done at home is very attractive to him . It is also very adjustable - one can do any exercise with small weights or bigger ones or with more reps depending of a fitness level or ability in general.
He also fast walks 3 miles a day (early morning) and does plyometric exercises for bones.
He drinks soy milk and uses whey protein shakes mid day with some added supplements.
He is on Orgovyx for 2 mos and Nubeqa for a month and so far has no side effects of any kind. His testosterone fell to 6 from 746 in 2 weeks.
My 30 year old daughter joked the other day and asked if she can have some of that "ADT" lol since he is so full of energy 😆 and she was feeling very tiered that day. My husband is attributing good tolerance 100% to exercise.
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4 ReactionsI am on month 7 of planned 12 month Orgovyx (started 12/2025) though I had a single 3-month Lupron injection 9/2026 as I was receiving SBRT. The midday fatigue and aching musculoskeletal pain in my legs/feet are getting progressively worse, not easing, as time passes. I exercise daily (Zumba, occasional elliptical, bicycling, walks, and Pilates) by ignoring the pain and pushing through. It strikes me that the next few months will be difficult. My PSA has come down from 15.1 ng/ml to 0.04 ng/ml and my testosterone, of course, is <10 ng/dL. Some days I wonder if I can make it, but I don’t want to shortchange the opportunity for ADT to achieve its fullest effect.
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