Muscle recovery time post 12 months ADT

I am so sorry to hear that : (. You said that you maintained status quo but you also stated that you lost a lot of muscle so it is little bit contradictory but it is not important - the important fact is that you lost muscle : (.

To maintain muscle one really has to push them to work so perhaps resistance level that you used was not enough. Can you find personal trainer or ask to get referral for PT sessions where somebody will show you what you need to do ? Some weight training would be very beneficial as well as lot of exercising of a lower body with deep squats holding weights, bicycling with high resistance mode, Nordic Track machine etc. Some people however have physical limitations so having professional trainer help you would be probably very helpful. My husband exercises every day, perhaps you need to up the amount of exercise.

Also - you must have adequate amount of good quality protein in your daily food intake (chicken, fish , turkey) and added protein shake (whey protein or soy protein powder , no additives, gums, color or artificial aroma - please do not buy prepacked " Ensure" or similar).

Wrinkles- eat a lot of fresh fruits and veggies and take antioxidant vitamins and stay very hydrated. If you wrinkles are now mostly on your arms and legs, that is because you lost muscle mass : ( and you now have skin that is somewhat loose. As soon as you regain muscle wrinkles will be gone. Also skin has ability to "shrink" and adjust to new dimensions but it goes much slower with age. To help skin you need to stay very hydrated and also choose a body cream that you like (or any natural oil) and apply it every day.

Don't give up - this can definitely be improved , you just need proper nutritional and exercise program and perseverance 👍

About half the people have their testosteronereturn to >280 3 months after they stop Orgovyx.

That allows you to rebuild your muscles. Low testosterone makes it extremely difficult to build muscles at the best. You can keep them where they’re at by heavily exercising.

In the HERO study, relugolix demonstrated sustained testosterone suppression superior to that of leuprolide acetate (97% vs 89%; difference 7.9% [95% confidence interval, 4.1–12%; p < 0.001]).

Men (N = 934) were randomized (2:1) to receive relugolix 120 mg orally daily or leuprolide acetate injections every 12 wk for 48 wk.

Overall, 74 of the 137 men in the relugolix cohort recovered to testosterone >280 ng/dl, with a median time to recovery of 86.0 d (95% CI, 65.0–92.0), versus two of the 47 men in the leuprolide cohort, with a median time to recovery of 112.0 d
https://www.sciencedirect.com/science/article/pii/S2588931123002900

@jeffmarc hey Jeff, I think you ment in your first paragraph that the testosterone level returns to>280, NOT the PSA.

@jheadding
Thanks you told me soon enough that I was able to correct it.

It is common to gain weight while on ADT, and as noted it is not muscle. It is probably better that lost muscle is not being replaced with fat even if you have to deal with a few wrinkles.

Thank you folks for your responses!

@jim18

One can grow muscle without testosterone - it happens at slower pace than in a healthy person but studies show that it is absolutely possible.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9997646/
And example :

Fascinating article. Thanks for sharing!

Being on Orgovyx, your return to normal should occur quicker than what I experienced on Eligard.

I was a gym rat even before treatments. I lifted weights every day immediately after every proton radiation session (and also either swam for 30-35 minutes or ran 5Ks on alternating days).

I had two 3-month injections of Eligard, one in April 2021; the other in July 2021. I recall telling my wife (in January 2022), that I thought the Eligard was wearing off because I was beginning to lift heavier weights at the gym. Since I wasn’t due for another “official” bloodwork for another couple of months, I self-ordered another PSA & testosterone test (out of curiosity), and those came back as 0.13 & 403.0, respectively, meaning that everything was going exactly as expected - that is, PSA staying low and testosterone trending up as the Eligard was leaving my system.

Track your testosterone levels; that’s what determines when your strength will come back. Yours shouldn’t take long once you stop the Orgovyx.

Now that I'm 7 months into taking Orgovyx, I've noticed a slight but noticeable increase in my lower and upper body muscle size. I do 30 minutes of cardio 3 times a week, every other day, and on alternate days, approximately 50 minutes of resistance training 3 times a week. I take Sundays off.

That article surftohealth88 posted above has a section entitled "Exercise intervention program" where they describe exactly what they got their patients to do. They measured the maximum resistance for each patient could perform for each upper and lower body exercise, they call this the 1RM or one repetition maximum, then they designed a program for each patient consisting of sets of 10 reps of each of those exercises starting at 60% of that resistance, ramping the % up and back down so they could gather data. 2 sessions a week, 60 minutes total.

If your exercise program is something similar to what the cited article describes and you are not experiencing results, it is possible you could improve the situation.

The exercise oncologist I studied, Dr. Robert Newton, has been researching how to use exercise to help prostate cancer patients for decades.

The way he suggests, using a pin loaded machine for instance, is to set a resistance light enough so you can perform at least 6 reps, but heavy enough so by the time you've performed 12 reps you feel like you could only do 1 or 2 more before it simply would not be possible to continue. As time goes by and doing 12 reps is getting too easy, increase the resistance by 5 or 10%, making sure you can still do at least 6 reps. He suggests a routine including chest press, seated row, lat pulldown, leg press, leg extension, and leg curl.

I add a biceps curl machine, glute drive machine, and ab/aduction machine to that. It takes me 50 minutes to do my resistance routine. I keep a chart showing what resistance I set each exercise machine for the last time I used it, and as it gets easier to achieve 12 reps, I keep upping the resistance as Newton suggests.

His clinic uses machines that can be programmed to offer a different amount of resistance to each phase of an exercise, i.e. less for the concentric than for the eccentric phase. His research has indicated that this is the most effective way for a patient on ADT to gain muscle mass, i.e. to exercise on machines capable of doing this.

My gym has nothing like this. What I do to partially simulate this is to take 4 or more times longer to perform the eccentric phase of an exercise than when performing the concentric phase. I may not even understand what I'm doing here, but the way I figured it, for instance, during a leg extension, I quickly raise the legs straight out, then take much longer to lower the legs down. A biceps curl is quickly contract the muscles to lift against the resistance, then slowly straighten my arms out. This is my understanding of what Newton suggests. YMMV.

I experienced what exercise experts call DOMS, i.e. delayed onset muscle soreness, which sometimes was especially intense when I started out. Newton says this is not something to try to avoid. It can be a signal there is a problem you need to consult an expert about, but it is also the signal you're doing the right thing. I backed off a bit if the DOMS was severe, but I took it as a signal to slow down the rate of increase in exercise intensity, not as a signal I needed to reduce.

Newton has a book MyExerciseMedicine for Cancer.

He published a short article explaining his views: Prostate cancer treatment with
exercise medicine" https://onlinelibrary.wiley.com/doi/epdf/10.1002/tre.884

Newton, et.al. 2012 "Can exercise ameliorate treatment toxicity during the initial phase of testosterone deprivation in prostate cancer patients?” has a section "Exercise intervention" that describes exactly what he had the patients he was studying do. https://pmc.ncbi.nlm.nih.gov/articles/PMC3519595/

Newton has researched how to preserve bone health during ADT as well. He published "Exercise Mode Specificity for Preserving Spine and Hip Bone Mineral Density in Prostate Cancer Patients". I found the whole article which describes what the patients he studied were required to do, but any link I found just now is only to the abstract. Maybe I sent in a special request for access or something.