Is exercise with ADT the Secret Sauce?

Scott, what you’ve experienced with 6 months of ADT is really unfortunate - and, I think, not the usual outcome.
Your side effects seem profound, almost like someone years on ADT!
Even my urologist, who told me I didn’t need ADT with salvage radiation, said that 6 months of it wouldn’t hurt me if I was set on having it.
Don’t get hung up on “osteopenia” - it’s a nice way to scare people into “bone building” meds. VitaminD with K and resistance exercise stimulate bone growth much better with NO side effects ( read the label on those drugs - Orgovyx is nothing!).
What they never tell you is that while bisphosphonates (bone drugs) promote calcification of the vertebrae, they cause “spontaneous” fractures of the long bones. Nice, huh?
Your T problem and your fear of testicular failure should probably be addressed first since your trend is downward. You may need an endocrinologist to administer a cocktail (my word) to balance everything out, raise the estradiol, etc. Probably way too early for supplemental T after recent treatment, but I am not qualified to say.

Thanks Phil. They haven't tried too hard to push bone building drugs on me but did say they were available if I wanted them. I'm taking calcium and vitamin D3 so will keep on with that for awhile and keep up exercising. I did not know about the bone drugs causing fractures. It seems every drug causes side effects that require another drug that causes more side effects, etc. etc.

I think once it warms up enough to start my long bike rides again my mood will drastically improve and that being stuck inside for long periods of time is a big part of my mental health issues. Going to the gym is fine and all but not nearly as nice as pedaling up a steep hill and seeing the view from the top of trees, etc.

I will look into seeing an endocrinologist. They told me I need to wait at least two years before considering supplemental T and strongly discouraged me not to take DHEA, the precursor to T, but did say a Zinc supplement can't hurt so we'll see. The worst part is still feeling the ADT symptoms when the doctor says the drugs have been out of my body for awhile now but it is what it is. The small print on the Orgovyx web site does imply a small percentage of people don't recover, I just never imagined myself in that small percent.

I guess I need to appreciate that at least my cancer is in remission for now and that I can still do most of what I did before. My brain logically knows that being angry and sad is unproductive.

Making peace is always a work in progress. I doubt you have any so-called "character defect," just a lot left to process.

I'd give yourself at least 2 years after diagnosis to adjust to your new reality. You'll never be sitting around in karmic bliss, but 🤞 it will feel more normal to you.

I am on Calcium and Vitamin D My Doctor
put me on this to avoid bone problems.

Ditto. My family doctor said the vitamin D (1,000 iu/day) helps with the calcium absorption. Like Omega 3 (also recommended by my doctor), those are just generally good supplements to take as you age, even if you're not on ADT.

As others have mentioned, moderate resistance training (weights, exercise bands, etc) can also make a big difference for bone health.

If you are on ADT, you need more than calcium and vitamin D.

A few months ago I was at a webinar. A doctor came on who was a specialist in bone health for prostate cancer. When he finished his presentation, he said that everyone who has ADT should be on a bone strengthener.

Fosamax, Xgeva and Zometa are the usual choices. Fosamax is a pill you take once a week. The other two are infusions.

Ask your doctor about this. If you’re only on ADT for a very short time then maybe you don’t need it.

I'm the kind of guy that always sees the dark side first. But, I finally went to the gym 3 times this month. Just came out of deep depression and anxiety. I think it is related to ADT. But it's hard to tell because I've got Parkinson's disease as well. I did ketamine therapy and it's a lifesaver.
I'll be 80 this year and I want to be as healthy as I can be.
It's been a rough year but I'm working on making this year better.
Exercise is vital for both my conditions.
So I hope you can push through and go forward. It takes every and commitment, but the pay offs are worth it in the run. Good luck.

ADT can cause depression in a lot of people. Good to hear you’re coming out of it.

If it starts to come back, there are some medications that can resolve that depression problem.

I had depression and anxiety before my prostate cancer diagnosis due to my Parkinson's disease. Things were going along fine until my ADT shot on top of a bad case of shingles. Then my meds quit working.
Now I have what's called Treatment Resistant Depression, meaning normal antidepressant meds don't work on me anymore. Now I get ketamine therapy and it took care of the depression and the anxiety

It’s great to hear ketamine is so effective. I know some people get like six sessions at first. And then some of them repeat it, though the frequency varies.

How much treatment was it necessary for you to get out from under the depression?

Other people come on here with depression as well, They would be interested in hearing more.