Surprising tE2 (transdermal estradiol... - Advanced Prostate...

Advanced Prostate Cancer

22,391 members28,156 posts

Surprising tE2 (transdermal estradiol) results...fifth update

E2-Guy profile image
61 Replies

Just received the results from my August 10 blood draw and I am pleasantly surprised. I started using the E2 gel 16 months ago after my PSA continued to rise despite having sacral lymph node surgery in an attempt to counter the post RP BCR. I have chosen this regimen in lieu of Lupron and other ADT drugs because of the devastating side effects that many of you are experiencing. Zero hot flashes/flushes, zero bone density loss, zero fatigue, zero muscle mass loss, zero mood swings...only some gynecomastia! The only other med that I am currently taking is a 0.5 mg dutasteride capsule every third day due to its long half life. I am going to reduce my dosage of the gel since my PSA and T levels have dropped to such low levels. Actually I was not too optimistic about the results since I recently spent two months in Chicago eating all the 'junk' that we shouldn't be consuming like Costco pizza and hotdogs, Italian beef sandwiches, gobs of pistachio ice cream, Czech pastry, etc. My thanks to Richard J. Wassersug, PhD for being my mentor. I highly recommend his books on "Androgen Deprivation Therapy".

Written by
E2-Guy profile image
E2-Guy
To view profiles and participate in discussions please or .
Read more about...
61 Replies
NPfisherman profile image
NPfisherman

Congratulations....

E2-Guy profile image
E2-Guy in reply toNPfisherman

Thank you Don!

Break60 profile image
Break60

Ron

My E2 is a lot lower than yours but T is the same and Psa is .1. I use (3) .1 mg estradiol patches by Sandoz changed twice weekly . Maybe you can get away with less gel than you’re using. What’s your Psa?

Bob

E2-Guy profile image
E2-Guy in reply toBreak60

Bob, I am definitely going to reduce my daily dosage and see what happens in the next three months. My PSA (0.004) is shown on my lab report.

Break60 profile image
Break60 in reply toE2-Guy

That’s amazing. But I’m happy with .1 too. I get all those blood tests every two months.

Tall_Allen profile image
Tall_Allen

Good news! It is also so much cheaper than GnRH agonists and antagonists. I suspect the trials in the UK will be game changing. Do you take aspirin or tamoxifen with it? How are your liver enzymes?

E2-Guy profile image
E2-Guy in reply toTall_Allen

Alan,

I haven't had a recent liver panel done...I will do that soon. I assume you are referring to albumin, bilirubin, AST and ALT levels?

Tall_Allen profile image
Tall_Allen in reply toE2-Guy

Those and PTT. Might as well look at alkaline phosphatase and LDH too.

E2-Guy profile image
E2-Guy in reply toTall_Allen

Sorry that I didn't answer all of your questions in my first reply. Yes I do take a nightly 80 mg aspirin. I have not started taking tamoxifen even though I know you have recommended it several times to help with the gynecomastia. Do you think that since it reduces this side effect of E2 that it could possibly be counterproductive in other ways?

I normally monitor my ALP level (see my lab results); however, I believe that there is another ALP test for the liver...correct?

Tall_Allen profile image
Tall_Allen in reply toE2-Guy

tamoxifen is an estrogen antagonist in breast tissue, but an estrogen agonist in other places. I haven't seen any studies about whether it hurts or helps with E2 therapy. I'd guess it would help, but it's just a guess. Have you discussed with Richard Wassersug?

Bone ALP is a specific kind of ALP. Sorry - I missed that - it looks good!

E2-Guy profile image
E2-Guy in reply toTall_Allen

Thank you Alan. I guess it wouldn't hurt to try it; however, my breasts may already be to the point where reducing the excess tissue growth may not be possible...do you think reversing is possible?

Richard hasn't used tamoxifen himself and still questions if it would interfere with the efficacy of the tE2.

Tall_Allen profile image
Tall_Allen in reply toE2-Guy

They say 20 mg/day reverses existing gynecomastia, but if connective tissue has formed, it will take cortisone injections to break it down. Tamoxifen acts as an estrogen agonist in bone cells, improving BMD and, in high doses, it slows bone metastatic growth in breast cancer. In early studies on prostate cancer, it was mildly beneficial:

clincancerres.aacrjournals....

ar.iiarjournals.org/content...

E2-Guy profile image
E2-Guy in reply toTall_Allen

Thank you for your absolute devotion and assistance to everyone on this forum!

StayingOptimistic profile image
StayingOptimistic in reply toE2-Guy

Ron, this way s what dr. Myers has suggested about the use of tamoxifen and he gives his patients something called ( cabaergoline). That is what I got from his video about the breast enlargements issue.

Break60 profile image
Break60 in reply toTall_Allen

I also take cabergoline to keep prolactin down as well as avodart metformin, rosuvastatin and celecoxib.

Shanti1 profile image
Shanti1 in reply toBreak60

May I ask what dose of cabergoline you take and if you have noticed side effects?

Break60 profile image
Break60 in reply toShanti1

Shanti1

Back in 2015 when I started casodex ( which is known for causing gynecomastia ) to Lupron I started taking (3) .5 mg cabergoline tablets weekly. When I stopped casodex and trelstar (which I had switched to from Lupron) in 2018, I dropped down to two per week then none. After adding more estradiol patches in January 2019 in accordance with the PATCH trial ( I had been using just one patch changed twice weekly since 2015 to eliminate hot flashes), and noticing gynecomastia, I started back on two cabergoline tablets weekly just awhile back. I never noticed any side effects except gynecomastia subsided.

Shanti1 profile image
Shanti1 in reply toBreak60

Thank you for the reply. You have probably seen this paper as it has been posted a couple times on the forum:

A Novel Patient Case Report to Show the Successful Termination of Untreatable Androgen-independent Prostate Cancer: Treatment with Cabergoline ncbi.nlm.nih.gov/pmc/articl...

and this related one:

A Proposed Efficacious Treatment with Clioquinol (Zinc Ionophore) and Cabergoline (Prolactin Dopamine Agonist) for the Treatment of Terminal Androgen-independent Prostate Cancer. Why and How?

ncbi.nlm.nih.gov/pmc/articl...

Anyhow, we are not considering cabergoline at this time, but I like to gather info and have backup plans, and backup plans for my backup plans.

Break60 profile image
Break60 in reply toShanti1

No I had not seen these links and thank you for bringing to my attention. My RO who is very knowledgeable about and only treat PCa is the one who put me on cabergoline and now that you have reminded me it was to eliminate another source of cancer progression other than testosterone. It seems like few oncologists are aware of this.

Shanti1 profile image
Shanti1 in reply toBreak60

We put prolactin on my husband's next blood test. Did you ever check your levels?

Break60 profile image
Break60 in reply toShanti1

Yes every time I get my other blood tests. When I was taking three tablets aweek my prolactin was way low like 2.0. The last test it was 19 . I want to get it back down again which is why I went back in it.

StayingOptimistic profile image
StayingOptimistic in reply toTall_Allen

TA,

I just listened to dr Myers talking about the breast enlargements issue. He mentioned he gives his patients a drug called (cabaergoline) 1/2 mg, 3 pills a week. He didn’t mention the tamoxifen.

HOPEFULSPOUSE profile image
HOPEFULSPOUSE

Congratulations Ron! Amazing. May I ask what your PSA was before you started the topical estradiol?

My husband is about one month in and has had a 16% drop in PSA so far. 🤞🤞🤞

E2-Guy profile image
E2-Guy in reply toHOPEFULSPOUSE

Thank you Emily! My post lymph node surgery PSA was 0.71 16 months ago when I started using the gel. I have posted more details in my profile.

LearnAll profile image
LearnAll in reply toHOPEFULSPOUSE

Is your husbands still on ADT and other stuff ? Is he using topical estradiol along with any other meds and supplements ?

cesanon profile image
cesanon

Reconsider Lupron & casodex. You only hear feedback from those who had problems with it.

People who didn't have problems don't complain about it.

I for one didn't have much problem with it. Just make sure you take it with Vivelle estrogen patches.

Break60 profile image
Break60 in reply tocesanon

If estradiol is working there’s no need to take Lupron or casodex. Plus why put up with the side effects and high cost of Lupron? You’re just feeding the pharmaceutical industry.

cesces profile image
cesces in reply toBreak60

Why wait around to find out after the fact if it is working or not?

Especially if it is not part of any generally accepted standard of care?

Break60 profile image
Break60 in reply tocesces

Not true. Estradiol pills ( DES )were used long ago but stopped due to CV issues. The transdermal patches or gel have been found to have no greater risk than SOC like Lupron for CV issues with less impact on bones and other body functions. The only negative has been breast enlargement which can be controlled with tamoxifen or cabergoline. Google the PATCH trial in UK and read the attached: ncbi.nlm.nih.gov/pmc/articl...

cesces profile image
cesces in reply toBreak60

Well I guess in the end, if the estrogen reduces testosterone to acceptable levels, it really doesn't make any difference as to how you get there.

What is an acceptable range of testosterone for purposes of androgen deprivation therapy?

Break60 profile image
Break60 in reply tocesces

20 or less

cesces profile image
cesces in reply toBreak60

Is that free testosterone or regular testosterone?

Break60 profile image
Break60 in reply tocesces

That's total serum testosterone

E2-Guy profile image
E2-Guy in reply toBreak60

I wanted to say the same thing; however, I'm too old to argue with anyone! Trying to keep the stress level at a minimum...said "To hell with everything in the States" and moved to Thailand!

Break60 profile image
Break60 in reply toE2-Guy

Ron

That’s quite a move! I’m 75 and not too old to argue with people who are uninformed or pigheaded.

Bob

E2-Guy profile image
E2-Guy in reply toBreak60

But I'm older than you are!

Break60 profile image
Break60 in reply toE2-Guy

Ron

Haha so you get to sit back and relax! Good luck!!

monte1111 profile image
monte1111 in reply toE2-Guy

Admit it. You just wanted the drunken noodles.

StayingOptimistic profile image
StayingOptimistic in reply toBreak60

I see it the same way as you do break60, besides if the patches stop working, we can always go on Lupron, correct?

dbrooks_h profile image
dbrooks_h in reply tocesanon

How long have you been on casodex and lupron combo.

jdm3 profile image
jdm3

Good news. Congratulations. I'm glad to know this is working for you.

Thanks for the update! Very interesting!

Have a good weekend. A lot to be thankful for.

JDM

E2-Guy profile image
E2-Guy in reply tojdm3

Thank you Josh! Wishing you utmost success in this war that we are battling.

AlanMeyer profile image
AlanMeyer

I'm always amazed, and impressed, when someone adopts a treatment strategy that runs counter to standard protocols and is successful with it. It shows that there is a great deal that we still don't know about treatment strategies and a lot of need for additional research.

Congratulations on the results of your treatment and thanks for the report.

Alan

E2-Guy profile image
E2-Guy in reply toAlanMeyer

Thank you Alan for the encouragement in my 'somewhat' unconventional regimen! I chose this route based on the successful, (minimal side effect) experiences that my father and his two brothers had taking DES for MANY years. They all had RP's in their early 60s which failed and consequently were put on DES until it was discontinued in the mid 80s and replaced with Lupron. My dad and one of my uncles eventually opted for orchiectomies because of the side effects from Lupron. They all lived into their late 80s!

jfoesq profile image
jfoesq

Congrats- but I have one q for you. If your T levels have dropped significantly, why haven't you suffered the typical SEs from T loss, such as loss of muscle mass. My history is a bit complicated, but, in essence, I have been on Lupron for 7 yrs (on and off) and while it took place over a period of years, my muscles have all but disappeared. I would think the same would be true for anyone with low T levels, regardless of how those low T levels were obtained. Am I missing something here?

Break60 profile image
Break60 in reply tojfoesq

jfoesq

For us with stage 4 cancer its all about staying alive with acceptable quality of life not about becoming like Arnold. I've had muscle atrophy ever since having low T and I have had three bone mets. So indeed I worry about losing strength and breaking bones. So I work out daily with weights and other resistance methods (cables, bands, machines, etc.) to provide variety.

The patches have been proven to reduce bone thinning (osteoporosis) compared with traditional ADT. That's the primary reason I switched away from traditional ADT. Resistance work is supposed to increase bone and muscle strength. My bone density is normal but my muscles are not. However my strength has not suffered too much. If I were not working out I'd be a mess.

At the same time, I'm on a weight loss regimen to reduce my gut. And it's working.

jfoesq profile image
jfoesq in reply toBreak60

Sounds good.

I must admit that I have not exercised as I should have.

I will have to start doing more.

All the best.

Break60 profile image
Break60 in reply tojfoesq

Once you start you won't want to miss a day. It's infectious. Plus the women are fun to watch.

E2-Guy profile image
E2-Guy in reply tojfoesq

You have raised a very valid point. Every night (usually five nights/week for about 35 minutes) when I go to our gym here at the condo I ask myself the same question. Other than the recent use of transdermal E2 gel, I have never been on any type of ADT. These are my T levels before and after I started the tE2 gel regimen:

7/13/2017 - 455 (prior)

6/19/2018 - 349 (2 months after starting)

8/3/2018 - 106

10/30/2018 - 72

8/10/2019 - 10

I am not a very big guy (currently 5' 9'' @ 157 lbs...was 5' 11" @172 lbs when I was on the gymnastic team in college); however, I was always fairly strong for my size. I never smoked, drank, and never stopped exercising. At about 65 I started noticing a decrease in strength and adjusted my workouts to more reps with lighter weight. The exercise that showed the biggest decline for me was the bench press. At age 60 I was still benching 8 reps with 170 lbs. Now I use between 90 and 130 lbs for most of my upper body exercises...dumbbell curls with 35 lbs. This has been pretty much been the weight that I have been using for several years and I've noticed no change since I started using the tE2 gel. I try not to think about the low T and how its absence 'should' be destroying me! There are times; however, especially while doing bench presses that I start thinking that I must be getting weaker and immediately lose the strength to finish the reps. The next day (hitting the gym with a positive attitude) I find myself able to complete my workout without a setback.

I wish I could explain why I am experiencing none of the "typical SEs from T loss, such as loss of muscle mass", but so far the gel has been a 'wonder antidote' for me. I am going to ask my mentor Richard Wassersug this question and get back to you with his opinion.

Best regards,

Ron

jfoesq profile image
jfoesq in reply toE2-Guy

V ery good- thx

in reply toE2-Guy

A great response ..

E2-Guy profile image
E2-Guy in reply tojfoesq

This is what Richard Wassersug had to say regarding muscle mass loss from ADT:

"I've seen guys on LHRH agonists gain no weight and maintain a lot of muscle strength, but they are intensely committed to exercising. Not exercising is most likely a major factor; however, as we age we are also dealing with sarcopenia."

Regarding the other "typical SEs" experienced from ADT, I guess that 'so far' (I've only had this low T for a short time) I am one of the lucky guys...many men on this forum have stated that they are still feeling good despite being on ADT. As I have previously mentioned, my father and his two brothers while on DES never complained about SEs. I spent a lot of time with one of my uncles and I'm sure that even when he was 80 he could still have kicked my butt!

jfoesq profile image
jfoesq in reply toE2-Guy

Thanks for the info, Ronron

- but no surprise there. Of course, those who work out and exercise will lose less muscle than those who don't. And- no doubt there are people who don't gain weight from ADT, as we are all individuals and react differently. However-the Q your doctor didn't answer was, IFFF ALL OTHER FACTORS WERE THE SAME, (i.e. exercise, diet.....) whether lower T levels will result in less muscle. Of course, I believe the scientific answer to the Q is YES- regardless of how the lower T is brought about (i.e. ADT, estrogen patches or other means). There is no doubt in my mind, that if I exercised more than I have, my muscles would be stronger. But-they would also be stronger than they are at present, if I had higher levels of T.

E2-Guy profile image
E2-Guy in reply tojfoesq

I agree with your statements above; however, I still haven't experienced what is presumed to be inevitable when a man is deprived of T. The operative word here is "still"...I imagine my time will come!

j-o-h-n profile image
j-o-h-n

I could press around 25 trousers in an hour.... I picked up that talent since my Mom and Dad were in the Iron and Steel business.... yep you guessed it... My Mom would iron and my Dad would steel.....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 08/17/2019 7:45 PM DST

Macco1 profile image
Macco1

Fantastic news Ron!

Thank you Ronron ..

jfoesq profile image
jfoesq

That's great and I hope it continues.

For me, it took several years of ADT before I lost what appears to be, all muscle.

I hope it takes even longer for you.

E2-Guy profile image
E2-Guy in reply tojfoesq

Thank you!

Lyubov profile image
Lyubov

I just posted regarding use of estradiol for hubby & saw this. You're having great success! How do you get the prescription? Have you tried the estro-patch as well? Thanks.

E2-Guy profile image
E2-Guy in reply toLyubov

I buy it in Thailand OTC. I haven't thought about the patches since this gel is working well, and besides, the patches are more expensive, can irritate the skin and fall off while bathing/swimming.

Not what you're looking for?

You may also like...

Transdermal Estradiol (tE2) update # 2

Just a quick update on my tE2 gel progress (sample taken on 8/3/2018, 6 weeks after previous......
E2-Guy profile image

43 Month Transdermal Estradiol (tE2) Update

Just a brief history: Robotic RP in 2004. BCR in 2013 (PSA-0.21). 'Failed' lymph node excision in...
E2-Guy profile image

My 51 Month tE2 (transdermal estradiol) Results

Just received my recent blood test results and needless to say that I'm thrilled with the numbers!...
E2-Guy profile image

My 46 Month Transdermal Estradiol (tE2) Update

PSA - 0.006, T - 231, E2 - 162, ALP - 88 Actually I was quite pleased with my trimonthly blood test...
E2-Guy profile image

Fourth Transdermal Estradiol Update

It's been one year since Richard Wassersug got me started on tE2 gel and I am elated! My PSA is...
E2-Guy profile image

Moderation team

Bethishere profile image
BethishereAdministrator
Number6 profile image
Number6Administrator
Darryl profile image
DarrylPartner

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.