My post RP changes in Cholesterol and Testosterone

In a nutshell: Aged 70, RP on 5/19, high risk, pT3b and GS=9.

I have Familial Hypercholisterolemia (FH), LDLR gene mutation verified.

Diet has no influence on my cholesterol count usually at 320-400 mg/dl under no medication.

After RP I am seeing a dramatic drop in 3glycerides and LDL, a considerable one in total cholesterol and a slight increase in HDL.

During my last 15 years the [total chol./HDL] index has ranged from 10.8 to 5.4 (worse under no medication to best after 1 year on Inegy), while after RP to 3.2 - 2.7 under Liptruzet.

Equally, the [3glyc./HDL] index has ranged from 8.8 to 3.3, while after RP to 2 - 1.4.

My crude estimate is that medication can lower my chol. up to 30-35% which has now been supplemented by another 30-35%.

On Testosterone I don't have any pre RP data.

But, at 4 months post RP 820 ng/dl and at 5 mo 935 ng/dl total-T places me at the 98-99 percentile for my age. I am reading papes that indicate a drop after RP and subsequent rise to pre RP levels.

Has anyone else noticed such changes?

[tango65]

I can't comment on lipids profile and radical prostatectomy.

I wonder if you have discussed the possibility of being treated with proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. PCSK9 could be effective in patients with high levels of LDL and they could improve cardiovascular outcome.

ncbi.nlm.nih.gov/pubmed/299...

rxlist.com/praluent-drug.ht...

ncbi.nlm.nih.gov/pubmed/316...

ncbi.nlm.nih.gov/pubmed/315...

[pjoshea13]

Justfor,

Patrick Walsh reported 20 years ago that T increases after RP. PCa seemingly controls T production at a distance. Two other studies confimed the Johns Hopkins study, but I'm no wiser as to the mechanism.

I have alternated between castration & high-normal T for many years & I can confirm that increasing T is associated with lower LDL-C - particularly VLDL-C - & higher HDL-C.

In my case triglycerides were lower than HDL-C when T was close to 1,000 ng/dL.

Enjoy!

-Patrick

[Hidden in reply to pjoshea13]

Thank you tango65 and Patrick.

I will study the proposed literature.

Two post-RP tests found the following counts:

Time, total T, triglycerides, LDL-C, HDL-C

3.7mo, 820, 89, (>) 61, 47

5.0mo, 934, 70, (<) 79, 51

So, I may be seeing a triglycerides_to_LDL-C inversion, like the triglycerides_to_HDL-C you mentioned when approaching 1,000 ng/dL.