Lupron fatigue, etc.

[nexusprom]

Greetings everyone. Just had my second Lupron shot a few weeks ago and overall, things could be a lot worse. BTW, I am 64 y.o.

Fortunately I have a great fiance, although we battle about air conditioning levels (she likes 78, I like it a lot lower due to flashes)...

I am accepting the reality of what seems like castration, hot flashes, sudden increase of love handles, increase of incontinence, too many early morning trips to bathroom, and occasional diarrhea, presumably par for the course.

And while I read about mood swings or bawling, I haven't experienced those and attribute my occasional melancholy to the virus destroying my business and not Lupron.

But the one side effect that concerns me is FATIGUE. First, how does one define fatigue? SEcond, it's not so easy to determine an increase in fatigue unless it's major, or so I guess. So here is my situation. I am a 64 year old very good tennis player, and over the years, I have played to exhaustion. And I did get stress tested, nothing there. And I was hospitalized a few years ago after playing, which led to the discovery that I have AFIB, i.e. afibulation, so had a procedure and a heart monitor now buried in my chest. Add to the mix, I have a tendency to run for balls that most guys wouldn't bother with, plus I live in South Florida where heat and humidity can be rough. Anyway, I have noticed lately that the exhaustion is worse, since I now can barely finish a set of tennis without doubling over, gasping for air and wonder if this is just my getting older or whether the Lupron has diminished my energy/stamina. I understand that fatigue does happen and that muscle mass is diminished.

So assuming that the Lupron is impacting my game, what do I do? Reduce my days played, as I do play five days a week? Or, do I play five days and on my two days off, do intense cardio? Do weight lifting every day? Stop playing tennis and do cardio and weight lifting daily?? Stop drinking beer and coffee?

Sorry for the length of this email, but appreciate any suggestion(s).

Jordan

[noahware]

You might do weight lifting every OTHER day, to allow recovery time. But I'm not sure that maintaining muscle mass alone is going to fix fatigue issues. It can't hurt, anyway.

The ADT is going to have an impact on estrogen as well as testosterone, and will impact metabolic function. There has been a lot of talk lately on the forum about using low-dose estrogen patches to mitigate some ADT side effects, but I do not know if fatigue is one of those that might be helped. Perhaps others do?

[Tall_Allen]

Unfortunately, some fatigue is a price of ADT. But your tennis regime sounds excellent! It fights fatigue as much as possible, maintains bone mineral density, and lean muscle mass.

As for the hot flashes: acupuncture, venlafaxine, transdermal estrogen or progesterone (with tamoxifen)

The incontinence is not because of Lupron. What other treatments have you had? Do you still have a prostate?

[VN6465 in reply to Tall_Allen]

Finished HDR and IGRT five months ago. Just had 4th three month Lupron shot, each with bad SE. First set of numbers are good. Am a life long exerciser and know its even more important now due to ADT which I'll be on another year or so. Currently have a bad knee and unusable shoulder/ torn rotator cuff which requires replacement and long term rehab. Walking as much as knee will allow but can't do needed weights, biking, swimming,etc. Hesitant to undertake the surgery at this point. Any recommendations?

[Tall_Allen in reply to VN6465]

Most men on this site are on ADT permanently. What can you do if you can't do any kind of exercise? Just resume when you can.

[nexusprom in reply to Tall_Allen]

No prostate, taken out almost three years ago. So with psa rising, had radiation and lupron combo a few months ago, and second Lupron a few weeks ago.

thanks,

J

[Tall_Allen in reply to nexusprom]

It's the radiation on top of surgery that is causing the incontinence, not the Lupron.

[timotur]

Nexus: tennis is the perfect gauge of what Lupron does to us, because it requires a combination of strength, coordination, and aerobic conditioning. The things you are noticing is a new normal that you have to get used to.

A few things are going on with Lupron: muscle fatigue and diminished muscle mass that lessens your ability to run/start/stop, possible anemia from lower RBC and hemoglobin counts that lowers your max VO2 levels and aerobic conditioning, and joint pain that crops up after a year or so as low T starts to affect your joints.

I've experienced all of these and it's affect on my level of play as a USTA 4.5 level player here in San Diego, and have battled this for about 15 months. Best advice I can give is to back off tennis every day, and substitute with days of strength training and aerobic exercise. The other is to watch your RBC/Hg levels and supplement with B12 and eat liver if necessary to boost your oxygen carrying capacity. For joint pain, try Boswella extract and Advil as necessary. Finally, get used to losing to guys you used to beat, because you're not going to have the pop on the ball as before, or be able to chase down balls or play long matches at a high level due to the diminished O2 capacity. It sux, but Lupron, and ADT is like advanced aging, it notably reduces our athletic performance as if we were 10-15 years older, and it's really noticeable in competitive tennis.

[j-o-h-n]

My suggestion would be to replace the tennis balls you're playing with to Stage 3, 75% reduced bounce tennis balls.... Also be prepared and buy yourself some teenage training bras....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 06/25/2020 7:02 PM DST