Hot flashes and fatigue

[Rberke]

Am on Lupron and apalitamide which is causing discomfort from hot flashes and extreme fatigue. Dr. prescribed Gabapentin for hot flashes- seems to help minimal but not sure if that si causing the fatigue or not.

Any suggestions are appreciated

[LearnAll]

Gabapentin is a anti seizure, mood stabilizer drug. It does cause mild sedation in people depending on how high the dose is.The most effective medicines to suppress hot flashes are Anti Depressants in general and Venlafaxine (effexor) in particular. On natural side, Evening Prim Rose Oil is also beneficial and reduces hotflashes.

[doc1947g in reply to LearnAll]

I am not sure about what you wrote. I am on Sertraline 200mg/HS(Bed Time) and I was on Lupron Depot 45mg/24weeks up to 2020/11/16.

I have Hot Flashes almost every hours and they trigger my Pulmonary Emphysema, so I also get Short Of Breath.

🐵🐒🙉🙊🙈

[LearnAll in reply to doc1947g]

Although the researcher used Sertraline in the study, I think all SSRI meds might have the same anti cancer effect.You can discuss with your doctor if he/she is willing to switch from Sertraline to Venlafaxine (effexor) as Effexor is more well known to have effect against hot flashes.

[doc1947g in reply to LearnAll]

Thanks for the info.I will see my GP next Wednesday.

[doc1947g in reply to LearnAll]

Just back from my GP.We talked for almost an hour but I forgot about Sertraline.

But my GP beat me to it because she changed ALL my medication except my RO's ones.

[Hidden in reply to doc1947g]

Besides that, you’re ok

in my book doc! Happy Easter brother

[noahware]

Low dose estrogen patches may help.

[Tall_Allen]

Gabapentin wiped me out when I took it.

Here are 4 things that work for hoy flashes: estrogen patches, Megace patches, Venlafaxine, and aural acupuncture. They've tried all kind of herbs in trials that do not work.

[Shooter1 in reply to Tall_Allen]

Megace wrecked my driving but was great for hot flashes, Venlafaxine made them much worse and took my eye sight from 20/30 to 20/300 +made my balance unstable, Gabapentin for my neuropathy also helps with my hot flashes. (3600 mg daily) . Boy are we all different in what meds we can tolerate and use and those we can't.

[Hidden in reply to Shooter1]

20/300wtf?

[Shooter1 in reply to Hidden]

Yeah, as a railroad engineer, it wasn't comforting to my conductors when I told them to call out all the signals as I couldn't see them!!!

[Hidden in reply to Shooter1]

You amazed me by working during APC at that job .

[Hidden in reply to Shooter1]

That is so comical , got me chuckling 😂... I’ll bet you dream

About trains?? 🤔

[Hidden in reply to Shooter1]

The reason I’m saying that you must dream it

After doing it for so many years ? I dream

Of the different good and bad jobs I’ve had . 80 today 99 in the valley of the sun. Ouch .. too soon and a record for the day . I’m hiding from the sun under cover . I don’t want want any more stuff cut off of me . I pray that you are healing from the burn . 🙏

[fireandice123]

My naturopath put me on magnesium glycinate for hotflashes. It doesn't completely eliminate them but it definitely reduces them and calms them down for me.

[GoBucks]

I was against taking any new drugs for a long time. My hot flashes recently became more intense. I gave in and am now taking venlafaxine 37,5 mg. I now have very few hot flashes during the day. At night I still get warm flashes but no big sweaty ones. Re: fatigue, you fight that with strength. Need to workout and walk.

[fmenninger]

I concur with Go Bucks...... I'm on lupron and have similar issues such with nightly hot flashes and fatigue. Not easy to do but I find if you can do a walk or workout at night it actually makes me more tired so I can sleep at night. The hot flashes remain a constant but I have trusty fan and ice cold water next to my bed stand that helps me fight thru them. Stay strong!

[ARIES29]

I could not stay awake on Lupron, so much so it was dangerous to drive or operate machinery but the hot flashes were not a problem.My solution & only option was not to take it! I can not tolerate these drugs but soon to try Firmagon, which will no doubt have the same effect?

I might add two infusions of LU177 gave me two years of extra life with few side effects at a 1.6 psa level, but very costly if you can not find a trial.

Stay healthy & battle on!

[EasyE]

I’ve been on Xtandi and Lupron for 7 months. Hot Flashes seem to be leveling out. At this point, I am just working through it. I am wondering what’s better a drug to try and curb them, or just dealing with it?

[pete-ginger]

I've been on that drug combo recently, and your side effects are similar to mine. Hang tough. FYI, some people just can't tolerate gabapentin. Made my dad and a cousin "crazy," and they had to come off. I seem to have developed gabapentin fatigue. Multiple pain sites. 2 weeks ago changed to pregabin, and it seems to help more.

[pete-ginger]

BTW, apalutamide brain fogs me intensely + it or it in combo with lupron adversely affect my cognitive and memory functions. I can't drive on apalutamide.

[fish7days]

Megace works well for me. I also take 5HTP and Mg Threonate.

[larry_dammit]

My doctor gave me Effexor to help with the hot flashes and mood swings. Does help but daughter gave me a small hand held fan. That was a real saver to start with. Mo more sweaters or pullover cloths for me. Layer up and strip down 🤣🤣🤣🤣

[London441]

Take all the drugs you want. Exercise is still the best tool you have. It’s not just good for one or two of the side effects, it’s good for every one of them.

Specifically to hot flashes, being fit and strong probably minimizes them. I only say probably because I have no proof, but it seems obvious.

It is very likely the main reason my time on ADT has been easily tolerable.

[PSA680]

Hi Rberke - on Firmagon & Xtandi - spoke to NHS specialist cancer nurse & she said some of her patients had tried sage (the herb) tablets to ease hot flushes - don’t think there’s any science behind but I tried & although still get warm flushes in evening & at night but they have eased - when i forgot to re up ‘ missed a week they got worse - co up of of course be purely psychosematic but does it for me without any additional SEs from a prescription drug. Good luck.

[Shooter1 in reply to PSA680]

I also use old remedy of Black Cohosh Root, seems to help some.

[EdBar]

Estradiol (estrogen) patches work great for me and help with bone health. I’ve been using them for over 6 years now, originally prescribed by Snuffy Myers. I used to get wicked hot flashes about 1 every hour. Fatigue is another thing though, exercise helps a bit, I’ve learned to adjust to it.

Ed

[DenDoc]

I have been on Lupron for 12 years and now also on Xtandi so hot flashes are a way of life for me. I tried acupuncture and gabapentin initially. Could not find any studies in men for the effectiveness of Effexor. I have been on low dose estrogen patches for about 6 years with pretty good results. A ceiling fan has proved to be the best thing ever for the summer months and a partner who has hot flashes helps for understanding. I was better when I could exercise at a higher level. Age, chemo and muscle wasting from lack of testosterone along with a left lung not working well have caused me to do exercise at a very low level.

[Hidden in reply to DenDoc]

I salute those 12 years DenDoc! 🏋🏻‍♂️

[bunny91]

Tell the doctor to try Megace. It has been like a miracle for my hot flashes.

[jastf]

As PSA680 above...Sage extract tablets. Some will mock but works for me. Sage related effects to estrogen and used for menopausal hot flushes. Look it up.

[TJGuy]

I wanted to add that I've been on ADT primarly Lupron better part of two years. But took Eligard recently during the Lupron shortage.My hot flashes went through the roof on Elligard. I reported that to my doctors office at top us cancer hospital and they said a lot of their other patients reported the same thing.

They were switching back to Lupron.

My latest injection was Lupron and that reduced my hot flashes back to what I'll call my Lupron normal.

[Rberke in reply to TJGuy]

Thank You- I am on Eligard as I had bad reactions to Lupron many years ago but maybe should switch back.

[Hidden in reply to Rberke]

Are they not the same ?

[R1166]

Hi...I'm new to the forum and I think this post is a good chance to share my experience. I'm 54, was diagnosed in October 2019, PSA 49, G8, mets to multiple local and distant lymph nodes. 2 weeks later started ADT Triptorelin (Trelstar or Decapeptyl).

January 2020 two months of Radiotherapy. Since then my psycho-physical condition started deteriorating.Tired on most days, out of focus, sleeping problems, head aches, weight gain and very frequent hot flushes ( of a debilitating kind). I did everything advised including increase my physical activity/gym, yoga, meditation (which I did also before) but with mixed results.

Especially the fact that I could not focus anymore made it very difficult to perform a variety of tasks (from working to playing with my 9 years old daughter)

After a year of quite miserable life I decided to try with antidepressants. First Escitalopram and then Sertraline made me feel high and stoned (something like MDMA light) and even more out of focus than before....exactly the opposite than what I was looking for....stopped right away.

In the meantime I had been prescribed Tramadol for recurrent headaches and, while not very effective against head aches, I noticed I was feeling much better while on it.

I did some research online about the effects of this drug and I was quite surprised. It works in a variety of different ways: binds to mu opioids receptor and has SNRI properties (inhibits reuptake of serotonine and Norepinephrine (natural adrenaline).

Now...to make a long story short....it has been a life changer!!

In agreement with my GP and my urologist I've been (micro)dosing 25mg (half of a normal minimum dose) per day and , since December, I feel much better in any way.

Hot flushes almost disappeared (I typically get only one in the morning), feel focused again, my mood has stabilised, I sleep much better and all together I regained joy of living.

Now...while we are all biologically and personally different, to those of you struggling with ADT side effects (especially hot flushes and fogginess) I would recommend you give it a try.

At such low doses (at bigger ones the opioid effect tends to kick in and becomes unpleasant)

the dangers are very limited and I would trade them any day for the way it has helped me.

BTW my PSA is stable under 0.1...fingers crossed...

I wish all of you lots of strength and good moods

[Hidden]

Hey Rberke! I did the Lupron for 18 months. I was told not to lift more than ten lbs for a year and a half ,due to tubes out of kidneys . I lost all muscle and my bones went into osteo. You

Must exercise and I suggest simple bone nutrients. I’m now on prolia after entering painful osteopenia. You are ahead of the game if you can avoid this . It is almost impossible from my experience to gain muscle or restore bones once depleted without testosterone.. Adt is hard on our hearts. I did the orch allowing me to stop the damned Lupron shots . I’m still on a defunct adt test drug stopping adrenal production so far five years clear . The symptoms you’re having are the most common with no t and adt ... I fought my self three years until I finally accepted my weaknesses .. once the hare now the tortoise . We are all kicking this pc can down the road of a hopeful life extension. Good luck !

[tallguy2]

I take 75-mg of venlafaxine each day. Stops most of the hot flashes. No obvious side effects. A generic drug.