Extreme side-effects from ADT

[Purple-Bike]

Anyone have a clue whether the following rapid deterioration can be a result of ADT?

My fasting glucose went from excellent 78 mg/dL = 4.4 mmol/l to almost diabetic 123 mg/dl = 6.9 mmol/L. in stages in the space of not much more than a single month, after five months of Firmagon. Tested twice last time, after a 16 hour fast. Reference range below 100 / 5.6

Reported increases in fasting glucose on ADT are more than an order of magnitude lower. In the recent Lancet article about the PATCH trial, men on LHRH agonist for 6 months had a mean increase of 0.14 mmol/l, with a range of 0.04 - 0.24. My increase is 2.5 units i.e. tenfold that of the person with the largest increase in the group.

Likewise, my CRP over the course of around six weeks has risen from excellent 0.16 mg/l to 2.9 then to atrocious 75 (reference range below 3). My muscle strength has deteriorated stunningly fast over just the past two to three weeks, after a slow but steady increase the previous months as I was determined to counter the muscular weakening effects of ADT.

I was tested a couple of days ago extensively at a hospital for other reasons, related to heart and lung functions, with nothing discovered that could point to the deterioration and I have no known infection. I tested negative on Covid.

Is it even possible that Firmagon/ADT could be the main cause of this enormous and rapid deterioration....... If not, I should start looking for another cause.

[Tall_Allen]

I think you should get a complete workup for insulin resistance and metabolic syndrome. It sounds like you are having some ideopathic inflammation (pancreatitis?) somewhere that should be addressed. Have you tried NSAIDs and metformin?

[Purple-Bike in reply to Tall_Allen]

Fasting glucose down to normal 84 mg/dl = 4.7 mmol/l. But CRP zoomed further to 113 and erythrocyte sedimentation rate 120 mm/hour ref range below 22. Used to run up four floors without effort now take the elevator. When I went to the emergency ward for intolerable pain when breathing they ruled out heart attack or a plug in the lung and couldn´t find any reason apart from high CRP etc. Will travel to the clinic Monday and hope to find out if this is cancer/ADT-related or not. Suspect the former since I´ve virtually never been ill and nothing like this pre dx September last year.

[LearnAll]

A CRP reading of 75 is a bad news. It clearly indicates that you have significant inflammation in your body....This can be caused by prostate cancer getting worse and causing increased inflammation or it can be from some other organ which is badly inflammed. This level of CRP need an extensive medical work up. In the mean time, you can get some benefit from anti inflammatory foods and/or supplements. Do not ignore a CRP of 75.

[noahware]

Did your latest labs include ALP levels, which you have discussed here before? Have your labs in recent months included a monitoring of liver enzymes (ALT, AST), albumin and bilirubin? If so, are these all (still) in reference range?

[Purple-Bike in reply to noahware]

ALP up from 102 IU/L on March 18 to 156 on April 7, ref range 42-114.Albumin lower on April 7, 28 mg/l, ref range 34 - 45.

ALT,AST, bilirubin well within reference range.

[noahware in reply to Purple-Bike]

Sounds like it is probably not bicalutamide toxicity. The literature does show a case of migratory arthralgia in a patient undergoing treatment with bicalutamide for 4 months. This would be an extremely rare side effect, even more rare than liver toxicity, but it seemed worth considering in the absence of other explanations. Did your docs come up yet with other ideas for what might be at the root of such a rapid increase in inflammatory markers?

[Purple-Bike in reply to noahware]

Thanks, Noah.No, doc didn't come up with any explanation, only ruled out heart attack and plug in the lung. I will be at the cancer clinic starting Monday hopefully they will find out I guess it's cancer or ADT related since I vê not had CRP rises or major health problem before recent dx.

[Olivia007]

My dad’s cholesterol is through the roof since being on these meds I’m afraid for his heart than the prostate at this point

[Lost_Sheep]

Firmagon devastated the energy levels of a man in my local support group. It did not wait months to do that, though. It happened right away. I don’t know about your 5 month delay.

Do you have data on your testosterone levels during that time? Is there a clue there?

[Purple-Bike]

It finally urned it was a probably a radiation-caused bacterial infection that was rapidly resolved with anti-biotics. Could that be the cause for your friend?