Finally, after nearly a year after diagnosis with stage 4 PCA, DC has reached “within normal PSA levels” at 3.3! It’s been a long and winding road and one heck of a roller coaster but I’m happy to say he is on a good path for now. I understand “for now” is a fluid term. I am praying he can stay here for a while to let his nerves and his mental health unwind. He is a pessimist, always has been since he was little, so keeping his spirits up and positive has been my personal struggle. The doctor can tell him he is doing great, we all can for that matter, but every time he gets up to pee, he contradicts us in his mind. I am working on him to keep moving, do his strength exercises, eat high potassium foods. He is listening for once! You CAN teach an old dog new tricks…imagine that!
Be well and Happy Fathers Day to all you wonderful, beautiful dads out there!
All of you, fathers or not, are loved and cherished beyond words. Keep up the good fight Warriors!
ADT Vacation - Final Update
My Final Lupron Injection
Nalakrats To Finally Go On A Sabbatical.
Finally the damn PSA is approaching 0!
Lets finally peel back this onion.
Does he have low serum potassium? Is he taking Zytiga+prednisone? If so, he may not be taking enough prednisone. Don't overload him with dietary potassium if that is the problem.
TA, Why do you say “ overload him with dietary potassium? I’mOn Zytega and prednisone and My potassium level went to 3.1. Dr Scholz had me take potassium supplements. I’m back up to 3.6. Is this the wrong thing to do in your opinion?
Steve s
The reason one has to take 5 mg prednisone with abiraterone is to replace the natural cortisol that the adrenals produce. Without enough prednisone, one gets a condition called "syndrome of secondary mineralocorticoid excess." The symptoms of the syndrome are high blood pressure, low potassium, and edema (retaining water, especially in the arms and legs).
prostatecancer.news/2019/06...
Supplementing potassium won't help because low serum potassium is the symptom, not the cause - your body will just get rid of it. Excess potassium can cause cardiac arrhythmias and muscular weakness. But 5 mg prednisone/day is an estimate across all men - some men may need a little more, some men may need a little less. There was a retrospective study trial that suggested that Inspra (eplenerone) might help.
This link below specifically says that prednisone can lower potassium. Are you saying that’s not the case when it’s used with Zytega?
Dr. Scholz specifically prescribed potassium supplements and they increased my potassium levels back to normal range (from 3.1 to 3.6) . You say “Excess potassium can cause cardiac arrhythmias and muscular weakness”. Could I have “excess potassium” from the supplements even tho my blood tests now show only 3.6 levels? Are you suggesting I increase my prednisone vs the potassium supplements?
Do you have a link I can show Scholz? This is very confusing TA.
stjude.org/treatment/patien...
Schwah
Prednisone taken to replace lost cortisol because of Zytiga does the opposite of what extra prednisone does without Zytiga (as in your link). This is because cortisol levels are tightly controlled via negative feedback by the pituitary. If there is not enough cortisol (because of Zytiga) or not enough prednisone (biosimilar to cortisol) is taken with Zytiga, the pituitary reacts by producing Adrenocorticotropic Hormone (ACTH). ACTH increases the production of mineralocorticoids (like aldosterone), hormones that increase blood pressure, lower potassium and cause edema in the limbs. Too much cortisol (or prednisone) causes the same symptoms.
In the chart in my article, you see that, among men taking 5 mg every day, 7% suffered Grade 3 hypokalemia (low potassium). Many more were grade 1 or 2.. There was no grade 3 hypokalemia among men who took 10 mg every day. Maybe the right dose for you is 7.5mg?
All the links are in the article.
Shocking that you know more than many MOs that do this every day. Thank you so much!
Schwah
If you MO does not know everything TA said then you need a new MO. This is standard information. The only complicating feature might be if you are on a diuretic for BP control. Then adding potassium might make sense