ADT Holiday Unexpected Consequences - Advanced Prostate...

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ADT Holiday Unexpected Consequences

6357axbz profile image
33 Replies

After stopping Lupron and then, 5 months later abiraterone/dexamethasone, I began to experience what I believe to be arthritis joint pains. Not only in my hips (previously diagnosed with degenerative osteoarthritis) but other joints as well. I did a two week taper-off from the dex but I believe, and so does my doc, that the dex had been masking my arthritis pain, as corticosteroids will do. I have felt no hip pain over the last few years. Now I feel like a creaky old land crap when I climb out of bed in the morning.

Just mentioned this as a heads up to anyone going on “holiday” from ADT.

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6357axbz profile image
6357axbz
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33 Replies
Seasid profile image
Seasid

oh well holiday

i also started to feel like you recently without going to the drug holiday.

Actually i stopped crestor and I was wondering if I feel like that as a result of stopping crestor.

i didn't use dexamethason can you consider trying crestor maybe it helps you with the inflammation? Make sure that they are no compatibility issues with other medications what you currently use and crestor.

6357axbz profile image
6357axbz in reply toSeasid

Thanks, coincidentally my cardiologist just switched me from 80mg atorvastatin, which I’ve been on for years, to 40mg Crestor (rosuvastatin) for better LDL control.

Seasid profile image
Seasid in reply to6357axbz

i believe all statins have antiinflammatory effects. Yes I was using 40mg crestor daily. Maybe i should go back.

i stopped as I thought that a little cholesterol could be good for my body after years on statins.

the only problem is that I also feel like you and I was wondering why.

6357axbz profile image
6357axbz in reply toSeasid

we’ll neither the max dose of atorvastatin or crestor help with the arthritis pain cause I’ve never stopped using one or the other. Only felt the pain after stopping dexamethasone

Seasid profile image
Seasid in reply to6357axbz

i will try to go back to statins, maybe it helps my aim was just a drug holiday. Hoped to be without statins during the summer in Australia.

lokibear0803 profile image
lokibear0803 in reply toSeasid

May I ask why? What is it about statins that makes you want the summer break?

I ask b/c I’m strongly considering starting statins pretty soon…

Seasid profile image
Seasid in reply tolokibear0803

i hope that I will produce more vitamin d from the cholesterol in my skin after exposure to the midday sunshine.

and i wish to have a break so my PSA can go up a little bit. Crestor could artificially push the PSA down.

but i will go back to statins art some point of time

lokibear0803 profile image
lokibear0803 in reply toSeasid

Sorry if this is a duh question, but why do want your PSA to go up?

Seasid profile image
Seasid in reply tolokibear0803

becaus i want a prescription for Nubeqa

CSHobie profile image
CSHobie

I have a side question for you, why were you taking Dex with Zytiga instead of Prednisone? I am on Zytiga and Prednisone, but I am curious as to the benefit of Dex?

6357axbz profile image
6357axbz in reply toCSHobie

use this sites search routine to learn about dexamethasone

6357axbz profile image
6357axbz

Yes, many of us started on Zytiga/prednisone. On this site I was aware that many had switched to dex. I forget the reasoning but I remembered it was a good argument so when my highly respected MO recommended the switch to dex I was onboard.

London441 profile image
London441

do you have any joint replacements? How much do you exercise and what kind?

6357axbz profile image
6357axbz in reply toLondon441

no joint replacements

Was lap swimming a couple miles/week but our condo pool has been closed due to Ian

London441 profile image
London441 in reply to6357axbz

if you are on drug holiday ostensibly for ‘the benefit of my body would get from having testosterone’, that benefit is minimized unless exercising, especially weight lifting.

More importantly, as someone with both arthritis and high CV risk, I hope your condo pool being closed isn’t stopping you from walking or some other substitute.

6357axbz profile image
6357axbz in reply toLondon441

I have a beagle so walk quite a bit, at least a mile/day.

Why are weights so important? My bone density is about normal for my age and I see no benefit from excess muscle mass

London441 profile image
London441 in reply to6357axbz

Older people lose muscle mass continuously, and the older you get the faster you’re losing it. Lifting is the best intervention, and it’s very important unless you just want to accept that process, in which case I wish you luck.

For nearly everyone our age, lifting weights isn’t creating ‘excess muscle mass’. It’s slowing the loss of it, and it’s immensely worth it.

Strength is a prime determinant of longevity, but to be old and strong creates a quality of life unattainable otherwise.

EchoII profile image
EchoII

I wonder if the same is true of prednisone. I am on a holiday from ADT and Zytiga plus prednisone. Noticing some new pains, but mostly muscle pain.

SteveTheJ profile image
SteveTheJ

Who told you an ADT vacation was a good idea?

6357axbz profile image
6357axbz

going for labs next week. T was still very low in august. What’s SHBG?

6357axbz profile image
6357axbz

my MO suggested it thinking if I could go 6 months, a year, two years with out my cancer progressing the benefit my body would get from having testosterone and not having the cardio risk (I’m a high risk cardio patient) might be beneficial

Seasid profile image
Seasid in reply to6357axbz

Who is your MO?

6357axbz profile image
6357axbz in reply toSeasid

Dr Eleni Efstathiou, formerly of MD Anderson, now Houston Methodist

tsim profile image
tsim

Yep, steroids will do that. That's why everyone likes them so much.

6357axbz profile image
6357axbz

why would I want to do that?

6357axbz profile image
6357axbz

thanks

6357axbz profile image
6357axbz

my mo will put me on orgovyx when I resume ADT. Last holiday my T was back up after about 60 to 90 days.

Seasid profile image
Seasid

thanks

Seasid profile image
Seasid

I always thought that the steroids prescribed with abiraterone are only replacing the lost natural steroids produced by your body because of the effect of the abiraterone? How much dexamethason did you use?

Seasid profile image
Seasid in reply toSeasid

ChatGPT :

Q. After stopping abiraterone how long does it take to get back your body natural steroid production which was artificially suppressed by abiraterone and Prednisolone or Prednisone?

A. "The natural production of body steroids, particularly cortisol, typically begins to return after stopping Abiraterone, but the exact timeline can vary depending on factors like the duration of Abiraterone and corticosteroid therapy and individual patient factors.

- **Short-term use**: If Abiraterone and corticosteroids (e.g., Prednisolone or Dexamethasone) have been used for a relatively short period, the adrenal glands may recover their normal function within a few days to weeks after stopping the medication.

- **Long-term use**: In cases where these treatments have been used for several months or longer, adrenal recovery can take longer, sometimes weeks to months. During this period, the body may need time to resume adequate cortisol production.

Gradual tapering of corticosteroids rather than abrupt discontinuation is usually recommended to allow the adrenal glands time to recover and resume normal cortisol production. This process should be carefully managed by your healthcare provider, who can monitor for signs of adrenal insufficiency and adjust the tapering schedule as needed.

Always consult your doctor before making any changes to your medication regimen."

Seasid profile image
Seasid in reply toSeasid

Q. Could it return but at much lower level?

A. Yes, after stopping Abiraterone and corticosteroids, it is possible for the body's natural steroid production to return at a much lower level, particularly if the treatment was used for an extended period. This condition is known as **adrenal insufficiency** and can occur if the adrenal glands do not fully recover their normal function.

Adrenal insufficiency can lead to symptoms such as fatigue, weakness, weight loss, low blood pressure, and even more severe issues if not addressed. In some cases, the adrenal glands may partially recover but continue to produce insufficient amounts of cortisol, requiring ongoing treatment or monitoring.

To manage this risk, your healthcare provider may taper the corticosteroid dose gradually and monitor your cortisol levels to ensure that your adrenal glands are resuming normal function. If low cortisol production persists, further evaluation and potential treatment might be necessary.

6357axbz profile image
6357axbz in reply toSeasid

I use .5 mg per day

Seasid profile image
Seasid in reply to6357axbz

Thanks

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