May second follow up appointment since new treatment

[Blueribbon63]

I had my 2nd follow up yesterday since start of zytiga, Prednisone and Lupron. All of my blood labs are within normal range, PSA continues to ⬇️ now at 2.6 (from 16) before treatment restart. Testosterone also ⬇️ to 74 (from 158) after a two year 'holiday' But, here comes de drama, I've put on 20 lbs weight in one month! No real eating habits changes. The muscle cramps, feet spams and twitching at night time getting worse almost unbearable. I don't know yet what the oncologist is going to say as we didn't have the PSA results at the visit time. My blood pressure is in the rising too, I've never had hipertensión issues. The treatment seems to be working but not being able to get a good night of sleep in such a long time is driving me crazy, not to mention how uncomfortable I fit in my clothes now. The fat seems to have stuck mostly in my stomach and back. Please advise. Thanks

[Derf4223]

My weight remains stuck at about 200 lbs. On ADT + Abi + Prednisone since September 2022. We went modified vegitarian w/some fish and occasional chicken circa May 2022. And I started exercising more and more -- daily = nowadays 1 hour of resistance, 1 hour of walking in the woods, 1 hour of aerobics. My weight is stubborn at 200 #, as if my body wants to gain fat and everything else is wrestling it to a standstill. From studies I've seen this is what you get on my sort of PCa regime with diet and exercise dialed in. GL all

[dhccpa in reply to Derf4223]

Based upon my own experience switching to a whole food plant based diet, favorable changes to weight, blood pressure, cholesterol, etc. take time, up to a year or more, partly depending on how strict or consistent you are. Don't expect results in 1 or 2 months. Your body wants to know you're serious about it. Best success! It will work with time.

[Blueribbon63 in reply to dhccpa]

dhccpa Thanks

[Sandiego2]

I've also gained 20 lbs. (over about 18 months) since starting on Lupron, abiraterone, and prednisone. However, I was very slim before diagnosis. So while I'm still not really "overweight," I've found that I've really needed to revamp my dietary practices since starting on this medication--to keep a reasonably slim figure. I've needed to cut my caloric intake nearly in half! As has been noted previously by "experts" on this forum, a person on ADT should probably not be consuming much more than 1, 500 calories per day. That's pretty drastic, but probably what's required to keep one's weight in check. I also find that restricting calories helps immensely to decrease hot flushes. So I try to eat small amounts of exquisitely fine food. In the course of doing this I've also discovered that eating large amounts of even very good food does not necessarily increase my appreciation of what I'm eating!

[Alturia]

I have been on Eligard/lupron, Abiraterone, and prednisone since May 2022 and (I know you won't want to hear this) I have lost 15lbs. I started using a calorie counter app when I started on the drugs because, like everyone else, I didn't want to gain weight. And I kept walking and weight lifting. At first I limited my calories to about 1700 a day. After losing 15 pounds I have increased my calories to 2000 as I don't want to buy new pants. So, like others have said, I think the key to weight management while on these drugs is strictly counting calories and exercising. One thing though. Even though I have lost weight I have a lot more fat around my waist in both the front and the back. It's as if all the fat cells in my body decided to migrate to my waist.

[Scout4answers in reply to Alturia]

similar experience

[Kaliber]

in my case, ADT treatment definitely caused me weight gain. When DXed I was losing roughly 17 pounds of weight a week. My weight basically in a free fall. A few weeks after I started Lupron Xtandi Zometa…. I began a seriously rapid weight gain and became super hungry. I went from 235-240 pounds to 325 pounds in a very short amount of time ( I’m a big guy , biker type , anyway ) Nearly all of it belly fat.

I can exercise ( treadmill, stationary bike) twice a day … or could exercise.. and keto diet ( 50 carbs - 1000 calories) and nothing will cause me to lose a pound. It’s stubbornly stuck on. I stay at 325 no matter how much I eat or don’t eat. Hasn’t changed in over 2.5 years.

Oddly …both my wife and my oncologist are happy with my weight gain. Oncologist says it’s one indicator of my ADT still working , and both my wife AND oncologist like me having the reserve that could give me a few additional weeks of life if my weight goes into free fall again. Yayahahahaya. ADT has put me in a wheelchair mostly , so I don’t get a lot of exercise anyway ( can’t) and going 3/4 of a mile on my stationary bike the first week of January , almost put me in the emergency room …. I believe from aggravating my lower spine Mets . My wife likes to tell me that my trying to diet is a remnant of past vanity and screwing with my diet , now, just doesn’t make sense. She wants to keep me porked up and gets testy when I try to change things. It’s a weird world we live in brother Ben , ….. isn’t it ?

Love ya brother

❤️❤️❤️

[tango65]

If your BP is going up you should check if you are retaining fluids (may explain part of the weight increase) and request a metabolic panel to look at electrolytes since potassium could be going down.

If that were the case you could increase the dose of prednisone or discuss taking inspra.

When on abiraterone it could be an increase in aldosterone with water retention , hypertension, edema and hypokalemia.

These problems caused by the elevation of the aldosterone could be corrected with inspra which is an aldosterone receptor blocker. Consider to consult with your MO and your internal medicine doctor ASAP.

[Scout4answers]

when I had pain and was unable to find a comfortable position so I could sleep. I found that THC plus cbd oil worked wonders. If you live in a state where weed is legal ask for a pain relief product based on the Indica strain.

[j-o-h-n]

LBS...... and Neuropathy are team mates.....

See your MO and/or Urologist - tell them I sent you.....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 03/13/2023 8:02 PM DST

[Blueribbon63 in reply to j-o-h-n]

Will do, thanks

[j-o-h-n]

I nominate the following gentleman to be the lead analyst here on Health Unlocked. (he makes sense and so did Dean Martin when he drank Tequila)...

youtube.com/watch?v=TFijGR4...(Not working as expected?)

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 03/13/2023 8:25 PM DST

[Blueribbon63]

UPDATEJust received a call from oncologist, she said that based on the PSA and testosterone lab results (both continue to go down) they indicate treatment plan is working so, we are lowering Prednisone dosage to 2.5 mg a day (from 5 mg) This should help improve the muscle cramps and manage excessive weight gain. I am rebuilding my aerobic physical endurance too. I am aware of how losing fitness is so much easier that getting it back on.

[Derf4223 in reply to Blueribbon63]

How much Abi are you taking?

[Blueribbon63 in reply to Derf4223]

1000 mg/ day I take it first thing in the morning on an empty stomach. Breakfast at least one hour later.