What's the deal with ADT and increased risk of metabolic syndrome? Can anyone confirm this personally?

[Bigmaristuff]

Just here to learn as much as possible.

[Tall_Allen]

Important to increase exercise and watch caloric intake on ADT. It slows down metabolism. Abdominal obesity, lipids, and hyperglycemia should be periodically monitored. Metabolic syndrome increases risk for atherosclerosis, diabetes, and weakens prognosis.

ascopubs.org/doi/10.1200/JC...

[Bigmaristuff in reply to Tall_Allen]

So, a good BMI, keep an eye on LDL, HDL, triglycerides, etc... normalize Blood sugar. Should I check Insulin and IGF 1 periodically?

[Tall_Allen in reply to Bigmaristuff]

if your blood sugar is high, there are several follow-up tests.

[London441 in reply to Bigmaristuff]

Forget BMI. Get periodic Dexa scans instead. Dexa measures body composition, BMI doesn’t.

[chefjlu in reply to London441]

Yes, BMI does not give a full picture although it can be used as a guidance. Prednisone is the likely the biggest issue - it can increase appetite, redistributes fat storage, can lead to water retention. Protein consumption with meals is essential - good fiber intake (vegetables & fruits) - in many cases small meals throughout the day are better than 3 large meals - exercise - regular sleep pattern all round out the ways to combat the issue.

[London441 in reply to chefjlu]

BMI as 'guidance' is not advisable for most men on ADT. Sarcopenia can typically lead to a 'break even' muscle loss/fat gain. The weight can easily stay the same while adding considerable fat.

The mirror works pretty well though.

[chefjlu in reply to London441]

Yes correct, it is still a guide to look at with professional dietitian help. I lost 140 lbs before being diagnosed in a health reset. BMI was only a part factor and my dietitian and I still look at, but body composition is much more important - as well as visceral fat which can be measured.

[London441 in reply to chefjlu]

I suppose. BMI is the crudest of measurements, but it’s available instantly anytime you have access to a scale so there’s that. Congratulations on your dramatic weight loss!

[ADTMan in reply to London441]

That's an excellent point. I was on ADT for 2 years and my weight remained pretty much the same. (6'1", 180). Went off ADT Oct. 2022 and I am now 185. I think what happens is that when you are on ADT you lose muscle mass but it is replaced by fat. Once off ADT, muscle mass increases but, the fat gained during ADT does not. This seems to go against the theory that weight decreases because of increased testosterone leading to increased muscle metabolism.

[London441 in reply to ADTMan]

Weight loss from increased testosterone is a nice theory, but we are old! Both fat loss and muscle gain are ever more challenging, ADT only makes it more so.

[Mgtd]

hi London441. Thanks. I just pulled out my scan and there it was in the very very fine print. BMI. Who knew!

When I started this journey my gym had this fancy scale with a button for BMI. I was clueless so I asked one of the really fit guys how to use it.

After some research into what this BMI was I decided to not only keep my muscle mass while on hormone reduction but to improve my overall health. Lost 10 pounds and reduced my BMI to within normal range for my height.

Funny but just yesterday the dietitian at radiology wanted to know if my weight loss was intentional or otherwise. Sad part is she wants me to stop my healthy eating while on radiation. Seems all those fruits and veggies may not do well with the treatment. Side effects. First time ever I was asked to stop eating healthy.

[chefjlu in reply to Mgtd]

Yes, high fiber intake during radiation can increase side effects. She's not saying go out and eat a bunch of junk food. A good intake of lean protein, healthy fats and reasonable intake of vegetables with an eye on fiber content is the goal. Once off radiation therapy you can return to eating more fiber. BMI only tells a bit of the picture - guidance so to speak. Many body builders fall off the BMI scale and are far from unhealthy in their weight. Muscle weighs more than fat so body composition is much more important. Exercise, activity and good protein intake all help to reduce the muscle loss.

[Bigmaristuff in reply to chefjlu]

On the subject of enhancing the efficacy of radiation or chemotherapy I came across this fairly recent article promoting the reduction of dietary protein in association with chemo and radiation.

news-medical.net/news/20221...

[London441 in reply to Mgtd]

I was given the low fiber orders before radiation as well. They gave me a list of acceptable foods, to which I said I don’t eat any of this anymore. We cut a deal where I eliminated kale and it worked out fine.

[chefjlu]

A good intake does not mean lots or large amount. I have used a dietitian or over 6 years and oncology dietitian since diagnosis. Lean is the key as you can get sufficient protein from small amounts without adding unwanted calories & saturated fat. While going through radiation treatment over a year ago I encountered no real side effects other than having to urinate frequently when completed in the morning for a 2-3 hour window. I credited much to my radiation team and following a diet reworked for the treatment. Normally I eat meat infrequently getting protein from legumes/tofu/low-fat dairy. However, my normal diet also included appx. 45g fiber per day. This was reduced greatly requiring a drop in legumes which are good sources of both protein and fiber. Lean meat was brought in to replace the protein. Most Americans in particular eat way more protein than they need. A balance of macros is essential and an oncology dietitian was extremely helpful.

[chefjlu]

A quick check of my dietary journals confirms what this study says - 1 to 2 weeks of lower protein to improve efficacy and then moving into a more standard range. My oncology dietitian did just that.

[Wgly]

I don't want to promote Keto. It is a high fat, low sugar/high fiber (high net carb), and limited protein, that some think should be good for metabolic problems which they say include cancer and Alzheimer. I don't think it interferes with any cancer treatment. So unless our sages here know differently, nothing ventured, nothing gained.

[RMontana]

Yes, it affects a lot of processes and body functions! It raised my blood pressure for a while, then went away. Similarly, my glucose shot up and then went down, then came back and forth. It definitely affects a lot of your normal bodily functions. When I asked my RO about it he said; 'Go see your heart Doctor...not my problem,' really, that is a pretty close quote...but, he flat out denied that ADT had any blood pressure effect!

Here is what I found. Take a look. BUT exercise, especially weight training, is key. The harder you work your body the less symptoms you will have (except to your penile tissue; you wont be able to stop its effects there-if you need more info on that let me know). Good luck. Rick

healthunlocked.com/active-s...

[Bigmaristuff in reply to RMontana]

Just out of curiosity, did you try a low carb diet when your glucose shot up. If so, did it work?

[RMontana in reply to Bigmaristuff]

I was on the Atkins diet when he was still alive. So I’ve always restricted my carbohydrates. I’ve sort of live that way for the last 20 or 30 years. So I don’t know if that made any difference as I don’t typically eat a lot of carbs to begin with. I’m not a fanatic about it but I restrict them as much as possible. But with my glucose did shoot up, I would pull back harder and control the carbs more strictly. Yes, this does have an immediate impact on your glucose level. If you haven’t done it, go out and buy a glucose monitoring kit and keep it at home. I had to use this for Biofeedback during that period of time when my blood sugar was going crazy. Again it wasn’t continuous and it came and went. But I have no doubt that it was ADT that was doing it. hope this helps. Rick.

[Bigmaristuff in reply to RMontana]

Glad to hear that by restricting your carb intake you were able to keep your unstable glucose in check. I think I will be ordering that glucose monitoring kit just to be safe. Thanks for the tip.

[cancerfox]

Not only did my metabolism slow down during ADT when I put on 20#, but after over a year away from ADT and despite exercising and working out regularly, I still don't have much appetite and think my metabolism is still slowed down. But at least the continued loss in appetite helped me to lose the 20#! 😀 🦊

[j-o-h-n]

No Pasta, No Pizza, No Femmina, No Vino.

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 06/03/2023 1:05 PM PST

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

Parole sacro santo👍