Brain Fog and ADT

[NecessarilySo]

Let's say, just stretching the imagination, that since testosterone is necessary for cognitive function, ADT, in lowering testosterone, lowers brain function to some degree. But in my case, ADT does not bring T to zero. I seem to have a T reading of around 12 or so in spite of the ADT. But some more powerful attempts to lower testosterone might bring the T nearer to zero. By eating foods that increase testosterone, let's say we can bring our T up a bit to the 20-50 range. It could be that the "brain fog" some people complain about is due to near zero T levels and a diet low in T support. Then the brain fog might be eliminated by eating more eggs or avocados or salmon or whatever increases T. But suppose the extra T from diet also causes metastasis growth? Then we have a choice: do we want to lose our cognitive function or cause metastasis growth?

[j-o-h-n]

There is a logical answer but I can't recall what it is....

Good Luck, Good Health and Good Humor.

j-o-h-n

[Mgtd]

Well scanned your bio and we are about the same age. I will be 80 next year. I did not see any mention of physical condition or your exercise routine. I may have missed it in quickly scanning over your bio.

My increase in T reduced the brain fog. I could actually feel it lifting at around a T of 125 to 150 and really noticed the difference at 233. I had a T prior to this whole process of about 700. Stopped getting it tested at 590.

My T started climbing back after two months of stopping Lupron. I attribute this to my natural body level prior to ADT, diet and MOST IMPORTANTLY resistance training and walking.

Worked for me not sure it will work for you but worth a try. I chose mental health over spread of cancer. At my age Quality of Life is critical to me. Your decision may vary. So far I have had both QOL and no spread.

[Doctorsceptic in reply to Mgtd]

Good choice

[Cyclingrealtor]

I believe the goal of castrate T is < 20.

I have had some testing outside of Kaiser Permanente to see what my T may be because they just use a standard < 19(?).

After 24 months of leuprolide and 18 months of abiraterone I had a T < 3.

I was 54 when I started the leuprolide and abiraterone.

Brain fog, loss of libido, penile atrophy, loss of strength, fatigue, focus and concentration, loss of muscle, hot flashes and depression all affected me. Some of the side effects were low, some mild and some more prevalent and strong. They ebbed and flowed.

The brain fog was tough because I knew it was one of the side effects. I couldn't say some words. I could describe/ define the word but couldn't verbalize it.

After looking at my pathology and treatment history, my MO and I agreed that if it was a curative result we have thrown enough at it. I stopped the leuprolide and abiraterone at the end of June 2024.

What a significant and noticeable difference so far for feeling more "normal". The brain fog has definitely subsided too.

Fingers crossed for a long path with disease free and treatment free survival! 🙏🏻🩵

[Scout4answers in reply to Cyclingrealtor]

We are on the same page

5 months post Lupron and Abi I am still experiencing this:

The brain fog was tough . I couldn't say some words. I could describe/ define the word hut couldn't verbalize it.

Thinking seriously of doing BAT if PSA returns

[Iscetic7 in reply to Scout4answers]

I would highly recommend double extraction lions mane tincture and take it 3x the recommended daily dosage. It has made a huge difference for me. I still have issues, but it did make it bearable.

[dhccpa in reply to Iscetic7]

Made a difference in mitigating SEs of low T? Or in the cancer itself?

[garyjp9 in reply to Scout4answers]

I'm experiencing the same

[Anthonyve]

Are there really foods that increase testosterone levels?

I didn’t think so.

[NecessarilySo in reply to Anthonyve]

Many articles suggest that certain foods, and exercise, help to increase testosterone levels. For example, this one: muscleandstrength.com/artic...

[Maxone73 in reply to NecessarilySo]

I have randomly checked one of the studies they refer to in the article...apart from a very low level of confidence and high variance, the increase is small and temporary, nothing that would influence T level of someone under ADT

[Anthonyve in reply to NecessarilySo]

Thanks.

Very interesting.

[Grandpa4 in reply to NecessarilySo]

Yes but would they work for someone on ADT. If they work by stimulating testosterone production from the testes I would guess no.

[Maxone73]

My testosterone is also not zero, I don't think anyone can have a flat zero level because ADT blocks testosterone produced by testicles, but they are not the only organ producing testosterone, also adrenal glands produce it. That's why we usually have ADT plus something like abiraterone or darolutamide or enzalutamide and similar (they are broadly called ARSi), because in simple terms, ADT blocks as much production as possible, ARSi block the reception of the remaining testosterone.

[London441]

Keeping the T under 50 was SOC in the past. For good reason it has moved lower, ideally <10.

Even if certain foods could make a small difference, an increase from 20 to 50 isn’t going to cause any lessening of any of side effects, including brain fog- other than by placebo effect. 50 is the threshold of ‘castrate level’. Even 75 is too low to impact brain fog.

On the other hand exercise produces a substantial and palpable decrease in all the sides, most certainly including brain fog. How much are you getting and what kind?

[vintage42]

"... It could be that the "brain fog" some people complain about is due to near zero T levels and a diet low in T support... suppose the extra T from diet also causes metastasis growth? Then we have a choice: do we want to lose our cognitive function or cause metastasis growth?"

I don't think that is the choice.

Orgovyx ADT and Abiraterone ARI has reduced my PSA to .02 and T to <3. Yet I barely notice what I guess is either brain fog or normal for being 2 months shy of 82. On the other hand, ten years ago my younger brother developed medically significant loss of cognitive function after his Lupron shots (coincidence or not). So I would not class brain fog with loss of cognitive function, although you may be considering them together on a sliding scale. I think brain fog is more like attention deficit, a small inconvenience for slowing metastases.

I agree with the value of exercise, using a 9 Matrix machines at a club, 3 sets of 10 on each machine, designed to stress muscles and bones.

[Miccoman]

My T is under 12, as well. But my brain fog has cleared after stopping Lupron because I had an orchiectomy. The boys were totally atrophied after 7 or 8 years of ADT so no loss there but my mind cleared and I feel 100% back. I'm also beyond Xtandi and Aberiterone so I can't comment on those drugs effect on brain fog. YMMV

[Aardvark4]

Maybe the 'sleeping giant' (pun) in this is a lack of sufficient quality sleep while on any of these regimes. Without that baseline sleep level it is hard to say how the treatment is DIRECTLY affecting your QOL and how much is caused by sleep deprivation; recognised as a form of torture by international bodies.

betterhealth.vic.gov.au/hea...

Check out the list of physical and psychological effects.

Is anyone aware of any studies involving non sleep affected Vs sleep affected patient adverse events on ADT?

[SteveTheJ]

All very speculative. My testosterone has been as low as 7 and is now 150. (Before ADT it was 400.) Each and every day I experience brain fog, lack of motivation, and general fatigue but I think that now at a higher testosterone those episodes are not as bad ... in what ways, I can't exactly quantify.

You might as well try what you have in mind and see if it works. On most days I take a 200mg Provigil (prescribed by oncologist) and that helps with fatigue, focus, and brain fog. But it's temporary like everything else.

I seriously doubt you'll feel a bit of difference with a testosterone of 20 but who knows? It's worth a shot.

[CAMPSOUPS]

In the nearly 5 years I've been here you have always had imaginary thoughts.

I'm glad you seem to be doing ok though. Hope so.