Added Xtandi to Orgovyx. PSA falling, but Test. Still rising.

[Startech]

Hello everyone. Mo says continue orgovix because I'm still considered castrated under 50. This last month has been kind of tough, as I think I'm experiencing PRES posterior reversible encelophalopathy syndrome. I messaged my MO some of the symptoms like blurred vision dizziness confusion light-headedness lethargy and his response was sorry you're not feeling well, you need to consider adding zometa. He's really a nice doctor so it shouldn't be too hard to fire him. What's the general consensus if my Test. continues to rise?

[Tall_Allen]

How high is your T?

[Startech in reply to Tall_Allen]

My T was 18.5 Jan 3, and 21.5 Feb 3.

[Tall_Allen in reply to Startech]

That's terrific!

[Startech in reply to Tall_Allen]

Thanks TA!

[kainasar]

Maybe the MO thinks you have hypercalcemia. That can interfere with brain functions.

[janebob99]

Zometa is for fighting osteoporosis. If you use transdermal estradiol, you will very likely grow bone and prevent osteoporosis. My bone mineral density increased by 10% over a 8 month period on estradiol (N=1). Data from the PATCH trial supports this result, as well.

[Startech in reply to janebob99]

Thank you, I'm not on Zometa. The side effects of long bone breaks and osteonecrosis doesn't make sense to me. So I added vitamin d and K2 and maybe I'm overdoing it. I see you're somewhat of an expert on e2. I haven't really looked into it yet but so far it looks pretty appealing. Except for the boobs part...

[janebob99]

Google "Patch" and "bone mineral density" or "bone", and you will find papers on how well estradiol fights osteoporosis. What was your last DEXA scan data, and date?

Since your testosterone has been castrated on Orgovyx, your estradiol is close to zero. That's why you likely will have hot flashes and osteoporosis. At the least, you need to supplement E2 to bring your E2 levels back to the high end of normal, and preferably 2-3 times the high end of normal.

[Startech in reply to janebob99]

Okay I found my report. It was done June 1st 2023. It states I have osteoporosis, but to me the scores indicate osteopenia. The worst being T score -2.5 in my neck.What's everyone doing about boob enlargement and I was going to look into replacing xtandy and Orgovyx? Thank you for your help.

[janebob99]

Thanks. Yes, it sounds like you have osteoporosis. Supplemental Estradiol will prevent any more bone loss, and you may find that your BMD increases. That's what happened to me (10% increased in BMD over 8 months on estradiol).

Some people get prophylactic breast irradiation (1-2 session), which prevent breast enlargement. Tamoxifen is also used, but some people believe that tamoxifen would interfere with the ability of estradiol to lower testosterone as a replacement for Lupron ADT. I wanted to do RT of my breasts, but the machine was scheduled too far out to make a difference. I'm used to my larger breasts now and it's no big deal. My wife doesn't care what my chest looks like, too.