Adverse effect from Orgovyx + Abiraterone + 5mg Prednisone.

[Spinel_Cutter]

I've been on Orgovyx + Abi + 5mg Prednisone now for 3 months. I've had to hound my doc for an A1C and lipid profile, since these are known to affect them.

My A1c has moved from the upper range of normal to well within diabetes. It was 5.5 and is now 6.7, ouch. That 5mg of prenisone is like eating a banana split, it ups my BG (blood glucose) by 40-70 points, all by itself. So if I take Org + Abi + Pred at 9am and eat a carb-rich lunch, my 2 hour post-prandial BG ramps up into the 200 to 260 BG. So, I now, just don't each lunch, or eat a lunch with zero carbs, and that oddly drops my BG down quite a lot. A 5 ounce burger on 2 pcs of zero carb bread raises my BG by only 8 points at one hour and then drops quite a lot two hours after eating (from 160BG, to 124). I've been prone to high morning BG (dawn phenomenon) and now wonder if I should eat a zero carb meal earlier. It's as though it kick-starts my cells to take in insulin. Very odd.

But my question is this: I seem rather oddly "flighty," unable to focus and so very easily distracted. I've always been ADD, but now it's like ADD on steroids (which it may actually be). Has anyone else found that they lose the ability to focus, and have become very easily distracted?

I have a job that's virtual, and I can rack up hours at whim. It pays well, but at the end of the day, instead of racking up 9 hours, I rack up only 2, distracted by everything and anything. Anyone else?

My doc seems to not give a damn about moving into diabetes, but that's what kills us, the move into Syndrome X (metabolism syndrome). Yes, I'm now into a moderately strict keto diet (<20 grams/day) and yes, I need to get out to the gym a lot more.

On the other hand, I have friends not on Org+Abi+5mg Pred, and their adverse effects seem far worse than mine. I really have no fatigue, and minor hot flushes. (The are on Lupron only)

On a good note, I've gone from PSA of 50.4 to 0.28 in three months and have yet to start IMRT. I'll take that!

[Doctorsceptic]

Well your doctor should give a damn!! Suggest you ask to see a metabolic specialist to assess you and advise on medication and management.

[Mgtd]

May want to see your GP or family doctor. If it were me I would take action now!

[vintage42]

"I've been on Orgovyx + Abi + 5mg Prednisone now for 3 months... I seem rather oddly "flighty," unable to focus and so very easily distracted.... Has anyone else found that they lose the ability to focus, and have become very easily distracted?"

I have been on your same meds for 15 months and notice a little brain fog, a normal side effect. It does not bother me much, but is perhaps a problem if one already has ADD.

[Countergod]

Just wanted to let you know that you can buy your own lab tests online without going thru any doctor. I use Ulta Lab Tests and have the bloodwork done at any Quest location nationwide. See ultalabtests.com/partners/u... They often have sales on their lab tests. The A1C Test is Hemoglobin A1c (HgbA1C) #496 and the Lipid Panel Test is Lipid Panel #7600. Both of these tests should cost you about $50 total. If you're interested in doing some research on the different blood tests, you can go to this Quest website testdirectory.questdiagnost... and use the Ulta test code numbers that will give you more info on each type of test. Never realized that there are so many different blood tests out there. Your journey sounds alot like mine with the Orgovyx + Abi + Pred for slightly over three months. I've also been diagnosed as pre-diabetic and have been using 7.5mg Mounjaro to keep my blood sugar under control, but my fasting glucose numbers are starting to creep up since I've been on the ADT drugs. The good news is that my psa score has gone from 41 back in Dec to .4 as of March 11th. Getting ready to start 8 weeks of RT next week to hopefully kick this cancer to the curb.

[Mgtd in reply to Countergod]

Great info! Thanks and good luck on that radiation.

I am a total supporter of “cancer cruelty” via radiation.

[Spinel_Cutter]

Thanks you'all. Yes, he "should," but then you "should" be a billionaire... I asked to see a metabolic specialist over a year ago, none available. This is not uncommon, these days. Mgtd, yes, I have taken action, I've moved to a keto diet + added 1 gram of slow release Metformin.

Since taking that 5mg Prednisone ups my BG 40pts alone, I'll wait 6 hours before eating anything with carbs in it. I found a keto bread at Aldi's that's great and helping immensely. I'm all in for the long haul, until I can get off the abi+org+pred. This morning (my BG was 125 and Keto 0.5, right were I want it).

Oh, though, I shall sorely miss my Rocky Road ice cream....

Vintage42 I asked Grok (the AI) and the response was that yes, if one has ADD/ADHD it can worsen it:

"Neurotransmitter Alterations: Prednisone may affect dopamine and norepinephrine levels, which are critical for attention, motivation, and impulse control in ADHD. These changes could exacerbate ADHD symptoms like inattention and hyperactivity.

Impact on the HPA Axis: Prednisone suppresses cortisol production, disrupting stress hormone balance. This imbalance might impair attention and focus, further aggravating ADHD symptoms.

Sleep Disturbances: Prednisone often causes insomnia or disrupts sleep cycles. Poor sleep can intensify ADHD-related cognitive and emotional challenges.

And the combo certainly affects my sleep, esp. due to nighttime hot flushes.

I guess it goes to show how different each of us can react to meds, others I talk to complain about fatigue, for me, no fatigue, so not a bad trade-off.

[j-o-h-n]

Unfortunately we're in our prime chilling with Father Time....

Good Luck, Good Health and Good Humor.

j-o-h-n

[Professorgary]

the drop to 99 non fasting was after 6 weeks taking berberine. Curcumin, berberine and magnesium are your friend. Research the effect of each supplement on the various side effects of ADT. Berberine is actually more effective than Metformin. I think it is common for many of the guys on this forum to ignore supplements but that would be their loss. I’m not saying supplements are for everyone but everyone should have an open mind to the possibility of their benefit. God bless.

[Spinel_Cutter in reply to Professorgary]

Uh.... the reality is quite the opposite! (For me) I am very much positive on berberine, curcumin w/ piperine + Magnesium. I will agree with Magnesium overall.

However, were I to continue taking my 2 grams of curcumin w/ 5mg Piperine, along with Berberine, which I used to take, daily, I would expect, at the least to have a miserable time. I did take 2g + Berberine before starting Orgovyx + Abiraterone, but was FORCED to stop as to not risk potentially severe adverse effects.

Curcumin and Berberine are great supplements, but NOT for me (currently) nor for anyone on Orgovxy and/or Abiraterone:

• Berberine: Risk: While not directly studied with Orgovyx or abiraterone, berberine is known to inhibit CYP3A4 and CYP2D6 enzymes. Since both drugs are metabolized by CYP3A436, concurrent use may increase their plasma concentrations, raising the risk of side effects like QT prolongation, fatigue, or hepatic toxicity.

• Curcumin: Risk: While not directly studied with Orgovyx or abiraterone, berberine is known to inhibit CYP3A4 and CYP2D6 enzymes. Since both drugs are metabolized by CYP3A436, concurrent use may increase their plasma concentrations, raising the risk of side effects like QT prolongation, fatigue, or hepatic toxicity.

• Piperine: Risk: While not directly studied with Orgovyx or abiraterone, berberine is known to inhibit CYP3A4 and CYP2D6 enzymes. Since both drugs are metabolized by CYP3A436, concurrent use may increase their plasma concentrations, raising the risk of side effects like QT prolongation, fatigue, or hepatic toxicity.

One would be wise when taking a med, especially chemotherapy, to consider what effects that the med might have with supplements and/or adjuvants. Sadly, when I started Org + Abi, I also, sadly, had to stop taking my favorites: Ashwaganda; Trans-Pterostilbene: Cayenne pepper extract and Quercetin, because ALL would have caused a blood-lever increase in the Orgovyx + Abiraterone. (All interfere with the 3A4 system.

Currently, I have found the following compatible: ALA (Alpha Lipoic Acid); L-Theanine; ALCAR, and NAC which all negatively affects PCa but does not compete with that all important Cytochrome P450 3A4 enzymatic systems.

Great advice, but not for anyone on a med that used the 3A4. Beware! I hear many men complain of terrible fatigue. I do not experience any fatigue on my meds. I do wonder if some who do complain of fatigue are using competitive supplements.

I do miss, especially the Curcumin which was great for my arthritic thumbs.

[Professorgary in reply to Spinel_Cutter]

All my doctors know the supplements I take and the exact amounts. I rarely feel fatigued but when I do it is usually because I allowed myself to become dehydrated. Fatigue will be accompanied by cramps in my toes and lower legs. I also take celebrex which carries it’s own cardiovascular risks. I have degenerative disc disease but with my regimine live a pretty much pain free life, as long as I drink plenty of water. My labs are great except for wbc being slightly elevated which has been the case all my life. You are absolutely right when you say supplements are not for everyone. This is why I suggest research and doctor consultation. Thanks for the input, very much appreciated. God bless.

[Professorgary]

pic for clarity

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