Low Testosterone Linked to Hospitalization for COVID - By Kristen Monaco, Staff Writer, MedPage Today, September 2, 2022

[cujoe]

This research is in direct contrast to the earlier held notion that "low T" (say, via ADT) is protective for COVID. Unfortunately, the research completely evades the issue of suppressed T due to ADT in the PCa patient population. However, the earlier notion that low T provides a protective benefit was noted (and seemingly repudiated) in the following comment in the research paper's Discussion section:

* * *

"We found that men with hypogonadism were 2.4 times more likely than men with eugonadism to be hospitalized if they contracted COVID-19. This increased risk was independent of other factors that increase the risk of hospitalization for COVID-19, such as advanced age, comorbid conditions, and immunosuppression. This finding contrasts with a widely held notion that men are more likely than women to be admitted owing to COVID-19 because they have higher concentrations of circulating testosterone. On the contrary, our data suggest that male hypogonadism is a risk factor for hospitalization for COVID-19."

* * *

Curiously, the "exclusion criteria" does not include men with PCa (on or off ADT), but does include "transgender individuals'. (If on ADT long enough, maybe some of us unintentionally qualify for exclusion under this category?) If this is applicable to those PCa patients on ADT, then we can add one more major SE to the many already on the list for SOC ADT. Surely, someday in the distant future ADT will be looked upon as a near-medieval treatment to extend the lives on men with PCa.

The MedPage article can be found here:

Low Testosterone Linked to Hospitalization for COVID — Future studies should look into testosterone therapy as a prevention strategy, study author says - by Kristen Monaco, Staff Writer, MedPage Today September 2, 2022

medpagetoday.com/infectious...

And the full JAMA research paper here:

Association of Male Hypogonadism With Risk of Hospitalization for COVID-19 - JAMA Network Open, Original Investigation, Diabetes and Endocrinology, September 2, 2022

jamanetwork.com/journals/ja...

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NOTE: The earlier MedPage Today article and related research paper on this same issue referenced in the above article are linked below:

Low Testosterone Could Be Bad News in COVID-19 — In small study, men with low levels were more likely to have severe illness - by Kristen Monaco, Staff Writer, MedPage Today May 25, 2021

medpagetoday.com/infectious...

Association of Circulating Sex Hormones With Inflammation and Disease Severity in Patients With COVID-19 - JAMA Network Open, Original Investigation, Diabetes and Endocrinology, May 25, 2021

jamanetwork.com/journals/ja...

Stay Safe & Well - regardless of your T level,

Ciao - Capt'n K9

PS One of the still unanswered issues from the earlier research is the relevancy of Free T vs Total T in the protective effects of higher T levels.

[NPfisherman]

K9 Center of Knowledge,

After reading your post and doing some looking around, it seems the study in 2020 had it wrong... all wrong...

Thanks for posting this valuable information where y'all heard it here first...

Thank you, Dogfather...

Fish

[cujoe in reply to NPfisherman]

DD the Fisherman - Seems we are not the weaker sex after all - at least when it comes to COVID - and assuming us old dogs have not lost most of our T naturally or via physical/chemical castration.

Fortunately, I'm back up well into the normal T range (total) @ 617 as of Thursday. However, the PSA was also up, so no indication I'll have the good fortune of a second multi-year durable response. I'll walk-in test again when I get back from AZ and if the trend continues may give a very low dose bical a try leading up to my next Mo appt on Dec 01.

Howz the fishing in Princeton? Land sharks don't count. Enjoy the change of scenery - & Stay Well. Ciao -MadDog

[MateoBeach in reply to cujoe]

Thanks to Marnie for very informative Video and insightful discussion.

Maddog, sorry to hear about the PSA bump up. On BAT high T invariably causes an increase in PSA secretion. It then it goes back down when on a low T cycle this does not always indicate accelerating progression. Hoping that is the case for you.

I’m back from hiking in Wyoming and Idaho. Dropping the testosterone cycle and going on a month of Orgovyx now. So will be back to an ADT Buddha-eunuch when we gather in Prescott soon. The easier-going Mateo.

[cujoe in reply to MateoBeach]

Back-country wandering man be U. I'm not overly concerned about the PSA rise. My next MO appt in early Dec, so I will walk-in test either before and/or after I leave later this month for my NE to AZ travels and based on results will consider a small dosage of bical to see if I can find a static state PSA near or below <0.1. An engineer-minded patient elsewhere did a n=1 testing of diminishing bical dosage and got to that with something around 25 mg (half tab) x twice a week. So far I remain a "good responder" to mono ADT, so that might work for me as well. (Many of my PCa friends think I should be on continuous ADT+ARI for the long haul, but I think you know where I'm coming from on not going down that road.)

A day at a time & all good days for this old dog. Energy and muscle tone slowly coming back now that there is some T to do it with. Test on 09/01 was 617, which is near the upper end of my historical range. Feels Good, Man - and I'm not talking about green frogs here!

My MO also said that if my PSA were to come down a bit, it might bring the PSA with it. However, in the past it has usually kept right on climbing. I had been thinking the disruption of my immune function due to the AUS surgery was the cause of BCR#2, but looking back over my COVID vaxx record, I'm beginning to wonder if that might have triggered it. (CLL figures in the mix as well.) And in reality, it might not be related of any of that. I'm now planning to just keep driving like an Italian for the rest of the year+.

See you at the Casa Lulu in about 3 weeks. Safe travels. Later On . . . S &W . . . Ciao - Capt'n K9

[GreenStreet]

Interesting. In the U.K. having APC and being treated with ADT did not get you on a priority list either for the Covid jab or for Paxlovid. However having radiotherapy within the last 6 months did qualify. So I got a jab and Paxlovid (after I caught Covid) due to having had CyberKnife treatment to pelvic lymph nodes. I wonder if this will be reviewed in future. Thanks for posting.

[cujoe]

smurtaw - Exceptionally thorough, as always is the case with your posts/replies. Thanks for the effort you go to in providing consistently useful information. You might want to also consider adding ionic zinc and selenium to your list - while also keeping an eye on iron and copper (relative to zinc).

I started supplementing with zinc (ionic form or Zn + quercetin), vit d3, and selenium early on and wondered why CDC and the medical community didn't suggest the use of such low-cost / low-risk protective supplementation to the public? (Well, I can imagine several fairly obvious reasons why . . . but, jeez, people's lives were/still are at stake!)

Can iron, zinc, copper and selenium status be a prognostic determinant in COVID-19 patients? - Environmental Toxicolology & Pharmacololgy, 2022 Jul 23

pubmed.ncbi.nlm.nih.gov/358...

Like you, I am in the ever decreasing pool of "COVID virgins". Even with my depleted IgG due to CLL, I remain one of only two members of my far extended family to so far avoid COVID. Several have had second infections, but fortunately no one serious enough to require hospitalization. To my credit, even with my 2 cancers, I likely have a healthier lifestyle than any of the others, so I'm not really surprised to be one of the two last men standing.* Low immunoglobulins is probably my biggest risk factor for a serious infection.

Seems probable here in the US that we will all eventually get infected, so having a when-needed treatment plan as well-considered as your is a fine idea. Let's hope neither of us needs one.

Stay Well - Ciao - Captain K9

*(However, that the other non-COVID individual clearly has the worse lifestyle and most comorbidities tends to stand that and any other logic about infection on it's proverbial head.)

[cujoe]

I saw that there are some CTs yet to report and some recent ones saying D, zinc, etc. do zilch as far as COVID protection OR treatment. As any of us who read much research come to know, with retrospective research, it's pretty easy to skew the outcome via population selection. I'm also convinced the data that has been collected in the US for covid is so non-uniform as to be useless for any reliable retrospective profiling. It could have and should have been different, but as the saying goes, now "it is what it is".

BTW, selenium caught my attention when it was seen that in populations where people are selenuim deficient, the infection and death rates were abnormally high. (Due to the low amount of it in their mostly locally grown food supply.) Vit. D was somewhat similar, where people who got infected were shown to generally have very low levels. Zinc has always be controversial when it comes to viral infections, so the COVID story is just a continuation of that.

As I'm sure you also know, with PCa the trick is to maintain levels of all these micro-nutrients that are protective for COVID and not detrimental to the control of PCa.

Keep Staying Safe & Well, Paz - K9

[cujoe]

Sorry for the delay replying. I'm getting ready for an extended trip.

The several people I know who qualified for Pfizer's Paxlovid or Merck's molnupiravir seem to have done very well and had only minor cold-like symptoms. Very sore throat seems the symptom that most recent COVID "victims" report as causing major discomfort. I will definitely call for an immediate script for Paxlovid at the first signs of a COVID infection and positive test. (Your implied notion of having some on-hand just in case, is not a bad idea.)

CLL and other blood cancer patients who are at greatest risk have been being prescribed monoclonal antibodies as a prophylactic treatment. However, monoclonals need to be administered prior to infection, so my CLL HO apparently did not consider me a "high-risk" patient when I saw her in June. It is worth noting that I am untreated 16 years after being diagnosed and for several years my blood labs (other than persistently low platelets) have been within/ near normal ranges - for CBC, CMP, & LDH. I also have not had a cold or flu in maybe as long as ten years.

The COVID information for blood cancers had been pretty variable over the last three years, to say the least. This article is typical of the variability of the information patients have to use to make decisions about their risk profiles.

Patients with blood cancers show immune response to COVID-19 vaccine boosters

healio.com/news/hematology-...

Keep staying safe with a positive attitude.

Ciao - K9 terror

[cujoe]

As aggressive as CVS is for proactively filling scripts, they might do it without even checking with your doc. I got an extra 30-day supply of bical due to them requesting a refill when one was not called for. I got a second refill, but I was out of town and when I tried to get them to hold the script until I returned, they must have called doc and cancelled it. Had I picked it up in time, who knows how many times it would have been refilled?

[cujoe]

Add in the old "I've got a sore throat and I can't smell anything" routine and get the script sent to CVS . . . or better yet, try calling in the symptoms to CVS and let them call your doc . . . if they feel the need to do that. Take one tab twice a day and check back in a week or so.