So my questions are based on my n=1 experience recently.
Preface: i have been starting and stopping Orgo as follows: while on high T i stop taking Orgo while on castro with darolutamide i take Orgo with loading dose. (If stopped Orgo for =>7 days a loading dose is recommended to start back on it.
1). My T and PSA levels are still fantastic after 4 complete cycles. All liver and blood markers are in the normal ranges. Not one out of place. Why am I feeling sooo good now? I feel so much more energy (pretty sure that’s the TREX talking) BUT I now am making longer term plans ie… projects I totally gave up on during my one year on just Orgo and Daro.
Q: is this mind high related to getting off Orgo since Orgo does cross the blood brain barrier?
Q: since Orgo lowers T below 50ng after 15 days and takes 49 weeks before it climbs above 50 why can’t we go even more intermittent with it like every 3rd or 4th daro cycle hop on the Orgo train, then jump off after your 15 days daro cycle?
Q: Since Orgo lowers LH Luteinizing hormone FSH Follicle-Stimulating Hormone by competitively binding to the GnRH receptors. Does this interfere with any other processes in the body? In other words does LH and FSH have any other roles in our body?
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A half dozen or so other data points for the mind-high. Every person except for one who tried pBAT has the same feedback. Life is back. Mental high when you go from continuous ADT to any type of long T therapy is amazing.
After a while you get used to the anabolism, libido, and T life (or at least I have). After 4 1/2 years of SPT and pBAT feeling good is the new normal.
I think trying to time the Orgovyx is dangerous. Paul can get away with it because, based on his indolent cancer, he uses 3-month high T cycles.
If you take Orgovyx full time and use propionate, when you end propionate your serum T should drop to less than 20 ng/dl by day 8 and then continue dropping.
Studies show conclusively that <20 is better than <50 for androgen sensitive cancer control. My MO and I think that lower is even better.
If your natural T is 500 (mine was 800-1200 before I got PCa), and you start Orgovyx the day following your last injection, your serum T could be over 20 a week out. Everyone is different though and if you want to time it, monitor your T to see how low it goes. Measure it with continuous Orgovyx use and then compare it to timed use.
The T recovery is interesting. If you feel that your T is completely shut off you could stop all GnRH drugs and monitor T for recovery. I did that once but my T recovered in months. That was after two years of SPT! Again, everyone is different, and my fast recovery surprised my MO and me.
It is also possible that T suppression isn't needed if we use ARSIs like darolutamide. Not proven though and no trials in progress to prove or disprove this.
The jury is still out on FSH and LH. FSH might be oncogenic. But it might not, and I wouldn't take a drug just to drop FSH.
The Orgovyx side effects are almost entirely from low T.
I presume you are using propionate. I've had this discussion with my MO. I may skip the next Lupron shot, (3 month). I've been on for 4 years. Monitor T.
I was on orgovyx for several months and t was <12 and within 19 days of stopping, t was back up to 585 and I felt great, so it’s not totally true it takes 49 weeks for it to return
Some guys have a T recovery greater than 280 ng/dl within 3 weeks. So you were on the very short side of the study data.
When starting Orgovyx, T starts to decrease in a few days but takes an average of 3-4 weeks before most men show a good suppression.
My T was 1500-2500 ng/dl for two years. My MO and I didn't expect a fast recovery. But my T recovered in a few months. Part of one BAT cycle was "wasted" before I could get Lupron activated in my system. I took ARSIs to try to salvage the cycle. Theoretically that might work but we don't have any trial data backing it. It's possible that because serum T is only blocked and not lowered, the T might do some things to the membrane ARs. We don't know much about membrane ARs and until 20 years ago they were a myth.
Yes that’s pretty much how orgovyx worked on me, fast acting in reducing t to below 12(3 days) and fortunately t recovered fully within 3 weeks. ironically that’s why I got off lupron after two months n went with orgovyx
My Dr. wants to reduce my cypionate to 300mg to speed up its useage in the body. (hangs in there too long). He feels it will provide the same high T effect. I was thinking of pausing the orgovyx for 3 weeks during washout and T high in order to add to high. Probably won't affect the T much, but why suppress T (with orgovyx).
Mateo is using 3-month T cycles. I use cypionate when I go very long cycles and then switch to propionate in the last month or so. He's doing the same thing.
Neither of us can use cypionate for any cycles under a couple of months.
If you look at BATMAN they had an effective setup. Not ideal but it worked.
Some of the other trials are going the route of ARSIs to simulate a low T environment. ExBAT is one that looks good. STEP-UP is a nice one for Xtandi.
After a single 300 mg testosterone cypionate injection, serum T will fall below 20 in 45 days. That is assuming that your body's T is zero.
Contrast that to an injection of propionate sized to get your T as high as the cypionate injection. T will fall below 20 in 8 days and continues a rapid drop.
If you have to use cypionate, a 400 mg injection can be done and then followed up a week or so later with 600-1200 mg of daily darolutamide. This simulates ADT and drops T activity less than 20 ng/dl by day 2. Fast. As talked about before it is risky to rely on ARSIs instead of ADT. I don't know if ARSIs block the membrane androgen receptors. They block intracellular ones. But if you can't get propionate or Androgel it seems like a bet with very low downside and a very good probability of success.
If your T recovery numbers are based on Hero that 49 weeks includes 48 weeks of therapy.
"Testosterone recovery was evaluated in a substudy of 184 patients who completed 48 weeks of treatment
90 days after treatment discontinuation, 55% of 137 men treated with ORGOVYX had their testosterone return to above the lower limit of the normal range (>280 ng/dL) or baseline values
3% of 47 men treated with leuprolide had their testosterone return to above the lower limit of the normal range (>280 ng/dL) or baseline values 90 days after discontinuation
This endpoint was analyzed for exploratory purposes without formal testing. The data from the leuprolide arm were not included in the US Prescribing Information for ORGOVYX"
For most men, it doesn't take very long for T recovery above 20 ng/dl.
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