YES, this time I am in need of your research! 😜
I will have a PET scan in January, and that will be followed by a nice talk with my MO.
I want to show him data from trials to convince him that in my condition some metformin would do me good (for metabolic syndrome and also because there seems to be a benefit for people with high burden) and I would like to ask him to let me get estradiol in low dose just to help me with ADT side effects (mainly muscular/joint pain). I can show him the PATCH trial, but that talks about high dosage, is there any research published on some reputable source that talks about estradiol used just for symptoms?
I know that some of you are way more informed than me about this matter.
Another question, in case a gynaecomastia, is it reversible?
Thanks!
Max
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Maxone73
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If my current strategy of preserving BMD is not working (will get a DEXA scan in 3 months), I will also ask to try estradiol patches. I will then also need to convince my MO so I would also be interested this.
I have read that tamoxifen can treat early stage gynocomastia but I will probably ask for it prophylactically if I do try estradiol.
This was a clinical trial registration I found for E2 therapy. It contains a lot of references but have not gone through them yet. These references are meant to support the trial so I guess it would be a good source.
not sure about trials . I got my doctor to prescribe me metformin 3 years ago and have Ben on 3 x 500g per day since then. Just recently cut back to 2 per day plus berberine which is a natural alternative. I take with food. Original recommendation was from Care Oncology Clijic(COC)as per of their protocol of metformin, artovastatin, membendazole and doxycycline. I ceased taking the doxycycline about 18 months ago as didn’t want my immune system compromised. If you send me your email I can send you what COC sent me which I shared with my doctor to get the prescription
Snuffy Myers has some videos on YouTube discussing both, I don’t recall if he mentions trial data but gives a very good explanation to arm yourself with.
Here is a link to the technical article "Estradiol for the mitigation of adverse effects of androgen deprivation therapy" that I showed my MO here in Oklahoma to persuade him to write a script for low dose (.025 mg) estradiol patches. I have been wearing them on all low T phases of my BAT cycles since March 2024 and I can't say enough good things about them, including improved QOL (mood, libido, etc.). You'll need to monitor E2 with a periodic ultrasensitive estradiol blood test for men, if that is available in Italy. Here in the USA, Medicare Insurance will pay for this if you have a PCa diagnosis. E2 should be kept at 10-29 pg/mL
That paper by Nick Russell in Australia is probably the single best reference summarizing the pros and cons of supplemental estradiol therapy. Thanks for posting it.
Here's some research on post-menopausal women that shows you need to get to an estradiol serum level of > 120 pg/ml to completely eliminate hot flashes from low estrogen levels. That's about 2-5 times the normal range of estradiol (25-50 pg/ml) for healthy men. The PATCH study averaged about 250 pg/ml, which is 5-10 times greater than the normal range.
Many men get prophalytic electron beam irradiation of their breasts to prevent gynecomastia before starting estradiol. The degree of gynecomastia is likely dose-dependent and symptoms will be minimized if you only take low-dose estradiol. Tamoxifen has been mentioned as a treatment for preventing gynecomastia, but I think it counteracts the beneficial effects of supplemental estradiol, so I don't recommend it.
I just had an 8-month DEXA scan, and my bone mineral density increased by 10% on the left forearm, after taking estradiol supplements for about 7 months. At a cost of $1 US /day, that's an impressive (and low-cost) outcome, with no risk of jaw necrosis from bisphosphonate drugs.
Hot Flashes Frequency versus serum Estradiol Level
I started on estradiol patches back in 2019 to mitigate the side effects of SOC ADT. I use three transdermal . 1mg patches changed weekly. They’ve kept my T down to 3.0 and the only major SE has been man boobs which I don’t care about at my age (81). Since estrogen is a natural hormone big pharma has no incentive to fund clinical trials.
my RO Dr Dattoli put me in the low dose patch since starting Orgovyx and Erleada in April this year. The side affects were minimal just loosing all body hair and man boobs that are super sensitive to the touch. Then my MO at a medical College of Wisconsin said since I am suffering from a lot of fatigue to stop the patch. I stopped for 2 weeks and one hot flash after another so went back on patch and hot flashes disappeared
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PSA suppression
ADT vacation versus Continuous
Finally Undetectable PSA on BAT
Bone Health issues re:Bisphosphonnates, etc. ????