I am hormone sensitive and have been doing BAT myself using different testosterones at times. Been doing BAT for 16 months. Recently had a one month PSA spike ( 1.4 to 6.3) along with uric acid/ kidney stone/gout. I attribute the PSA and uric acid spike to one of three things or all three. Dehydration/High Testosterone/huge spike in PSA. I picked up two bone mets from just a lymph story. I immediately jumped back on Daro/Orgo ADT and within two weeks PSA dropped of a cliff (6.3 to 0.85), two weeks later it is 0.05 and i am going back on BAT in 6 days.
At that time i convinced my OC to prescribe E2 patch at 0.025mg weekly.
Two months into ADT i started the E2 patch and it worked beautifully and it did not increase PSA. PSA actually dropped to 0.05 thanks to daro and orgo.
The E2 patch also gave me much more energy, eliminated my hand and elbow pain, and the hidden benefits like bone density and red blood cell production.
So besides all those other benefits my other positive benefit is my cognitive ability seems to have improved. I know this because i play chess online chess.com username “jmsandy” and i play a lot. My chess ratings were around 1220 before 1 1/2 years of ADT and declined with estrodiol decline to low 1100’s. Know while on 6 weeks of E2 my rating has climbed to 1247. It takes lots of wins to increase over 100 points.
Cheers !
John
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It boggles the mind why they just measure psa and T. E2 is never even considered and Side effects are just part of doing business. N considerations for the pain we go through.
Thank you for the positive report about low-dose transdermal estradiol therapy.
Just as a side note, the dose you are using, (1) 0.025 mg E2 patch, is at the very low end of typical E2 dosing. The PATCH protocol uses 3-4 patches at a time of strength = 0.1 mg E2. So, the PATCH protocol dose would be 16-20 times larger than your dose.
It's very interesting that you are getting such good results with such a low dose. Clearly, more research is needed on the positive effects of low-to-medium E2 dosing, especially on preventing hot flashes and reversing osteoporosis/osteopenia.
It would be interesting to see what would happen if you used the PATCH protocol combined with BAT therapy, where you replace Orgovyx ADT with Estradiol ADT. We could call that BET therapy, "Bipolar Estrogen Therapy". 😀
Lets see if we can figure out yhe possible ramifications of that.
So High T basically resets the cancer to survive off of androgen and balances out the ratio of monomers to dimers so less monomers thus less mutated transcription. No side effects.
So ADT like Orgovyx and Androgen Receptor signal Inhibitors like darolutamide would stop production of T/Rstrogen and Daro would stop any transcription from residual T and DHT made from other means like Aldo keto reductase AKR1C3. Major side effects and eventual resistance.
So E2 High dose would stop production of T thus no endogenous E production but wouldn’t the cancer use estrogen to do transcription? Would it be like high T where the androgen receptors would be dimers thus no monomer transcription except this would be estrogen receptors thus normal transcription? I haven’t really studied high E so i would rely on your expertise.
After high T cycle hit it with high E which would be the same as ADT like Orgovyx but not an ARSi like Daro.
So is the only side effect of high E is gynecomastia, weak muscles and low libido?
For muscles and low libido the high T cycle would take care of that I presume ?
My questions would be how fast does the high E shut down endogenous testosterone production? The reason is having low T to feed the cancers androgen receptors momomer transcription would not be optimal. I wonder if one could just use darolutamide for a few weeks or for however long it would take high E to shut down T production.
It’s all very fascinating but hard to imagine someone trying this BET as BAT alone is experimental and not many willing to try it.
You are too kind....I don't have your expertise in how BAT works. Estradiol, yes, but BAT, no.
Since high-dose E2 ADT works exactly the same way as Lupron ADT, by interfering with the HPA hormonal axis mechanics to stop production of T from the testes (the adrenals aren't affected), I would expect that one could substitute E2 ADT for Lupron ADT in the BAT protocol.
Any form of ADT, Lupron or E2), will cause muscle weakness/loss and low libido, because that is driven by T. Supra-physiologic levels of E2 in men and women cause enlargement of breasts and mastalgia, in addition to the the other SE's, such as muscle weakness/loss and low libido, caused by low T.
Getting a large dose of TRT once a month during BAT therapy would improve QoL, reduce muscle weakness, and increase libido, as you said.
Here's a plot of hormonal changes vs time after a single E2 patch is applied. The T and E2 (and LH and FSH) respond in a few weeks, while the PSA takes 1-2 months to change.
Good to know. I'm trying to bring my docs around on this. Let us know if you have to deal with gynecomastia. I wasn't clear if low dose estrogen led to that.
This is awesome. I'm currently trying iADT, but if my PSA bounces back too soon with T recovery I'll be investigating E2 dosing as another option to deal with ADT sides.
Hi John! I just read a whole bunch of your posts, or more accurately scanned. Regarding kidney stones, I once gave myself a kidney stone by eating way too many almonds.
As for transdermal low dose estradiol for estrogen add-back, and which I have not moved to head with yet, congratulations on the improvements all around!
May I ask what your analysis is concerning the whole business of the two estrogen receptors, alpha and beta, and they're relative population ratio change over time, and the whole question of alpha-bad and beta-good etc. Also I see that in a post I have teed up to read, that are familiar with SARMs. May I ask about SERMs?
oh boy the estrogen receptor alpha and beta is all theory and we can’t test for it ourselves so it is a concern that it would raise my psa but i am hormone sensitive and i figured i could at least be ok with average levels of estrogen to counter the side effects of ADT. I test often at quest diagnostics (approx every two weeks) so i keep an eye on my T,E2,PSA, and now uric acid.
I thought about using SERMS but i wanted to try low dose E2 first since it is not a driver in my cancer (I hope). I felt SARMS were well researched and used and i felt confident in using them. The website moreplatesmoredates has great articles on SARMS.
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3rd & 4th pBAT cycle results with daro question