Watching Out for Myself.

For the last three months of my ADT3 I have switched from a GnRH agonist as the tent pole drug for my blockade to a GnRH antagonist and from three-month depots to one-month shots. Since the agonists and the antagonist accomplish the same thing by opposite means I am keeping close watch on the opposite lane to see if I can catch a glimpse of myself going the opposite direction.

I am becoming something of a connoisseur of first-line hormone therapy drugs. I started off with Limpron and, at the insistence of my insurance company, I switched over to Swell-bar and now, and for the next three months I am on Firm-is-gone.

Since they all seem to have pretty much the same side-effects the main difference seems to be the injection-site experience. Trelstar seems to be the best one from that point of view. Less ache in the hip joint than Lupron. The new one -- Firmagon -- has moved into the lead as the most uncomfortable. The first (loading) dose is two shots in my all-too-ample belly flab. The time-release method for Firmagon is interesting. It is a viscous liquid when injected but it immediately sets up into an uncomfortable rubbery lump that your body spends the next month breaking down. Next month and the month after (May and June) I will only get one uncomfortable rubbery lump and then I'll be done.

I am switching from three-month depots to once-a-month shots because some studies have shown that men receiving more-frequent, shorter lasting shots recover to normal testosterone levels faster than men receiving fewer, longer-lasting shots. But that study was for similar drugs with two time-release timings. I'm not sure how switching from an agonist to an antagonist will affect my recovery time.

Usually I can bring some sort of intuitive understanding to bear but I am hindered by the fact that I have never really understood how GnRH agonists work to suppress testosterone. They tell your body to make more, More, MORE testosterone and, after making a good effort, some part of the controlling mechanism (pituitary?) finally says "the hell with this" and shuts down altogether.

A GnRH "antagonist" works in a more-easily understood fashion; it simply gets in the way -- binding to the attachment points for the GnRH without activating them.

It makes some sense that switching from an agonist to an antagonist at the end of ADT will give one's pituitary an opportunity go get over its sulk. But I dunno...

Thoughts?

Jim and Peter:

When I stopped the HT (end of Feb. was my scheduled shot) I noticed after a month some of the SE seemed a bit less. But in the last month, they have actually increased a lot. It feels like I am still on that crap.

My recent test said my T was at 10, so that certainly explains my SE.

I wonder how long it takes to recover (I am hoping soon). I was taking the 4-month shots, so I had three of them for the year I was on it.

Do you have information about recovery time and specific to the type of shots (maybe I should have done the 1-month shots the last 4 months?)

Mel

PDA,
At least the Firm-is-gone has not affected your sense of humor. It sounds to me like you understand the modes of action of these drugs perfectly.

A man in my support group continued to exhibit hypogonadalism after coming off Lupron. His Uro gave him low dose shots of human chorionic gonadotropin (hCG) over two weeks and followed that with Clomid (clomiphene) pills. The hCG is a subcutaneous saline shot that doesn't hurt and instantly dissipates. These were prescribed off label and were not expensive. There is a version of clomiphene (Androxal) that has been tested in a clinical trial among men, and the results were very good. Clomid and hCG can restart the natural production of T. If it doesn't restart, the alternative is TRT, but that would be a lifelong therapy.

- Allen

link didn't work :-(

Post Edited (Tall Allen) : 4/22/2014 1:23:16 PM (GMT-6)

Peter,

...I think they have me on a new Lupron-like drug called brain-is-gone!

Bob

Look up any site on the use of HT for PC, and the known lists of side effects is quite lengthy. Sure, it doesn't mean that all men will get all side effects, but they are there, and enough men have reported them at one time or the other, that's how they get on the list by the drug maker.

Some of the side effects have great potential harm, especially to the heart.

All drugs come with side effects and risks, that's a certainty, and that needs to be weighed out between doctor and patient.

D.

Post Edited (Purgatory) : 4/22/2014 5:06:32 PM (GMT-6)

Kayak Bob,

I'm pretty sure with me it is the Casoditz.

Goodlife,

We HT types love a good joke at our own expense. And they better be funny --
we pay enough for them.

Purg,

Risks and benefits. If you are going fret about the one you should also think about the other.

MsWW,

If his Eligard shots are as much fun as my Firmagon I can see his point of view. Glad he is getting to take some time off. And speaking of time off, the prices for the Alaska cruise are starting to drop as NCL does some last minute sales to fill up the boat. It's not too late.