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Blood sugar & cholesterol after RT/HT

User
Posted 10 Jan 2023 at 19:51

A recent non-prostate cancer related blood test ordered by my GP has revealed elevated cholesterol (total cholesterol 5.7 mmol/l) and blood sugar (43 mmol/l) levels, which I assume will prompt my GP to declare me pre-diabetic and yet again persuade me to start taking statins.

I finished Salvage Radiotherapy 4 months ago, and my 2nd and final 3-month lasting hormone injection is probably still have a lingering effect, with my testosterone at 0 a month ago. 

My cholesterol and blood sugar were normal before treatment, and I've read that RT/HT treatment can push those levels up, not least because of the absence of testosterone.

I don't want to start medication based on what could be a phase.

Has anyone had a similar experience? Or does anyone have any insight?

Peter 

User
Posted 10 Jan 2023 at 22:10
Interesting.

My GP has recently been pro-active in testing me for various things, I am not sure whether that is because of the salvage RT I underwent in the summer or the fact I turned 70. Anyway, my cholesterol was found to be 5.8 which resulted in a prescription for statins. I have gone along with that - even though 5.8 would have been in the normal range until a few years ago - but will be interested in the follow-up test.

The GP didn't mention a blood sugar result, but since I know he was going to test for HbA1c I assume he didn't find any indications of type 2 diabetes.

I was also found to have high blood pressure (which had been fine a few years ago), and have a prescription for that. It has been a bit of a shock to start taking so many tablets, but I thought it best to follow advice to avoid other risks given my main concern has been the prostate cancer.

And finally, the test showed I had low iron, which could quite plausibly be a consequence of radiotherapy. However it seems that isn't improving as hoped, since after follow-up bloods the practice has set up another telephone appointment.

Although on paper I have been off hormone therapy for the last 4-5 months (the last Zoladex injection took me just to the end of radiotherapy) I am only just getting the first indications of testosterone coming back, like return of body hair. So if any of these things are related to treatment it will be another few months before it is worth re-checking.

I can't give you any insight into what is going on, but I can reassure you you are not alone - in fact we seem to be on a parallel path. I am hoping that for me the return of testosterone normality will make a difference.

User
Posted 10 Jan 2023 at 22:53
Peter you don't say what your HDL LDL and Triglycerides are? They are probably more important than total cholesterol. Your pre diabetes may be linked too the Cholesterol issue too. There are some interesting presentations on this U tube channel if you are interested:

https://youtube.com/@lowcarbdownunder

User
Posted 11 Jan 2023 at 01:35

We feel exactly the same Peter and have the same dilemma. My husbands total cholesterol was 4.7 and LDL 2.9 both are within the range they should be although on the higher side of that. He has been prescribed statins. I really think the main factor that they use in the risk assessment is age, basically they would have everyone over 70 on statins as the risk of heart attack or stroke within the next 10 years will be over the 10% that you said. My husband only had HT for 6 months and his last injection was Nov 2021 so not sure that would be contributing to his figures.

I looked at his risk on the stroke association website and he only scored 1….purely because his age was between 70-74. Treatment is often recommended with a score of 2 or above.

He wants to stay off any medication if he can but we would also wonder ‘what if’ if anything happened. He’s having another procedure in March and after that he will probably end up taking the statins. 

Thanks for this post, it’s been on my mind for quite sometime.

Elaine

User
Posted 11 Jan 2023 at 11:38

Hormone injections tend to cause a move towards Metabolic Syndome, which is raised blood glucose, raised cholesterol, raised blood pressure, and increasing viscerol fat. So you should be monitoring all these while you are on hormone therapy. I cover this in "Surviving Hormone Therapy" talks/workshops. (This all goes back to saying you need to regard exercise as essential.)

I recently had Professor Mike Kirby who is one of the UK experts in this area of mens health, as well as being an expert on hormone therapy, come and give a talk at a local support group. His comment was that probably all men when starting hormone therapy injections would benefit from a statin and Metformin (anti-diabetic drug), to counteract these side effects.

Also note that HDL is usually regarded as the good cholesterol, but without Testosterone, it's not carried back to the liver, so it's not good either.

Edited by member 11 Jan 2023 at 23:34  | Reason: Not specified

User
Posted 10 Jan 2023 at 23:15

I have had a similar experience. Two years of zoladex. About half way through my GP did some blood tests. Cholesterol was above the top of the normal range and blood sugar was at the top of the normal range, Hba1C1 wasn't too far from normal. 

My GP had about 10 patients on zoladex at the time so is presumably familiar with the side effects. Testosterone is created from cholesterol so that explains why that goes up. I can't remember how HT caused higher blood sugar, but it can do. My GP wasn't concerned about these rises and was not inclined to start me on any medication.

About 15 years ago I was diagnosed with hemochromatosis, I had about four years of treatment (blood letting) and then I ignored if for 10 years. My iron levels are still above normal but lower than when they were treating me. My inclination is to leave things alone unless they are definitely causing a problem.

So if I were in your shoes, I would not be starting any medication for things which are not too far from normal until you have been off HT for a year. Now if your sugar or cholesterol were at dangerously high levels then that would be a different matter, I would start medication now but I would be asking to review that once I had been off HT for a year.

Of course these are just my opinions, and what I would do with my body. What you do with your body is up to you.

 

Dave

User
Posted 10 Jan 2023 at 23:36

Many thanks, Dave, for your very useful and encouraging reply.

My inclination, too, is to hold off further medication unless the levels are dangerously high (which they're not, at present), and wait until I'm more certain that the effects of the treatment have worn off.

The statin discussion is alway an awkward one with my GP, as the NHS position is to advise anyone with a risk above 10% of developing heart disease over the next 10 years (QRisk) to go onto statins. This is too much of a broad brush approach for my liking. But I could be wrong and be risking a heart attack...

User
Posted 11 Jan 2023 at 19:12
I had HT (ZOLADEX) for 3 yrs ending summer 2018 this also includes abiraterone and enzalutimide for 2 yrs as part of trial. (RT was also part of the primary treatment).

As with many of us I was pretty healthy/fit. Shortly after starting treatment put on tablets for high pressure, obv still taking them.

Started on statins July 22, cholesterol figures a bit high etc, put off having statins 12 months earlier but I do trust my go - whether treatment added to cholesterol issues one doesn't know. I am over 65 & on blood pressure tabs so will be over 10% risk anyway.

After regular annual blood tests etc July 22 found I've had chronic anaemia since 2017, any treatment etc being looked at now (seems zinc levels a bit low also). Again whether the anaemia is linked to treatment one can't say but I was in middle of treatment in 2017. I did ask during recent annual consultation but consultant said that maybe whilst on treatment yes but no evidence of lasting effect.

Year before last (2021) I was prediabetic and maybe before then, can't remember but think I was, but last summer levels gone down GP did acknowledge treatment may be a factor.

Peter

User
Posted 11 Jan 2023 at 19:30

I have found this thread very interesting and I understand the reticence in taking prescription drugs but.

I thought I was a fit and healthy man and at 55 had a heart attack resulting in open heart surgery mitral valve repair and a double bypass.     I feel so lucky that the blocked arteries were left and right and not the widow maker in the middle…… 

5/6 years on I hate having to take medication but I fear the alternative and the thing is heart attack just hits you no real warning no debate about this or that treatment

now as a member of this club I understand the options and considerations that cancer treatment offer and in some ways we are lucky that they are available and we generally have time to consider this and that option

But don’t take risks with your heart take the drugs and lower the risk as the surprise is not one you may live through 

User
Posted 11 Jan 2023 at 21:26

The point is with the forum is to give you the information to help you think 

good luck Peter 

 

 

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User
Posted 10 Jan 2023 at 22:10
Interesting.

My GP has recently been pro-active in testing me for various things, I am not sure whether that is because of the salvage RT I underwent in the summer or the fact I turned 70. Anyway, my cholesterol was found to be 5.8 which resulted in a prescription for statins. I have gone along with that - even though 5.8 would have been in the normal range until a few years ago - but will be interested in the follow-up test.

The GP didn't mention a blood sugar result, but since I know he was going to test for HbA1c I assume he didn't find any indications of type 2 diabetes.

I was also found to have high blood pressure (which had been fine a few years ago), and have a prescription for that. It has been a bit of a shock to start taking so many tablets, but I thought it best to follow advice to avoid other risks given my main concern has been the prostate cancer.

And finally, the test showed I had low iron, which could quite plausibly be a consequence of radiotherapy. However it seems that isn't improving as hoped, since after follow-up bloods the practice has set up another telephone appointment.

Although on paper I have been off hormone therapy for the last 4-5 months (the last Zoladex injection took me just to the end of radiotherapy) I am only just getting the first indications of testosterone coming back, like return of body hair. So if any of these things are related to treatment it will be another few months before it is worth re-checking.

I can't give you any insight into what is going on, but I can reassure you you are not alone - in fact we seem to be on a parallel path. I am hoping that for me the return of testosterone normality will make a difference.

User
Posted 10 Jan 2023 at 22:53
Peter you don't say what your HDL LDL and Triglycerides are? They are probably more important than total cholesterol. Your pre diabetes may be linked too the Cholesterol issue too. There are some interesting presentations on this U tube channel if you are interested:

https://youtube.com/@lowcarbdownunder

User
Posted 10 Jan 2023 at 23:10

Thanks J-B,

Yes, we seem to be on a very similar trajectory! Thanks for your thoughts on this.

I might have to bite statin bullet at some stage. I've been on blood pressure medication for ages, and it's well under control.

All the best for the return of the testosterone!

Peter

User
Posted 10 Jan 2023 at 23:15

Your right, francij1, the individual levels may be more important, and the high blood sugar may be linked to the cholesterol levels:

My HDL was 2.0, my LDL 3.3 (up from 2.4), and my Trglycerides 0.9.

Many thanks for the interetsing YouTube link - I'll take time to watch!

All the best,

Peter

 

User
Posted 10 Jan 2023 at 23:15

I have had a similar experience. Two years of zoladex. About half way through my GP did some blood tests. Cholesterol was above the top of the normal range and blood sugar was at the top of the normal range, Hba1C1 wasn't too far from normal. 

My GP had about 10 patients on zoladex at the time so is presumably familiar with the side effects. Testosterone is created from cholesterol so that explains why that goes up. I can't remember how HT caused higher blood sugar, but it can do. My GP wasn't concerned about these rises and was not inclined to start me on any medication.

About 15 years ago I was diagnosed with hemochromatosis, I had about four years of treatment (blood letting) and then I ignored if for 10 years. My iron levels are still above normal but lower than when they were treating me. My inclination is to leave things alone unless they are definitely causing a problem.

So if I were in your shoes, I would not be starting any medication for things which are not too far from normal until you have been off HT for a year. Now if your sugar or cholesterol were at dangerously high levels then that would be a different matter, I would start medication now but I would be asking to review that once I had been off HT for a year.

Of course these are just my opinions, and what I would do with my body. What you do with your body is up to you.

 

Dave

User
Posted 10 Jan 2023 at 23:36

Many thanks, Dave, for your very useful and encouraging reply.

My inclination, too, is to hold off further medication unless the levels are dangerously high (which they're not, at present), and wait until I'm more certain that the effects of the treatment have worn off.

The statin discussion is alway an awkward one with my GP, as the NHS position is to advise anyone with a risk above 10% of developing heart disease over the next 10 years (QRisk) to go onto statins. This is too much of a broad brush approach for my liking. But I could be wrong and be risking a heart attack...

User
Posted 11 Jan 2023 at 01:35

We feel exactly the same Peter and have the same dilemma. My husbands total cholesterol was 4.7 and LDL 2.9 both are within the range they should be although on the higher side of that. He has been prescribed statins. I really think the main factor that they use in the risk assessment is age, basically they would have everyone over 70 on statins as the risk of heart attack or stroke within the next 10 years will be over the 10% that you said. My husband only had HT for 6 months and his last injection was Nov 2021 so not sure that would be contributing to his figures.

I looked at his risk on the stroke association website and he only scored 1….purely because his age was between 70-74. Treatment is often recommended with a score of 2 or above.

He wants to stay off any medication if he can but we would also wonder ‘what if’ if anything happened. He’s having another procedure in March and after that he will probably end up taking the statins. 

Thanks for this post, it’s been on my mind for quite sometime.

Elaine

User
Posted 11 Jan 2023 at 11:38

Hormone injections tend to cause a move towards Metabolic Syndome, which is raised blood glucose, raised cholesterol, raised blood pressure, and increasing viscerol fat. So you should be monitoring all these while you are on hormone therapy. I cover this in "Surviving Hormone Therapy" talks/workshops. (This all goes back to saying you need to regard exercise as essential.)

I recently had Professor Mike Kirby who is one of the UK experts in this area of mens health, as well as being an expert on hormone therapy, come and give a talk at a local support group. His comment was that probably all men when starting hormone therapy injections would benefit from a statin and Metformin (anti-diabetic drug), to counteract these side effects.

Also note that HDL is usually regarded as the good cholesterol, but without Testosterone, it's not carried back to the liver, so it's not good either.

Edited by member 11 Jan 2023 at 23:34  | Reason: Not specified

User
Posted 11 Jan 2023 at 12:36

Many thanks for that well researched reply and your insight, Andrew.

So, I shouldn't really be surprised at my glucose & cholesterol levels. If my GP suggests going on medication, I'll try widening the discussion to my recent treatment.

I also had a fainting episode (first time ever!) about 7 weeks ago, followed by an immediate check-up at A&E, which - reassuringly - revealed no underlying causes. But I mention it because I'd welcome an overarching look at my overall health.

All the best,

Peter

 

User
Posted 11 Jan 2023 at 19:12
I had HT (ZOLADEX) for 3 yrs ending summer 2018 this also includes abiraterone and enzalutimide for 2 yrs as part of trial. (RT was also part of the primary treatment).

As with many of us I was pretty healthy/fit. Shortly after starting treatment put on tablets for high pressure, obv still taking them.

Started on statins July 22, cholesterol figures a bit high etc, put off having statins 12 months earlier but I do trust my go - whether treatment added to cholesterol issues one doesn't know. I am over 65 & on blood pressure tabs so will be over 10% risk anyway.

After regular annual blood tests etc July 22 found I've had chronic anaemia since 2017, any treatment etc being looked at now (seems zinc levels a bit low also). Again whether the anaemia is linked to treatment one can't say but I was in middle of treatment in 2017. I did ask during recent annual consultation but consultant said that maybe whilst on treatment yes but no evidence of lasting effect.

Year before last (2021) I was prediabetic and maybe before then, can't remember but think I was, but last summer levels gone down GP did acknowledge treatment may be a factor.

Peter

User
Posted 11 Jan 2023 at 19:30

I have found this thread very interesting and I understand the reticence in taking prescription drugs but.

I thought I was a fit and healthy man and at 55 had a heart attack resulting in open heart surgery mitral valve repair and a double bypass.     I feel so lucky that the blocked arteries were left and right and not the widow maker in the middle…… 

5/6 years on I hate having to take medication but I fear the alternative and the thing is heart attack just hits you no real warning no debate about this or that treatment

now as a member of this club I understand the options and considerations that cancer treatment offer and in some ways we are lucky that they are available and we generally have time to consider this and that option

But don’t take risks with your heart take the drugs and lower the risk as the surprise is not one you may live through 

User
Posted 11 Jan 2023 at 21:18
Thanks Andy, very interesting. In my case the move towards higher cholesterol, and blood pressure. and fat, all seem to fit. I must check that out, it didn't seem to be something my GP knew about when I asked about the possibility symptoms were a result of hormone therapy.

I guess while they are high it won't hurt to have drugs to lower blood pressure and cholesterol - as I understand those drugs aren't too problematic with side effects - but it may need reviewing in future.

User
Posted 11 Jan 2023 at 21:24

Thanks for all your replies - there's a lot of food for thought there.

Elaine, it looks like your husband's 10-year risk is low, lower than mine, in fact. I've tried working out my risk with the qrisk2 and qrisk3 calculators, and always score roughly the same as an average healthy person my age, but clearly above 10%. Like you, I've concluded that the most significant variable is age. But like him, I might end up taking statins once I'm further away from the treatment, especially if the levels stay the same, i.e. elevated.

Peter, you seem to be in a similar position to me, and your GP appears to have confirmed that treatment might be a factor. I hope your anaemia improves!

Nigel, your experience shocked me a bit, and is making think much more seriously about prescription drugs. I really appreciate your warning, and hope your heart is OK.

Peter

User
Posted 11 Jan 2023 at 21:26

The point is with the forum is to give you the information to help you think 

good luck Peter 

 

 

User
Posted 11 Jan 2023 at 21:27
Thanks Nigel,

it's all extremely helpful!

Peter

User
Posted 14 Mar 2023 at 11:04

Big thanks Andy for the such helpful advice and compelling insights!

Originally Posted by: Online Community Member

Hormone injections tend to cause a move towards Metabolic Syndome, which is raised blood glucose, raised cholesterol, raised blood pressure, and increasing viscerol fat. So you should be monitoring all these while you are on hormone therapy. I cover this in "Surviving Hormone Therapy" talks/workshops. (This all goes back to saying you need to regard exercise as essential.)

I recently had Professor Mike Kirby who is one of the UK experts in this area of mens health, as well as being an expert on hormone therapy, come and give a talk at a local support group. His comment was that probably all men when starting hormone therapy injections would benefit from a statin and Metformin (anti-diabetic drug), to counteract these side effects.

Also note that HDL is usually regarded as the good cholesterol, but without Testosterone, it's not carried back to the liver, so it's not good either.

User
Posted 21 Mar 2023 at 18:21

Goodness it's always good to come on here if for nothing else than to realise you're not alone! Similar tale but mine was when I went for PSA & Cholesterol check (I've been on Statins for 28 years after a Check up (the result of my mother & 4 sisters having dementia caused by mini stroks the result of high cholesterol back then it was 9 now 3.5).

My recent blood test showed everything OK (PSA - 0.05. 9 months post RT & a year on HT) except that I had a low blood count. I've been booked in for another test on 6 April. Post RT I've been doing well and my energy levels have been good. However over the last few months I've lost strength, have been extremely tired, have lost almost all motivation and have more and more withdrawn and depressed. I'd put all this down to the HT but all my symptoms are classic for low blood count, I'm still assuming that it's the HT effecting my blood count!  I don't recal seeing this on the list of HT effects ! I've asked the GP if I can take Iron supplements but she has said not till after my next test ☹️

User
Posted 22 Mar 2023 at 18:54
Re low blood count, I was referred to haematology fairly recently as red blood count, haemaglobin&zinc low, been mildly anaemic since 2017 (was on 3 yrs HT from end 2015, RT in 2016). My GP referred me as it was thought the treatment was a factor and by last year things should have settled. Actually had appt with haematologist who was of the opinion that the HT/RT (I don't know if just one of them or both) is probably to blame and a Zinc supplement should help with the lowish blood counts. It seems that HT may effect all sorts of things but things should settle down. I don't think the haematologist was just saying the easy thing.

Peter

User
Posted 23 Mar 2023 at 07:13
Thanks Peterco. How are you now? Is the treatment working? If so how long did it take? Many thanks.
User
Posted 23 Mar 2023 at 18:56
Afraid I only had the consultation (phone) with haematologist yesterday so not got any medication/supplement etc yet, I understand my GP will contact me accordingly when haematology report received.

Peter

 
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