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After Zoladex treatment

User
Posted 14 Sep 2024 at 13:51

I received Zoladex treatment for some years starting in ≈ 2014 (not cancer related) and stopped in 2019.


I am 60 years old & male.


I have suffered from severe fatigue, lack of libido, no body hair, several lack of motivation, symptoms of depression etc for some years. I have been to the GP many times re these symptoms.


Recently I requested a blood tests and this time requested that hormone inc levels were included and basically Testosterone levels are at ≈ Zero (0.1 nmol/litre) oestrogen is similarly ≈ zero.


Could the levels be causing the symptoms? Should I be on TRT?


I have now been referred to an endocrinologist through the NHS and this will take a minimum of 6 months for first appt.


I am very annoyed that no GP/Dr has felt the need to monitor my hormone levels post treatment, surely the symptoms were red flags...


So tired of being this tired.


.


 

Edited by member 14 Sep 2024 at 18:09  | Reason: Not specified

User
Posted 14 Sep 2024 at 13:51

I received Zoladex treatment for some years starting in ≈ 2014 (not cancer related) and stopped in 2019.


I am 60 years old & male.


I have suffered from severe fatigue, lack of libido, no body hair, several lack of motivation, symptoms of depression etc for some years. I have been to the GP many times re these symptoms.


Recently I requested a blood tests and this time requested that hormone inc levels were included and basically Testosterone levels are at ≈ Zero (0.1 nmol/litre) oestrogen is similarly ≈ zero.


Could the levels be causing the symptoms? Should I be on TRT?


I have now been referred to an endocrinologist through the NHS and this will take a minimum of 6 months for first appt.


I am very annoyed that no GP/Dr has felt the need to monitor my hormone levels post treatment, surely the symptoms were red flags...


So tired of being this tired.


.


 

Edited by member 14 Sep 2024 at 18:09  | Reason: Not specified

User
Posted 14 Sep 2024 at 22:49
It seems that Francij has had a bad experience with a GP, in my experience most work very hard in a very demanding job. But as with all professions, not all are as good as the best.

However the way the NHS has been run down over the last few years, referrals take time unless they are prioritised - and sadly because low testosterone isn't life threatening it isn't fast tracked.
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User
Posted 14 Sep 2024 at 17:53
Sounds like you gave found the problem, PS don't expect NHS GPs to do ANYTHING they are a useless bunch of layabouts creaming top dollar for doing nothing most of the time.
User
Posted 14 Sep 2024 at 18:09

Unfortunately, I am stuck with NHS as I went private but they declined to treat because of the back history.


 


So I am left with the NHS and it's interminable waiting lists.

User
Posted 14 Sep 2024 at 22:49
It seems that Francij has had a bad experience with a GP, in my experience most work very hard in a very demanding job. But as with all professions, not all are as good as the best.

However the way the NHS has been run down over the last few years, referrals take time unless they are prioritised - and sadly because low testosterone isn't life threatening it isn't fast tracked.
User
Posted 15 Sep 2024 at 10:48

Yes, this will be the cause.


I don't know why you were on Zoladex, so I don't know if TRT is safe, but on the assumption that they took you off Zoladex because you didn't need ADT anymore, then it might be.


However, in the mean time, you should be on Calcium, Vitamin D3, and Vitamin K2 (unless on some blood thinners) to try and preserve bone density (check with your GP none are ruled out by other drugs or medical conditions). You also need to get a DEXA scan, having been without Testosterone for >2 years, to check if bones are already dangerously weak and in need of treatment to prevent fractures. You need to be exercising also to preserve bone strength, but if you haven't been, wait for the DEXA scan result first or you risk breaking something.


You also need to get your blood pressure, blood glucose, and cholesterol levels checked, as ADT pushes them all up. Note, with the cholesterol check that it's the total level you care about, and not the ratio, because without Testosterone (or Estrogen actually, but that's made from Testosterone in men), then both LDL and HDL are bad cholesterols.


Your Testosterone level is lower than Zoladex can usually achieve by switching off all Testosterone produced by the testicles. Is there any issue with your adrenal glands, which usually produce a little Testosterone too? Have you been on Abiraterone which switches that off? I'm wondering if you are also short of many/all other steroids? That can have similar side effects, but usually others too.

Edited by member 15 Sep 2024 at 10:51  | Reason: Not specified

User
Posted 15 Sep 2024 at 18:01

Originally Posted by: Online Community Member
Sounds like you gave found the problem, PS don't expect NHS GPs to do ANYTHING they are a useless bunch of layabouts creaming top dollar for doing nothing most of the time.


 


I so sorry you’ve had such bad experience. Hope things improve for you.


 


I find they work really hard and have too many patients as practices close and the primary care work becomes increasingly tougher and they’re blamed for so much out of their control. . GP get a tiny proportion of NHS funds yet see and conclude care on majority of patients. Pay erosion and a decade of austerity has left NHS in bad shape and sadly it’s patient care that suffers. 

User
Posted 30 Sep 2024 at 01:42

Hello Andy,


I was intrigued by your comment that without testosterone , both cholesterols are bad? Can you please elaborate?


Many thanks

User
Posted 30 Sep 2024 at 08:28

Originally Posted by: Online Community Member


Hello Andy,


I was intrigued by your comment that without testosterone , both cholesterols are bad? Can you please elaborate?



HDL dissolves LDL and carries it back to the liver, where it's disposed of. This process requires estrogens, and without estrogens, it doesn't work. In men, estrogens are manufactured from Testosterone, so if you have low/no Testosterone, you will have low/no estrogens either, so HDL is no longer a "good" cholesterol.


Nowadays, cholesterol level test results usually concentrate on the HDL ratio, but that's only valid in the presence of estrogens, assuming the HDL is a "good" cholesterol. If that's not the case, you need to watch the total cholesterol level instead.

 
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