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Medical Forum / Diseases and Disorders / Prostate Cancer / July 2009

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Surprising Rise in Cholesterol

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Steve Kramer - 23 Jun 2009 13:14 GMT
WARNING:  The following is probably going to be a long, fact-filled post,
all about me, and probably not of much interest to any other than perhaps
the person who can answer my quandary.

The question is:  Is it likely that a dose of Lupron can spike cholesterol
and related numbers?

Background:  During 2000, I was diagnosed with PCa.  About that time, I was
also diagnosed with hypertension and my blood work (cholesterol, etc.)
numbers were high.  My weight was about 311 (36 BMI).

I immediately started walking and kept up this regimen to date.  Currently,
I walk 2.5 to 3.4 miles a day, 3 or 4 days a week.  I also began
hypertension and cholesterol meds and continue those to date.  My weight
increased over time.  It was 347 (41 BMI) in January 2009.  My blood
pressure was 140/82 and blood numbers were improved to and remained for
years about:  Cholesterol = 180; HDL = 33; LDL = 105; Triglycerides 338 --  
all too high or too low.

I started lifting weights when I retired January 10, 2009.  By March, my
weight ballooned to 358 (42.4 BMI) and I remembered muscle vs fat weight and
finally accepted that push aways were more important than push ups.  So, I
watched my diet.  But, my numbers were better: During April my BP was
116/65, Cholesterol = 145; LDL = 65; and Triglycerides = 236.  HDL did not
change.

Since January, I have had an impressive improvement in muscle strength:
biceps + 117%; pectoral fly + 275%; leg press + 228%; seated row + 118%;
shoulder press +175% (and since April) leg extension + 156%; rear deltoid
reverse fly + 153%; and leg curl + 112.  My 37-year back ache is gone.
While I thought I was doing well at my age in helping my kids with moving,
mulching, digging, etc., I am now doing much, much better.  I cannot tell
you how much adding a weight regimen to my life has helped.  I know, I
know...  I've been told this all my life!

But!!

On June 4, I had my uro appointment and got my 4-month Lupron shot.  The
next day, I had my blood pulled for PSA and blood numbers.  Yesterday, I
found that while my weight is down 25 pounds and BP is steady and great.
But my Cholesterol is 161 (up 16); LDL = 76 (okay, but up 11); and
triglycerides = 258 (up 22).  HDL is unchanged and too low at 33.  BTW, my T
was down, too, from 67 to 62 (on Lupron since 2003 and Casodex since 2006).

So what the hell happened?

Did my lupron shot 20 hours before lower my T?  Could it have had a spiking
effect on the rest of my numbers?  No change in diet since April and still
losing weight.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA  <.1  <.1  <.1  .27  .37  .75            PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32                        PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA  .07 .05 .06 .09 .08 .132 .145       PSAD 1.4 years
Casodex added daily 07/06
PSA undetectable since; last checked on 06/04/09
Illegitimati non carborundum

candt$ - 23 Jun 2009 18:17 GMT
>So, I
> watched my diet.  

Just a thought - the conventional wisdom is that vegetable fats are
not bad, even maybe good. However, almost all of these are high in
omega 6 which some now say can cause significant problems, most
notably if not balanced by a proportional amount of omega 3 intake.

cholesterol is not specifically mentioned, but the broader picture
seems to point to some of the problems which cholesterol is usually
blamed for.
see typically
http://www.ncbi.nlm.nih.gov/pubmed/12442909

Signature

ac

Steve Kramer - 23 Jun 2009 19:26 GMT
: >So, I
: > watched my diet.
[quoted text clipped - 9 lines]
: see typically
: http://www.ncbi.nlm.nih.gov/pubmed/12442909

Thanks.  I have been drinking a lot of Fusion to get my fruits and
vegetables.  However, I've also been taking 4 capsules of prescription fish
oil.

I'll have to factor the Omegas in my thinking.
I.P. Freely - 24 Jun 2009 00:08 GMT
> The question is:  Is it likely that a dose of Lupron can spike cholesterol
> and related numbers?

Yes. It's common, as has been discussed here before. Google words like
cholesterol ADT Lupron and many such references will surface, including
the PCRI's AD Syndrome chart.

> I cannot tell
> you how much adding a weight regimen to my life has helped.

No surprise ... and a big round of kudos ... there. But realize that we
"leg press" twice our weight simply walking up stairs. Walking up
stairs, for you, is equivalent to a two-leg press of > 600 pounds.

 > But my Cholesterol is 161 (up 16); LDL = 76 (okay, but up 11); and
> triglycerides = 258 (up 22).  HDL is unchanged and too low at 33.  BTW, my T
> was down, too, from 67 to 62

161 is pretty good for total chol, as is 76 for LDL, but that HDL is a
problem. Mine was 33 for decades, until statins -- later replaced by 4
gms fish oil -- increased it very significantly. Incredible amounts of
hard exercise didn't have anywhere NEAR the HDL-raising benefit of
statins or fish oil for me.

Your triglycerides are too high, as you know. Maybe yours is genetic,
and if your doctor thinks it's dangerous and you're doing all you can
for it already, extreme diets such as Pritiken's can drive it down further.

OTOH, better cardiovascular health markers than chol and trigs are
available, such as CPa and maybe homocysteine. I wouldn't subject myself
to my buddy Jim's Pritiken diet unless all my markers were pretty severe
(his trigs ran >800 and he's has a quad bypass).

I'm guessing your non-castrate T level may explain in part why you've
been so successful in keeping up with your walking regimen and adding
the weights.

I.P.
Steve Kramer - 24 Jun 2009 00:17 GMT
: available, such as CPa and maybe homocysteine. I wouldn't subject myself
: to my buddy Jim's Pritiken diet unless all my markers were pretty severe
: (his trigs ran >800 and he's has a quad bypass).

I tried Pritiken many years ago.  I think I'd rather die of a heart attack.
:-)
Tom Cular - 24 Jun 2009 00:54 GMT
Steve,
I remember reading something related to rising cholesterol and Lupron, give
me a day or so and I'll dig it up. I don't recall the author or the validity
, but I'll try to find it and send the info to you.

Tom
> WARNING:  The following is probably going to be a long, fact-filled post,
> all about me, and probably not of much interest to any other than perhaps
[quoted text clipped - 51 lines]
> effect on the rest of my numbers?  No change in diet since April and still
> losing weight.
Steve Kramer - 24 Jun 2009 11:50 GMT
: Steve,
: I remember reading something related to rising cholesterol and Lupron, give
: me a day or so and I'll dig it up. I don't recall the author or the validity
: , but I'll try to find it and send the info to you.

Thanks, Tom.

I know elevated cholesterol is a SE of ADT.  I accept that for what it is.

My issue is that it rose fairly significantly in two months even though my
other numbers (weight, BP, strength) have improved just as significantly.
Remember, I have been on ADT for six years!  Why the spike now when
everything else is doing so well.

I'm wondering if the 4-month Lupron shot can actually cause a spike and to
do so inside of 24 hours.

If I didn't feel so good right now, I'd consider shutting down the exercise
and eating steak and eggs every morning.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA  <.1  <.1  <.1  .27  .37  .75            PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32                        PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA  .07 .05 .06 .09 .08 .132 .145       PSAD 1.4 years
Casodex added daily 07/06
PSA undetectable since; last checked on 06/04/09
Illegitimati non carborundum

I.P. Freely - 24 Jun 2009 21:03 GMT
> My issue is that it rose fairly significantly in two months ...
> Why the spike now when everything else is doing so well.

One meal can easily spike our lipids dramatically. If you ate anything
within the 10-12 hours before your blood draw, or a fatty meal earlier
than that, your chol could easily remain elevated for many hours.

I.P.
Steve Kramer - 25 Jun 2009 12:00 GMT
: > My issue is that it rose fairly significantly in two months ...
: > Why the spike now when everything else is doing so well.
:
: One meal can easily spike our lipids dramatically. If you ate anything
: within the 10-12 hours before your blood draw, or a fatty meal earlier
: than that, your chol could easily remain elevated for many hours.

Fasted for 12 hours, but don't know about that fatty meal thingy.  I'll be
on the lookout for that next time.
Tom Cular - 25 Jun 2009 18:11 GMT
Steve,
Here's one link that suggests that 10 to 20% of patients receiving lupron
tratments will experience a risee in cholesterol levels.

http://www.chemocare.com/bio/lupron_depot.asp

> : > My issue is that it rose fairly significantly in two months ...
> : > Why the spike now when everything else is doing so well.
[quoted text clipped - 5 lines]
> Fasted for 12 hours, but don't know about that fatty meal thingy.  I'll be
> on the lookout for that next time.
safire - 25 Jun 2009 12:28 GMT
>  My weight was about 311 (36 BMI).

Experts believe the most effective approach for weight loss in obese
people is a diet aimed at reducing total energy intake; however, all but
five percent of people who lose weight on a diet regain it all.

http://psychcentral.com/lib/2007/obesity-and-mental-health/all/1/

Obesity is a mental problem. You need to be able to resist the urge to
eat. That requires character.
Alan Meyer - 25 Jun 2009 22:14 GMT
...
> Obesity is a mental problem. You need to be able to resist the
> urge to eat. That requires character.

For many people, dieting does indeed require a strong will.

I will add however that people have different responses to food.
Some put on weight very easily and some don't.  Some take off
weight very easily and some don't.  The amount of willpower
needed to stay thin can very dramatically from person to person.

Those of us who are fortunate enough to find weight control easy
shouldn't be too quick to judge the will power of those who
don't.

Ultimately however, I agree that the best solution to being
overweight is to cut down on calories, even if it's very hard.
Putative magic bullets, from drugs to surgery to fad diets, are
unlikely to be as good for an overweight person as is plain old
dieting - however hard it is.

   Alan
Steve Jordan - 25 Jun 2009 23:19 GMT
Alan Meyer replied to "safire:"

> For many people, dieting does indeed require a strong will.

(snip)

Won't feeding a troll anything at all make it fat?  ;-)

Regards,

Steve J
Steve Kramer - 26 Jun 2009 13:19 GMT
: ...
: > Obesity is a mental problem. You need to be able to resist the
[quoted text clipped - 4 lines]
: I will add however that people have different responses to food.
: Some put on weight very easily and some don't.

Thanks, Alan, but I'm sure Safire's remark had little do with helping me,
especially considering I expressed no interest in assistance.

For some of us, it is an analysis.  As our environments change, often our
priorities change, and therefore our decisions.  Currently, at my age and my
ever-elongating prognosis, I'm more interested in doing something about my
weight and all other cardiovascular numbers.  Furthermore, I now have the
time.

But, I enjoy food.  I like the taste, the texture, the time spent with
friends, etc.  When I'm alone at home, I eat oatmeal for breakfast and small
amounts several times a day.  When I'm out with or at my home with my wife,
relatives, and/or friends, I enjoy the entire affair.  If Saffire had any
family or friends, he would understand.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA  <.1  <.1  <.1  .27  .37  .75            PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32                        PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA  .07 .05 .06 .09 .08 .132 .145       PSAD 1.4 years
Casodex added daily 07/06
PSA undetectable since; last checked on 06/04/09
Illegitimati non carborundum

safire - 26 Jun 2009 18:14 GMT
Krammer wrote:
> : ...
> : > Obesity is a mental problem. You need to be able to resist the
> : > urge to eat. That requires character.
> :
> : For many people, dieting does indeed require a strong will.

> I'm more interested in doing something about my
> weight
>
> But

Quod erat demonstrandum.
People with character actually do something about it. They control their
urge to eat. Weak people start with "but...". Krammer is an addict.

358 lbs.

Decent airlines only allow guys like this as cargo, as they don't want
to offend normal passengers.
I.P. Freely - 28 Jun 2009 02:30 GMT
> I enjoy food.  I like the taste, the texture

It's difficult to eat enough fruit and vegetables and whole grains to
gain weight. Most people can satiate themselves on those foods and lose
excess weight. The main problem is the high-calorie-density foods, where
Safire's comment applies and where I find cold turkey the easiest solution.

I.P.
I.P. Freely - 28 Jun 2009 02:24 GMT
> I agree that the best solution to being
> overweight is to cut down on calories

Only if one gets plenty of exercise. Weight loss strictly by cutting
calories, without exercise, often sheds more muscle than fat.

I.P.
Lud - 30 Jun 2009 04:48 GMT
Steve

Dr Strum has written that ADT with Lupron or Zoladex will raise
cholesterol levels by about 30%. Mine did go up, fortunately it was low
to start so I am still in the safe zone.

Dr Myers last issue of Prostate Forum has an excellent write up on
cholesterol - very convincing  that every PCa patient should be on statins.

Best wishes in your battle.
Lud

> WARNING:  The following is probably going to be a long, fact-filled post,
> all about me, and probably not of much interest to any other than perhaps
[quoted text clipped - 45 lines]
> effect on the rest of my numbers?  No change in diet since April and still
> losing weight.
I.P. Freely - 30 Jun 2009 14:26 GMT
> Dr Myers last issue of Prostate Forum has an excellent write up on
> cholesterol - very convincing  that every PCa patient should be on statins.

Catch 22: strength-building exercise and statins in combination pose a
very high risk of muscle pain. I hurt like holy hell from my elbows to
my knees for a year after stopping my statins for that reason, and the
medical literature is apparently finally recognizing this threat to
people who actually *use* their muscles, as I've seen it mentioned in
health newsletters.

I.P.
Steve Kramer - 01 Jul 2009 01:53 GMT
: Catch 22: strength-building exercise and statins in combination pose a
: very high risk of muscle pain.

Just my luck.  I have been on a statin for years and just started lifting 5½
months ago.  Seems like avoiding SEs is a vicious circles sometimes.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA  <.1  <.1  <.1  .27  .37  .75            PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32                        PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA  .07 .05 .06 .09 .08 .132 .145       PSAD 1.4 years
Casodex added daily 07/06
PSA undetectable since; last checked on 06/04/09
Illegitimati non carborundum

Dave P - 30 Jun 2009 21:25 GMT
Steve,

Its great you are walking and lifting. Take it serious. Keep on going
- gaining momentum.

At 358 lifting all that weight - you must have monster size and had
offers from the Bengals.

PSA is undetectable?

Great News!!!

The lupron shot had to have some type of effect on cholesterol - at
least short term.

Just had my psa results <0.01 at 6 years after salvage. (for your
records)

Stay positive and thanks again for your support through the years.

Dave P
Steve Kramer - 01 Jul 2009 01:58 GMT
: At 358 lifting all that weight - you must have monster size and had
: offers from the Bengals.

I was on the field for some of the games back in the 90s and some jokes
where made about me suiting up.  Of course, I was a lean 315 back then.

: Just had my psa results <0.01 at 6 years after salvage. (for your
: records)

Your doc called it in December.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA  <.1  <.1  <.1  .27  .37  .75            PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32                        PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA  .07 .05 .06 .09 .08 .132 .145       PSAD 1.4 years
Casodex added daily 07/06
PSA undetectable since; last checked on 06/04/09
Illegitimati non carborundum

 
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