From the Research
Androgen deprivation therapy (ADT) typically increases cortisol levels in the body, as the suppression of testosterone disrupts the normal hormonal balance, leading to elevated cortisol production due to the hypothalamic-pituitary-adrenal (HPA) axis attempting to compensate for the reduced androgen levels 1. The increased cortisol can contribute to various side effects experienced during ADT, including:
- Metabolic changes
- Insulin resistance
- Increased fat deposition, particularly in the abdominal area These elevated cortisol levels may persist throughout treatment and can exacerbate other ADT-related symptoms such as:
- Fatigue
- Mood changes
- Decreased bone density Patients on ADT should be monitored for signs of hypercortisolism, and lifestyle modifications including regular exercise and stress management techniques may help mitigate some of these effects by helping to regulate cortisol levels naturally during treatment 2. It is essential to note that the impact of ADT on cortisol levels can vary depending on individual factors, and further research is needed to fully understand the relationship between ADT and cortisol production 3. However, based on the most recent and highest quality study available, it is clear that ADT can lead to increased cortisol levels, which can have significant effects on the body 1. Some key points to consider when managing patients on ADT include:
- Regular monitoring for signs of hypercortisolism
- Encouraging lifestyle modifications such as regular exercise and stress management techniques
- Considering the potential impact of ADT on cardiovascular health and quality of life 2
- Weighing the benefits and risks of ADT in individual patients, taking into account their unique medical history and circumstances 4.