This is a small, but thorough, study looking at the association of ADT with anemia. The researchers confirm that ADT reduced the number of red blood cells made in the body along with two other related markers of anemia, hematocrit and hemoglobin. For some 30% of patients, the change is enough for them to be medically classified as anemic when they weren’t anemic before.
Importantly, the authors confirm that ADT does not significantly lower iron concentration nor the body's iron binding capacity. So anemia from ADT is NOT iron deficiency anemia.
To quote the authors, “Anemia, particularly in [an] older population, has been associated with physical dysfunction, falls and fractures, fatigue, reduced quality of life, cognitive impairment… [and]...“men with PCa who are anemic have reduced overall survival compared to non-anemic men.” This may be because anemia means less oxygen delivered to the tissue in the body includes the heart tissue, which may in part account for the elevated cardiovascular risks associated with ADT.
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Gagliano-Juca, T., Pencina, K. M., Ganz, T., Travison, T. G., Kantoff, P. W., Nguyen, P. L., Taplin, M. E., Kibel, A. S., Li, Z., Huang, G., Edwards, R. R., Nemeth, E., & Basaria, S. (2018). Mechanisms responsible for reduced erythropoiesis during androgen deprivation therapy in men with prostate cancer. American Journal of Physiology, Endocrinology, & Metabolism. [Epub ahead of print.] doi: 10.1152/ajpendo.00272.2018