Brief Answer:
Lupron's side effect profile can be tricky to deduce at times

Detailed Answer:
Good evening and thank you for your question.

Lupron (as you likely know) reduces the amount of testosterone available in the body through inhibition of the PITUITARY GLAND to produce a substance known as LUTEINIZING HORMONE which in males is responsible for signaling to the testicles that MORE testosterone needs to be produced. Therefore, if LUPRON is injected the overall effect will be a drop in the amount of testosterone produced and available in the body....less testosterone.

Now, reducing the amount of testosterone in the body in the male reduces functions and actions of the body typically associated with MALENESS such as POWER AND STRENGTH in the muscles. Therefore, one of the direct consequences of loss of testosterone during chemotherapy of PROSTATE CA could very well be muscle weakness and fatigue in the arms or legs but it is most commonly noted in the legs first and foremost since balance impairment often times results in weakening the antigravity muscles of the legs which may be similar to your description of WOBBLINESS. Fatigue when performing short duration tasks could be as an indirect result of the development of congestive heart failure (CHF) symptoms and may not be actually tied to the symptom of WEAKNESS.

CHF is not seen often at all in patients on Lupron therapy and represents at MOST 1% of all complications and side effects but it can be one of the most debilitating when it does occur and potentially one of the most irreversible if not caught in time such if congestion in the heart goes on for very long then, the myocardial walls and tissues will begin their expansion or increase in size due to distention of the chambers on the basis of simply too much volume left over that cannot be easily pumped out of the muscle due to weakness and/or actual muscle fiber breakdown because of the lack of testosterone in the system.

Numbness and tingling or PARESTHESIAS in the hands and feet are also known to occur during Lupron therapy at 2 major points of treatment. The first is within the first several weeks of therapy when there is an actual OVERPRODUCTION of a man's testosterone stores...This is somewhat of a paradox since it makes little sense as to why Lupron would cause MORE male hormone to be produced instead of less after I just got telling you about how testosterone is dramatically reduced due to the ANTAGONISTIC effects of using the medication. But believe it or not there is actually a TEMPORARY and TRANSIENT window of time after Lupron use is started and initiated that testosterone levels in the body actually INCREASE and INCREASE SUBSTANTIALLY. It is during this period of time that most symptoms of numbness and tingling begin getting reported.

The 2nd point of when such paresthesias occur is during the course of therapy and after the TUMOR FLARE time when the agent is first started.

The nice thing about Lupron is that if suspected as causing side effects it is very easy and takes a relatively short amount of time to deduce whether or not a set of actions and/or things going on (such as numbness, tingling, leg weakness) are related to the medication or coincidence. That is because of a thing called TIMING. Therefore, if the complained of symptoms (as in the this case) of numbness, tingling in the upper and lower extremities, weakness in the legs and loss of stamina and they are TIME LOCKED with when the medication was started (usually several weeks to several months) then, there is a high probability that the problems experienced are as a result of side effects of Lupron and not something else.

And since there are certainly other possibilities of things that could be wrong aside from LOW TESTOSTERONE levels as the cause I would make sure the patient had a complete laboratory and diagnostic testing workup looking for anything in the following realms:

1. Serum Vitamin B12, folate, Vitamin D, HbA1C
2. Thyroid hormone status (TSH, FT4)
3. Muscle enzymes such as ALDOLASE, CREATINE KINASE (CK), CREATINE PHOSPHOKINASE (CPK)
4. Liver and renal function testing to include all appropriate ENZYMES such as ALT/AST/CHOLESTEROL PANELS

Remember, the side effects are typically found to be time locked with when the medication began being used (well, within several months usually) AND in the majority of cases, when therapy is STOPPED, symptoms revert back to normal fairly quickly and ROBUSTLY.

Of course, another way to test the LUPRON's culpability out is to STOP the medication and watch to see "what gets better?" and then, RESTART the medication to tell if anything you measured as better actually goes the other way...nifty, yes???

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This query has utilized a total of 59 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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