Taking into consideration the effectiveness of ADT in lowering testosterone, it is not surprising that anemia is a described adverse event of all hormone therapies such as finasteride, flutamide, bicalutamide and LHRH agonists. Although the prevalence of symptomatic anemia in published studies varies significantly between 0 and 37 percent, decreased hemoglobin levels can be seen in up to 90 per cent of patients receiving ADT.