New review paper by Abraham Morgentaler, below.
"The saturation point corresponds with maximal androgenic stimulation at 250 ng/dL."
He's stating, effectively, that at a testosterone [T] level of 250 ng/dL, one could raise T to 500, or even 1,000 ng/dL, without "adding fuel to the fire", as some fear.
The other part of that is that during the IADT 'vacation', as T climbs from near zero, the stimulatory effect on PSA levels off before T reaches 250 ng/dL.
The irony is that many men don't get much beyond that, & as Freedland has stated, castration lasts well beyond the on-phase of IADT. It can take more than 6 months for T to recover, & it rarely reaches the previous high.
Urol Clin North Am. 2016 May;43(2):209-16. doi: 10.1016/j.ucl.2016.01.007.
Testosterone Therapy and Prostate Cancer.
Davidson E1, Morgentaler A2.
1Men's Health Boston, Department of Surgery (Urology), Harvard Medical School, 200 Boylston Street, Suite A309, Chestnut Hill, MA 02467, USA.
2Men's Health Boston, Department of Surgery (Urology), Harvard Medical School, 200 Boylston Street, Suite A309, Chestnut Hill, MA 02467, USA. Electronic address: firstname.lastname@example.org.
Changes in understanding regarding the relationship of androgens and prostate cancer have led to changes in the use of testosterone therapy. The evidence supports a finite ability of androgens to stimulate prostate cancer growth, with a maximum achieved at low testosterone concentrations, called the saturation model. The saturation point corresponds with maximal androgenic stimulation at 250 ng/dL. Evidence is reviewed herein regarding the relationship of testosterone to prostate cancer and the relatively new practice of offering testosterone therapy to men with a history of prostate cancer. Although no prospective controlled trials have been performed, results have been reassuring.
Copyright © 2016 Elsevier Inc. All rights reserved.
Androgens; Hypogonadism; Prostate; Prostate cancer; Prostate-specific antigen; Testosterone; Testosterone deficiency
PMID: 27132578 [PubMed - in process]