Testosterone Levels

[Blair77]

My husbands testosterone level is suppressed to 10 and 2.5 free. He's on Lupron and Casodex. Are these levels low enough?

[Dr_WHO]

Yes. Anything below 40 is considered castration level. The above numbers indicate that it is working.

[Hidden in reply to Dr_WHO]

40 and below? So since my husbands is hovering 70-80s since starting HT in Dec thinking not so good👀

[Dr_WHO in reply to Hidden]

While on the high side, it is lower than the normal range of 300 to 900. What matters more is if he has a low PSA level. That said, have you discussed it with his doctor?

[Blair77 in reply to Hidden]

Bella I think you might be confusing this post as talking about the PSA number. I'm talking about my husbands testosterone level. Not his PSA

[Sisira]

Yes 10 is very good. Although castration level is below 40, below 20 is much better. I am under ADT2 and my present level 8.1 ( At the end of 2 years continuous ADT ).

[pjoshea13]

Here is a 2017 Canadian paper (below). They use nmol/L units, rather than ng/dL.

"Both prospective and retrospective data support a relationship between testosterone levels below the historical standard of 1.7 nmol/l and improved outcomes. Eight studies showed significant improvements in survival-related outcomes, with the majority of data supporting a testosterone level cutoff of ≤0.7 nmol/l."

Note that 1.7 nmol/L = 49 ng/dL; 0.7 nmol/L = 20 ng/dL.

So 10 ng/dL is good.

Dr. Myers insists that DHT is the more important test, since near-zero T doesn't always mean near-zero DHT.

-Patrick

ncbi.nlm.nih.gov/pubmed/284...

Can Urol Assoc J. 2017 Jan-Feb;11(1-2):16-23. doi: 10.5489/cuaj.4303.

Maximal testosterone suppression in the management of recurrent and metastatic prostate cancer.

Klotz L1, Breau RH2, Collins LL3, Gleave ME4, Pickles T5, Pouliot F6, Saad F7.

Author information

1

Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

2

Ottawa Hospital Research Institute, Ottawa, ON, Canada.

3

Kaleidoscope Strategic, Toronto, ON, Canada.

4

Vancouver Prostate Centre, Vancouver, BC, Canada.

5

British Colombia Cancer Agency, Vancouver, BC, Canada.

6

Hôtel-Dieu de Québec, Quebec City, QC, Canada.

7

Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.

Abstract

INTRODUCTION:

Testosterone suppression, or androgen-deprivation therapy (ADT), is an established treatment for recurrent and metastatic prostate cancer (PCa). Based on the accuracy and sensitivity of early assays (c. 1960-1970), the castrate testosterone level was set at ≤1.7 nmol/l. Improved sensitivity of testosterone assays shows that both surgical and medical castration can achieve levels <0.7 nmol/l. However, the clinical implications and importance of maximum testosterone suppression remains a subject of controversy. This evidence-based review assesses prospective and retrospective clinical data, linking maximum suppression of testosterone with improved outcomes from ADT.

METHODS:

PubMed and conference proceedings were searched for studies assessing the impact of low testosterone on clinical outcomes from ADT. The key search terms included combinations of prostate cancer and testosterone, predictive/prognostic, and androgen deprivation. Results were limited to studies investigating the relationship between testosterone levels and clinical outcomes.

RESULTS:

Both prospective and retrospective data support a relationship between testosterone levels below the historical standard of 1.7 nmol/l and improved outcomes. Eight studies showed significant improvements in survival-related outcomes, with the majority of data supporting a testosterone level cutoff of ≤0.7 nmol/l.

CONCLUSIONS:

Tracking both testosterone and prostate-specific antigen (PSA) levels has significant clinical benefits, and the serum testosterone threshold of ≤0.7 nmol/l is a practical goal. The relative levels of testosterone and PSA may indicate continued hormone responsiveness or progression toward castration-resistant prostate cancer (CRPC) and should, therefore, inform treatment strategy. Standardization of assay methods and clinical coordination to facilitate widespread access to state-of the art laboratory equipment is necessary to ensure accurate decision-making.

PMID: 28443139 PMCID: PMC5403681 DOI: 10.5489/cuaj.4303

[Blair77 in reply to pjoshea13]

Thanks for this explanation. I had read this article also and understood it to be saying less than 1.7 so thanks for the correct conversions 🙂

[Hidden]

Almost fourteen years ago during my chemo trial, the stated objective was to suppress T to less than 5.0. I was able to keep my testosterone to less than that for seven years. Then a year later after ceasing hormone injections, my T did not recover. Since then, with a topical application of 4mg of Androgel twice a week, my T ranges from roughly 400 to 650. It is tested along with PSA and other levels currently three times a year.

Keep kicking the bastard.

Gourd Dancer