High Testosterone after one month Leuprolide shot

[olloreda]

My dad went to his first blood control one month after his first 3-months Leuprolide shot, but his Testosterone is still on normal levels (4.7 ng/ML equivalent to 470 ng/dl).

His PSA come from more than 50 to 22, but I guess is only because Bicalutamide.

His alkaline phosphatase is on 75.

His platalets come from 100 to 220, but his Hemoglobine levels are still low with 11.2.

Do You know what can we do in this case? Wait? A new shot?How long is supposed to take to get castration levels?

[Tall_Allen]

Leuprolide actually causes a surge in testosterone levels before it causes the testicles to stop manufacturing testosterone. Bicalutamide also causes testosterone levels to go up at first because it accumulates in the blood because it is blocked from getting into cells. In another month, the T level should go down considerably

[olloreda in reply to Tall_Allen]

Thanks, I am worry because I thought in one month he was going to be castrated.

I want to think that decreased in PSA and low level of ALP without achieving castration levels, it is a good sign.

I just sent a WhatsApp to his MO, but I am wondering when would be the best time to do the next blood test? And what are the options if T levels are not under castration.

[Tall_Allen in reply to olloreda]

Perhaps I did not explain that well. Leuprolide has to raise the testosterone level at first. That's how it works. Bicalutamide also has to raise the serum testosterone level at first. If they do not raise the testosterone level at first, they are not working.

[olloreda in reply to Tall_Allen]

Perfect!good to know

[LearnAll]

The timing to go castrate level varies from one man to another man...Lower T goe s..better it is. Most men reach castrate T within 6 to 12 months.

Watch for the lowest reading of T in first year...that is called "Nadir T".....lower the Nadir T ,longer the survival. Same applies to Nadir PSA. Lower the "Nadir PSA" longer the survival.

[olloreda in reply to LearnAll]

Yes, I am worry about that because I know it is important to achieve a very low T level. I need to know some other options just to be less anxious in case T leves don't come low next time.

[LearnAll in reply to olloreda]

You need to wait and see how T is going down and how far. Nadir T level depends on the individual and so does Nadir PSA.

[olloreda in reply to LearnAll]

Lets wait then...crossed fingers!

[olloreda]

Thanks Nalakrats. Good to know from your experience...Lets wait then! He is feeling good, so it would be better not to be worry for a few days...

[RonnyBaby]

Not enough time has elapsed to see how effective the treatment is / was. I think looking at a 6 month interval (ongoing ADT treatment refers) is a better time frame to see how low you can go (nadir @ undetectable ?).

In my case, it took closer to 8 months before I got there.

[olloreda in reply to RonnyBaby]

Thanks Ronny..I was not waiting for his PSA numbers but for his T levels. If T levels are not under castration it is hard to get good PSA numbers.

How long it took you to get T under 50 or 20?

I know one month sometimes is not enough, but anyway I was worry.

[RonnyBaby in reply to olloreda]

I understand your concern.

In my case, I took nearly 8 months to get there, but I got there and that is what helped guide the decision process(es).