Should I have my testosterone levels checked?

[JazzMan42]

I have been doing very well since DX in November 2018, on Lupron, 750mg of arbiraterone, and prednisone. My PSA seems stabilized at 0.3 and my other blood readings are well within limits. I keep reading about T levels on this forum, but my MO does not seem to think I need to know my T unless something changes. Is it important to know one's T, and if so, what is an appropriate reading? Thanks, brothers.

[Hidden]

I used to be obsessed about my T. Anymore along with many other things I let my doctors stress.

[FinalBossMatt]

Honestly if you want to know your T levels, pay extra for private testing. Honestly, you're asking how much does a bag of groceries weigh. This isn't an exact science.

[pjoshea13]

A paper from 2008 sums up the modern view:

"The effective castration level, classically considered to be 50 ng/dl, is currently tending to be replaced by 20 ng/dl."

Men who achieve the latter are said to do better.

One could also make a case for testing free testosterone:

ncbi.nlm.nih.gov/pmc/articl...

& Dr. Myers has said that the purpose of ADT is to inhibit DHT. Testosterone is a pussy cat.

Your MO evidently believes that none of these matter & that PSA is good enough.

Best, -Patrick

[Hidden]

JazzMan42,

If you MO doesn't check T levels periodically how does he know you've reached castration levels of T

After all, that is the point of taking ADT;to suppress T.

[noahware]

One question to ask is, how will knowing your exact T level influence treatment decisions? Unless you think the Lupron could be failing to bring your T to castrate levels, there doesn't seem to be any decision to be made right now about continuing current treatment.

On the other hand, adding T level to the current labwork is essentially without major cost. If YOU want to know, there is no reason the doc shouldn't include that in the lab orders.

[LearnAll]

The real reasons to know T level while on ADT are ..

(1) to see what is the lowest T being achieved...it gives us some idea about long term survival...Lower it goes better long term survival... A very low T like less than 5 is very good indicator of longer survival.

(2) To assess if the PCa becoming castrate resistant... Because if your T is less than 20 and your PSA is rising.. then it is possible clue that PCa is becoming castration resistant.

[Hidden in reply to LearnAll]

This is NOT the real reason.

The real reason is to ascertain if the meds are actually working ie lowerering T to castrate levels. Longer survival and castrate resistance is a by product of taking these meds.

[teacherdude70 in reply to Hidden]

Are we not concerned with longer survival and low T combined with low psa is the goal.

[Tall_Allen]

If the Lupron+Zytiga (both suppress T) has been keeping your T level below 20 ng/dl, there is little danger it will suddenly stop working. If PSA starts rising, you can check it. Or, to be prudent, check it at least once a year.

[tango65]

You need to check it at least once, to be sure is below 20. Because you are receiving Lupron and Zytiga most probable your T is below 20 since both meds block testosterone production.

[London441 in reply to tango65]

Yes. With a Lupron/abi combo you are almost surely very low. Of course, get it checked. You want low.

[EdBar]

My MO checks mine regularly to make sure it is staying below 20, I just have it done along with my other bloodwork. I’ve been getting it for years, I remember Snuffy Myers was a big proponent of having it done. I still stick with the majority of his treatment/testing regimen.

Ed

[teacherdude70]

Your insurance covers the test and if for no other purpose than to ease your mind. But T levels can rise even with ADT and then so does psa.