Testosterone level seems to have plateaued at 250 post 2018-19 IMRT, ADT and brachyboost; was never more than 270 pre-treatment. Criteria for starting/stopping TRT? What are its pros and cons? Responses to it from men here? Many thanks,
EdinBaltimore
As long as your PSA has been consistently low, why not? I used TRT after 2 years of low PSA.
How low was your PSA and did it fluctuate on TRT?
PSA is < 0.04 three weeks ago. It does not fluctuate and has been this low since my last treatment at university of heidelberg since 11/2019. On a PSMA pet scan shows a little amount of cancer on the gland. Have not had any scans in two years and have been that a PSA of < 0.04 is too low to show anything and should wait for PSA to be at least 0.5
It was 0.1 after SBRT. It never rose as I went on TRT. It is now 0.08. I used Androgel and my T was about 800. I recently had to stop because of a diagnosis of AFib and a concern for blood clots with high T.
Interesting, how long were you on TRT?
Thanks for responding.
I have not tried TRT yet. Post treatment PSA has been 0.02, 0.03, and 0.04; taken every 6 mos. Most recent reading (3/2023) was 0.02. I am hoping that TRT will help with fatigue, loss of muscle mass, wt gain, joint discomfort, and depression.
EdinBaltimore
EdinBmore wrote -- " ... I am hoping that TRT will help with fatigue, loss of muscle mass, wt gain, joint discomfort, and depression. "
I've played with my TRT injections (self directed and not recommended form of BAT -
onlinelibrary.wiley.com/doi...
- since 2016. PCa diagnosis was in 3/2015 and had Orchiectomy before having right half GL10 cryo treated. Cypionate every other week provided 1,600ng/dL after injection down to 450/600ng/dL before next injection. When off *T* due to rise in PSA causing a concern such as NOW (note that I still have left half of prostate remaining and PSA rose to 3.0 before stopping) my *T* < 2.5ng/dL *undetectable* my LAB's lowest reading. Unlike others only on ADT via drugs, due to having my Orchiectomy I still had muscle + bone loss with poor blood numbers continuing and other minor effects however recovery from intense exercising was better than when off.
NOTE - NEVER had depression, foggy brain or other issues many suffer from while on ADT drugs
Almost 73yo and preparing for 30 to 50 miles of bicycle riding today with NO *T* because not to do so lowers my Quality of Life and IMO is stupid.
What you are describing is severe, at least significant hypogonadism, including sarcopenia with obesity or overweight, fatigue and depression. Probably loss of libido and other symptoms? Anxiety or mild cognitive impairment? Osteopenia?
This is a condition that requires treatment. Testicular failure to recover after prolonged ADT with aging is very common. It warrants TRT to correct. Your successful PCa treatment does not preclude nor contraindicate TRT. I would insist upon it. I am on a high testosterone cyclic regimen since my PC is controlled but not cured like yours. It makes an outstanding difference in health and well being. Insist upon it and perhaps consider consulting another doctor if need be.
Mateo,
Thanks for your response and comments. Frustrating that docs seem to have missed my complaints re ADT (was devastating for me) and have continued to ignore low T. Apparently, I got the uro's attention this time! Side effects from TRT? A friend complained of testicles shrinking to the size of a pea...???
Thanks again,
EdinBaltimore
TA,
Many thanks for your prompt response. With the exception of one 0.03 and one 0.04 PSA level, it has been 0.02 since conclusion of treatment in Jan 2019; taken every 6 mos. Did you experience any side effects? Did you feel better while taking it? Did your PSA rise? Thanks again.
EdinBaltimore
My PSA has continued to fall. I liked having my libido back.
T_A -- Could you elaborate on you PCa diagnosis --- i.e.- Gleason numbers and Cores positive + %? TIA and if you would rather not - not a problem
GS6- more than half of cores positive. I don't remember offhand.
Thank you 👍👍
About 8 years. I tried to cure my Afib, so I can resume it. If I have no incidents in the next 6 months, I'll resume TRT.
I, too, have afib but very infrequent. I'll make sure uro knows.
Thanks,
EdinBaltimore
My Afib was only 6%, but my cardiologist put me on a daily blood thinner. T makes my hematocrit go high, so they are at cross purposes.I guess I could have had monthly blood letting, but it seemed I was asking for trouble.
What is your T without TRT?
It was about 200 - I haven't tested it since I stopped.
I was curious if you natural T had recovered but it sounds like it had not and that is why you tried TRT.
You are not metastatic, right? So what about the rest of us with oligometastatic or outright metastatic cancer? I am guessing TRT is a no no.
I wonder about that. What is the risk of you are watching your PSA carefully, say monthly?
As always I advocate generous amounts of cardiovascular and weight training. With those you maximize all the good that higher T is known for. Without it your results are never as good.
PSA does not tell you anything about micromets.
Of course. But if your PSA is consistently low and no scan or PSA can detect such micromets, then it’s simply your estimation of acceptable risk, isn’t it?
Yes, you’re just guessing.
I agree- TRT when one is metastatic is dangerous and should not be done outside a clinical trial (for BAT).
I am metastatic and I am on TRT. You should focus on your PSA test to determine if TRT is appropriate. If you have a low PSA and it has been consistently low, you can safely take TRT.
That is very dangerous advice. What proof do you have?
how do you know you are metastatic? And define low PSA in the context of post-IMRT with some prostate remaining
I am deep into looking for options in the areas of Testostone Treatment (TrT) and Therapy (TTh)...here is what I have found. I will never, ever go back on pure ADT...its old school and is destructive to our bodies. It appears we dont have to have ZERO TET while on AS or in recovery!!! Who knew...take a look. TNX
healthunlocked.com/active-s...
Shifting the Paradigm of Testosterone Replacement Therapy in PCa.
Testosterone Therapy After Lupron?
BAT - Bipolar testosterone therapy
