How low should Testosterone levels be ?

[Simpson80]

I have been on Orgovyx and Xtandi since May. I am doing fairly well.

PSA at 0.05

Testosterone at 27

Wanted advice if the testosterone number is alright or should it be lower. I have read some posts on the board that lower testosterone levels increase overall survival ? Does anyone have any study links showing survival benefits corresponding to even lower testosterone numbers ?

Any advice would be much appreciated.

[Tall_Allen]

Anything below 50 is castration level, but lower is better.

[Simpson80 in reply to Tall_Allen]

So would around 27 be reasonable to control disease ?

[Tall_Allen in reply to Simpson80]

It's not bad. What does your oncologist say?

[Simpson80 in reply to Tall_Allen]

He says anything below 50 is fine. Does getting it to near zero increase the time to CR or not necessarily? Thank you.

[Tall_Allen in reply to Simpson80]

Here are some studies:

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

clinical-genitourinary-canc...

urotoday.com/images/stories...

redjournal.org/article/S036...

bjui-journals.onlinelibrary...

[Simpson80 in reply to Tall_Allen]

Thank you for the links. May I ask a few questions please -

1) these studies mostly seem to be based on just a single ADT. Would they apply to those on ADT and also an ARPI ?

2) Usually are Testosterone nadir levels reached soon into therapy or does it take some months ? Wondering if mine may go down more.

3) Do you have any preference for an agonist vs an antagonist ?

[Tall_Allen in reply to Simpson80]

1) The only ARPi that lowers testosterone (produced by the adrenals) is abiraterone. Anti-androgens when taken along with ADT have no effect on serum testosterone.

2) It often takes 2-3 months to reach nadir

3) I have no preference as long as the patient keeps dosing in time.

[Justfor_]

Tinkudi posted the exact same query few days back. In a nutshell, Xtandi rises T and studies with ADT alone are not relevant to the combo.

[Simpson80 in reply to Justfor_]

Do you have a link to that post ? Are there studies done with both too ?

[Justfor_ in reply to Simpson80]

Click on Tinkudi to get you to her bio and search her latest posts.

[Tinkudi]

I am also wondering about this. Some say below 20 and 10 is best and some say below 50 is ok. My dad’s last T came to 29. MO was ok with that but said if lower it’s even better.

[Simpson80 in reply to Tinkudi]

Beats me why they don’t have clearer instructions !

[j-o-h-n in reply to Simpson80]

Doctor's oath, Clearer means less billing amount on their part.....

Good Luck, Good Health and Good Humor.

j-o-h-n

[ulfhbg]

Hi !

Adding Abiraterone probably carries it’s one side effects and in the end, you have no guarantee so, perhaps a PSA of 0.05, a T-level of 27 and doing fairly well is not that bad compared to adding Abiraterone and perhaps having new side side effects and perhaps not doing fairly well anymore.

Best wishes - Ulf