Rising testoserone on Lupron/Extandi/Estradiol

[ironwood]

There seems to be a trend upwards in my serum testosterone.

Feb 15/24 - T = 20.4 nmol/L - start Lupron/Extandi PSA = 5.15 three months post prosectomy

May 9 /24 - T = .6 " PSA = <.02

Aug 6 / 24 - T = .7 " PSA = <.02

Oct 29 / 24 - T = .9 " PSA = <.02

Nov 21 / 24 - T = .7 " PSA = <.02

Nov 27 / 24 - Start Estradiol Gel

Jan 27 / 25 - T = 1.0 PSA = <.02

Feb 26 /25 - T = 1.2 ( no PSA taken )

As I understand it a testosterone reading of less than .7 nmol/L predicts favourable outcomes.

I want to avoid castrate resistance for as long as possible. Is this apparent rise in testosterone concerning ? Why is it happening ? Is there anything that I can do about it ? Could the Estradiol be muddling my blood assay ?

[NecessarilySo]

"Castrate level" serum testosterone is considered <50 ng/dL, which converts to 1.7nmol/L.

My own total T varies slightly from 8-14 ng/dL which converts to around .4 to .5 nmol/; I am on Lupron only.

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

Core tip: Castrate testosterone level of less than 20 ng/dL achieved after primary radiotherapy plus androgen deprivation treatment for non-metastatic prostate cancer is associated with better biochemical relapse free survival.

20 ng/dL converts to .68 nmol.L

I understand your concern, but I cannot explain your rise in serum T.

[ironwood in reply to NecessarilySo]

I appreciate your reply

[Izzysdad]

T levels fluctuate through the day being highest in the morning. For that reason I always get my lab appt. for the same time (10AM) and I always use the same lab. I’ve been on Eligard and Erleada for over 4 years and my T has fluctuated between less than .2 and .7. Once it went up from .2 to .6 in 3 months for no apparent reason and then dropped back to .2 on the next blood draw. I initially thought I was getting close to an injection for it to have gone up and then dropped because I got an injection but that was not the case. I didn’t get the injection until a week after the reading had gone down. I don’t know anything about Estradol but it does look like that could be the culprit. Suggest you ask your MO. I recently read that some doctors now think that under .7 may be better than under 1.7 but I don’t know if that is supported by the majority. I also don’t know how accurate these labs tests are when dealing with such small amounts of T. Another question for your MO or the lab tech at you next draw.