Testing Testosterone

Anther thread made me think about this. I've never been tested for testosterone levels. But I've never had symptoms of low T, that I'm aware of, and never been on HT.

Is this a routine test that every man should have? Or is it a "situational" test?
My first inclination is to not bother, because if you look for trouble, as we all know, you'll probably find it. On the other hand, I've always been thorough in my approach to trying to stay healthy.

Thanks Allen. Something to discuss with my urologist at the next visit.

Not sure how the numbers work on the Testosterone test.

I recently had mine measured after coming off hormone treatment and it was recorded as 7.3 nmol/L with the "normal" range being shown as (8 to 38). I am in Australia.

Numbers I have seen reported here are in the 100's. I asume there is some difference in the reporting method between Australia and the USA.

Chas

I love that I have a patient portal where I have access to all test results.

I have had my testosterone tested 2-3 times in last 6 months....last time it was a six. Which I think legally makes me able to mark female on applications....

Dear Pratoman,

A testosterone test is an OFTEN overlooked topic, in my belief. My oncologist is very proactive and vigilant with my particular case, and has me come in for lab work every four weeks, without fail --- including PSA and testosterone.

My PSA seems to have some "Crouching Tiger, Hidden Dragon" lurking within --- to borrow a description from a movie title of the same name. Out of the blue, my PSA can suddenly creep up --- and has occasionally doubled in the course of just one month. YIKES ! Because of that, my oncologist keeps a careful eye on all of my lab work each month.

I think it is important for men who are on ADT hormone shots to ask for occasional testosterone tests. I've read lots of research articles that show that many men are experiencing testosterone SPIKES that they might not be aware of --- having an occasional testosterone test can ensure that the ADT hormone shots are working to their greatest potential in suppressing testosterone and thus, PSA, as a result.

In my case, I eventually went to a four-month LUPRON shot --- sure enough, during the course of that shot, we began to see some noticeable testosterone SPIKES --- which impacted my PSA during those months. My oncologist vowed that he would work to get my testosterone suppressed to the greatest extent possible --- so from there, we switched over to the once-a-month FIRMAGON shots, which work very well for many patients. We did not see the testosterone levels going down, as we had hoped. Finally, we tried the once-a-month dose of ZOLADEX injections and then began to see my testosterone go down, finally wrestling my testosterone down below ten, at long last. So, my oncologist kept experimenting with ADT shots ... leaving me with a range of experiences with 3 forms of ADT shots in my treatment experiences.

This past fall, my oncologist felt we could finally give the three-month, slow-release ZOLADEX injection a try. ZOLADEX is injected into the abdomen in "pellet" form, which is a bit different than LUPRON and FIRMAGON shots. However, just this past month, my testosterone SPIKED up again, while the three-month injection is still running its course. So --- I'm going to request that we return to the once-a-month injections again, hoping that the testosterone spikes will settle down once again. In my case, my PSA creeps up just as soon as the testosterone spikes up --- which helps explain why my oncologist tracks my testosterone levels so carefully with monthly testing.

I appreciate all the work my oncologist has done to keep my PSA levels controlled, and the meticulous ways in which he has manipulated my treatments to achieve the best possible outcomes. He has continued to work small miracles in my case over the course of time. When Christmas time came this year, I delivered a Christmas present directly to him in his office, just to show my gratitude for all he continues to do for me. I honestly could not ask for a more dedicated and compassionate doctor. He also treats my father, a fellow prostate cancer patient.

This has been my experience to date --- I realize that other men would NOT need their testosterone tested so frequently --- but for my particular case, it seems imperative that we continue to monitor the testosterone levels to keep my PSA suppressed to the greatest extent possible. It's fair to say that the testosterone test can often be overlooked in the treatment plan, and it should be a conversation that each patient has at their next doctor visit.

Thanks for always being a brother on this website, PRATOMAN. You have always been a friend and fellow "battle brother" on the forum. I know when posting a new threat topic, it's helpful to receive a wide variety of responses, based on individual experiences ... so thought I would add my experience to the mix of responses you are receiving.

In my case, I'm there for lab work each month, no matter what, anyway --- so it's easy for them to test the testosterone level when they are testing for PSA and the other lab levels that they are monitoring in my case! For anyone receiving ADT hormone shots, I think it would be wise to have your testosterone level checked periodically, just to ensure that your ADT shot is working to its full advantage. No harm, no foul, right ?!! These are my thoughts and reflections, based on my personal experiences ...

Keep posting, PRATOMAN, you're a loyal brother on this forum !

"Cyclone" From Iowa State

Thank you Dan. I appreciate all you kind words.


I am admittedly no expert, but I thought that t levels should be at 20 or below oh ADT. But....in your case, as long as you are pulling undetectable, I'd be happy.

No voice change, but I crave Bon bons and watching soap operas. It's weird,... Lol

Thanks Guys.
Cyclone, tough road for you, for which i am so sorry. But you seem to handle what comes with grace. Its a blessing to be able to do that.
I could see why you would be testing T regularly, with the PSA apparently, inextricably linked to your T level
Wings - i don't know the answer to your question, just thanks for the support.

I think TA's suggestion for someone like me, to get a baseline T is a great one. I obviously hope that i don't ever need to be on HT, but you never know, and like a good boy scout, i like to be prepared.

Hello,

To add to the informative banter and discussion on this thread ...

I read back through some research articles on testosterone suppression, for those of us who need to control testosterone to suppress PSA, to the greatest extent possible ---

Past research showed that many doctors FAIL to track testosterone for their patients ... perhaps an overlooked component, depending on the individual patient's case ... many doctors simply relying solely on PSA as a marker of treatment success or cancer progression ...

Interestingly enough, research also showed that many patients on ADT shots actually WERE experiencing testosterone "spikes and flares" during their ADT treatments, when researchers began screening their testosterone levels ... some of the spikes and flares being significant ... and this phenomenon is called "testosterone escape" ...

Historically, doctors once considered testosterone levels of 50 or below sufficient for PSA control ... historically, testosterone levels below 50 were considered "castrate level" ... and testosterone levels above 50 were classified as "testosterone escape" ...

Over time, this number has now been lowered in the medical field ... there were studies that indicated that optimally, a testosterone level that falls below about 32 seemed to be the most helpful in keeping PSA suppressed for advanced cancer patients ... and many doctors strive to achieve testosterone levels below 30 or even 20, with the idea of suppressing PSA to the greatest level possible.

The articles I read stated that the ultimate goal of ADT hormone shots would be to achieve castrate levels that would be EQUAL to the very low levels of testosterone achieved from surgical orchiectomy.

In my case, my oncologist experimented with LUPRON, then FIRMAGON, and finally ZOLADEX ... all forms of ADT ... trying to achieve the lowest level of testosterone possible. In my particular case, ZOLADEX seemed to have more of an "edge" in bringing down the testosterone levels --- but it took some months of experimentation to determine that. Yep ... I've been a "guinea pig" at times, I guess you could say ... but it seemed worthwhile to see which form and dosage of ADT might work to the best advantage.

At the current time, the ZOLADEX injection and the addition of ZYTIGA has managed to bring my testosterone level down below 10, most of the time. By some miracle, I have 100% of my energy, work full-time, and still stay up past midnight, so I'm thankful for that.

Informative thread that you started here, PRATOMAN, our fellow battle brother here on the forum --- perhaps an overlooked topic that needed to be brought to light, for those of us needing to keep testosterone suppressed to help control our PSA levels. Thanks for shining a light on this aspect of prostate cancer treatments, PRATOMAN !

Keeping in touch,

"Cyclone" From Iowa State University