what is your natural testosterone level? is it low?

hey all-

we just got our 2nd PSA test back following RALP, and we're still undetectable at <0.02. we're thanking our lucky stars for these scores & also for minimal side effects from surgery.

having said that, our doc said his testosterone levels are very low -- 149. and he's only 42 years old. yes, there have been symptoms like crushing fatigue & muscle loss (even though he eats well & works out often), but he's not depressed and/or without libido. however, a recent heart scan showed the beginning of cardiovascular disease. could this be related? could low T have caused cancer & heart disease already?

our doc is suggesting TRT which seems crazy to me with his path report. but without it, how will he ever bring up his numbers naturally if he's technically doing all the right things now & he's still so incredibly low.

with it, we risk so much & without it, we risk so much. how does one possibly decide?

if you've been in our shoes, can you please share your story?

thanks in advance.

pwallace,
Congrats on the < numbers and good results. Im also curious about the effects of TRT for us at risk for cancer/heart disease. My grandfather (a fit Sheriff and frogman) died at 40 yrs old from heart attack and I've always worried about having that happen to me. I had the TRT option last year but avoided it because I 'thought' it might escalate any heart issues I 'might' have. Then again... im certainly no doctor and didnt really ask enough about it. I'll be interested to see what you decide and how it goes.

pwallace,

pwallace said...
we just got our 2nd PSA test back following RALP, and we're still undetectable at <0.02. we're thanking our lucky stars for these scores & also for minimal side effects from surgery.

having said that, our doc said his testosterone levels are very low -- 149. and he's only 42 years old. yes, there have been symptoms like crushing fatigue & muscle loss (even though he eats well & works out often), but he's not depressed and/or without libido. however, a recent heart scan showed the beginning of cardiovascular disease. could this be related? could low T have caused cancer & heart disease already?

Boy, sounds a lot like me. I was uPSA-undetectable for five years after RALP (2012) with minimal SEs. Had been on TRT for the last three of those five, with blessing of uro. But this Feb., I saw a uPSA = .025. Notified my uro then but he did not ask me to stop shots. But I was concerned, so stopped my testosterone injections early March and watched uPSA closely until now. It went on up to .027, stabilized, then last four month's readings have been about .018 (+- .001).

I tested my total and free T this month. Total was 406--slightly above the LabCorp lower limit for "normal". But free T was 6.2--below LabCorp lower limit for "normal". So I have decided to start my T shots up again tomorrow. I am 68 now and eat well and am very fit. But, being off the T, have had spells of fatigue--not "crushing", but unusual for me. Mood is low but not depressed. Libido not great. Have been lifting most this year, but cannot gain weight or make much barbell progress. Plan to stay on shots and monitor uPSA until my next yearly appt. in Dec. Would stop the shots if I saw a major uPSA jump before then.

When on the T shots, my total T ran in the 700's, and free T was within range. I just felt a whole lot better than now. I guess some is psychological, but I know there is a real physical boost, too. Psychological is a real part of the whole TRT deal, too, of course. TRT affects a guy in many physical and mental areas.

Here are some reading materials I had stashed away that may help inform you in your choice:

www.ajandrology.com/article.asp?issn=1008-682X;year=2015;volume=17;issue=2;spage=206;epage=211;aulast=Morgentaler


The first one of the following two-part article mentions T helping heart:

www.drdach.com/Testosterone_PSA_1.html
www.drdach.com/Testosterone_and_PSA_2.html


This one, in particular, does indicate that low free-T level can predict PCa:

www.jurology.com/article/S0022-5347(14)02595-6/fulltext


Wish u the best. Any questions, just ask.

Robert

I'm probably an outlier, but my T was low for years prior to diagnosis. I was on TRT for about 5 years before diagnosis, and remained on TRT through treatment and remain on it. As TA indicated, there is no reason to withhold T unless your hubby needs total hormone suppression to control his cancer. Absent that need, the two conditions (PCa and low T) are separate and should be treated as such.

If you want to read any of the research publications about this, Google the name of Dr. Abraham Morgentaler (in Boston, Harvard). He has done quite a lot of research over the past 20 years or so, and was my doctor/consultant in making my choice to remain on TRT throughout the process.

Notam - That may be the case, IF the patient is already having the side effect and dealing with it, then it may (probably can't) get worse. For example, if he already has hot flashes, how much worse will then get? If he already has loss of muscle mass and weight gain, it probably won't get a lot worse. True, these side effects are not binary (have or have not), they are relative, so some could get worse. I would also guess that the patient might have additional side effects if his natural T level is enough to ward off, say, loss of libido. . . and then you take away the remainder of his T, I'd guess his libido would get worse.

I doubt that anybody knows. It is probably unique to each patient.

pwallace said...
i worry about the same thing. what if my husband relapses once he gets his T to a good place, and then he knows what it feels like to fall...whereas now he has minimal symptoms of low T, know what i mean?

So you don't want him to feel really good because, on the off chance that he might have to undergo hormone therapy at some point, you don't want him to know what he was missing? Really?

Tall Allen said...

pwallace said...
what if my husband relapses once he gets his T to a good place, and then he knows what it feels like to fall...whereas now he has minimal symptoms of low T, know what i mean?

So you don't want him to feel really good because, on the off chance that he might have to undergo hormone therapy at some point, you don't want him to know what he was missing? Really?

Trying to hold my tongue here, but that's the life of a married man. I lost most of my right testicle 15 years ago and started having hot flashes and loss of libido immediately. Needless to say, she was disappointed.

No one ever checked my T level until I requested it this past summer, just to be sure the Lupron was doing its job. Lefty is all alone now, and I don't really care much because of the HT. I could take it or leave it.

So if my T level was low before HT, it's in the basement now. When trying to discuss whether or not to continue HT with my wife, she thinks I'm crazy. It's like she's being deprived of something she feels entitled to. Meanwhile I'm just trying to save my life.

I was going to comment here yesterday but it reminded me that it was Monday and I was overdue for my Monday self-injection and after taking care of that I never got back to it.

Most of what I might say here would just be rehash so I'll just link to my thread from two months ago:

Hung Like a Hamster

just seeing these responses now... it's been a long couple of weeks.

paxton, thanks for your response. reading morgentaler's book now & it's all very eye opening & interesting!

tall allen & roblee- i think i misspoke. i wasn't trying to say that i don't want him to feel really good or know what he was missing, i was trying to say that i don't want him to suffer. he's such a stable happy person that i was worried about a possible yo-yo-ing of emotions, that is all. besides fatigue & some muscle loss, he's been really lucky w/low T (not symptomatic). trust me, roblee, i'm not worried about depriving myself of anything, i'm sincerely just fearful for his mental & physical health. i think about it all the time.

anyway, all of this to say, he's been on T now for 2 weeks without any added benefit YET, but we are hopeful. for those of you have added T into your lives, has it ever taken awhile to see results? experience benefits? muscle wise? fatigue wise?

thanks so much for sharing your experience. really appreciate it.

makes sense that it would be a gradual climb as your body adjusts to the T.