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TESTOSTERONE, TOTAL VS TESTOSERONE, FREE TEST QUESTION

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Prostate Cancer
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Posted 6/23/2014 2:02 PM (GMT 0)

Just received my PSA Test Kit from Mayo.  Under Test Ordered it has ONLY the Testosterone, Free test ordered and NOT the Testosterone, TOTAL.

ALL of my pervious Testosterone Tests were for the Testosterone, Total.

They were as follows:

    1.  On February 13, 2013 (just before beginning Casodex and Proscar)

         it was 826ng/ml

    2.  On April 15, 2013 (just before starting IMRT/IGRT) it was 11ng/ml

    3.  On November 1, 2013 it was 13ng/ml

    4.  On April 15, 2014 it was up to 425ng/ml

Since ALL of my previous testosterone tests were for the total testosterone WHY would Mayo now just order the Testosterone, FREE test and NOT the

Testosterone, Total Test?

How will I be able to compare the Testosterone, Free test to all of my previous Testosterone, TOTAL tests?

Why would Mayo order the Testosterone, Free test anyway?  It is inconsistent with all my previous Testosterone, Total tests and makes it

impossible for me to know whether my Testosterone, Total has increased or decreased.

PhilC  

Posted 6/23/2014 8:24 PM (GMT 0)
Sounds like an error - why not call them?
Posted 6/23/2014 8:44 PM (GMT 0)
Tall Allen says: "Sounds like an error - why not call them?

Good advice as usual from you. Thanks

They said they were actually doing BOTH the Testosterone, Free and the Testosterone, Total tests. But it was not marked that way.

BTW What value is in the Testosterone, Free test? Guess it has some value for Mayo but I have no idea why they want it.

PhilC
Posted 6/24/2014 12:29 AM (GMT 0)
Free T is a better measure of the T available to do stuff in your body. Most of the rest gets complexed with Sex Hormone Binding Globulin (SHBG). It is not clear, however, what the optimal levels are - it seems to vary widely among men.
Posted 6/24/2014 7:08 AM (GMT 0)
I have this note in my spreadsheet, unfortunately cannot give due credit to the source since I did not cut and paste credits too

PSA Free%<10 suggest prostate cancer 8 times more likely

PSA Free 10-25% suggests BPH is 3 times more common than prostate cancer

PSA Free% > 25 rarely associated with cancer

This is true for PSA's in the normal range not for the undetectibles. where % on uber low #'s can cause to much variability to be accurate projection from one test to the next.

LupronJim
Posted 6/27/2014 12:11 AM (GMT 0)
LupronJim says:

"I have this note in my spreadsheet, unfortunately cannot give due credit to the source since I did not cut and paste credits too

PSA Free%<10 suggest prostate cancer 8 times more likely

PSA Free 10-25% suggests BPH is 3 times more common than prostate cancer

PSA Free% > 25 rarely associated with cancer

This is true for PSA's in the normal range not for the undetectibles. where % on uber low #'s can cause to much variability to be accurate projection from one test to the next."

I have never read anything about this and have read 3 of the best books recommended here on HW.

Just got my Testosterone Free result: 11ng/dL

So I am just on the edge of being 8 times more likely to have a recurrence of
prostate cancer???

PhilC
Posted 6/27/2014 12:48 AM (GMT 0)
You guys seem to be confusing Free PSA and Free T. They are totally different things. PhilC - Free PSA is irrelevant to you.
Posted 6/27/2014 2:11 AM (GMT 0)
I would just ask my primary care doctor to perform the tests I wanted...You had a Lupron injection on 5/28/13..Is that all the ADT your Radiation Oncologist thought was necessary, 6 months worth? Your "T" level is a minor issue at this point compared to your PSA number......
Posted 6/27/2014 3:29 PM (GMT 0)
For what it is worth, my local oncologist is much more interested in my Free T level while I am on HT. Though this is in the context of having both to review.
Posted 6/28/2014 2:11 AM (GMT 0)
Tall Allen, Thanks for pointing that out. My Testosterone, Free came back at 11ng/dL. Would that be 'normal'? My Testosterone, Total increased to 521ng/dl. When I try to add this to my signature it eliminates one letter for every one letter I add, so how can you update?

Fairwind, Yes, 6 months of Lupron was all he said I needed. He also ended by casodex on the last day of radiation. With a starting PSA of 164 I thought (and it was suggested on HW) that I would require a longer usage. I agree the PSA is more important than the Testosterone, but as the Testosterone goes up I sure feel a lot better.

tarhoosier, Since I am not on HT now I don't know why Mayo wants the Free T level. Of course they have a reason... would you/anybody know??

Forum Moderator, Why can't I add my new PSA numbers without something being taken off the end with each entry?
Posted 6/28/2014 4:22 AM (GMT 0)
Whatever level helps you feel most like yourself is the right level.
You are limited to 400 characters in your signature.
Posted 6/28/2014 9:27 AM (GMT 0)
Hi Phil, - Let me try to explain why it only needs to show a Free Testosterone on the order.

A Free Testosterone test, is usually reported as a % of the Total Testosterone. It, therefore, must be run on the same blood sample as the Total Testosterone to determine that ratio. In other words, BOTH tests must be done to obtain the results. So although you can have a Total Testosterone reading without a Free Testosterone result, the reverse is not possible. Since both are necessary to determine results, both are therefore reported.

This is the same mechanics as that is employed in the Free PSA test, where the Total PSA must be run on the SAME blood drawing sample to allow determination of the % of Free PSA that is present as a ratio of the Total PSA.

Hope this helps! - [email protected] (aka) az4peaks
Posted 6/28/2014 7:02 PM (GMT 0)
As to the sig, 400 total characters (including spaces, punctuation) is the limit. I suggest that you keep yours in a text doc, where you can use the "properties" to see what the real count is, and edit that, then paste the new copy over the old. Remember to abbreviate without mercy. Everyone will know that 6/14 means June 2014, as long as you consistently use the same date scheme, and it saves 5 characters.
Posted 6/29/2014 12:50 PM (GMT 0)
142 (Forum Moderator) says:

"As to the sig, 400 total characters (including spaces, punctuation) is the limit. I suggest that you keep yours in a text doc, where you can use the "properties" to see what the real count is, and edit that, then paste the new copy over the old. Remember to abbreviate without mercy. Everyone will know that 6/14 means June 2014, as long as you consistently use the same date scheme, and it saves 5 characters."

Thanks for this explanation. Why isn't it more widely available to newbies (although I am no longer a newbie, I have been in the 'dark' about this and also HOW to make use of the features
(i.e.: color, font, size, etc.)? Still can't make them work.

PhilC
Posted 6/29/2014 1:04 PM (GMT 0)
az4peaks explains,

"Hi Phil, - Let me try to explain why it only needs to show a Free Testosterone on the order.

A Free Testosterone test, is usually reported as a % of the Total Testosterone. It, therefore, must be run on the same blood sample as the Total Testosterone to determine that ratio. In other words, BOTH tests must be done to obtain the results. So although you can have a Total Testosterone reading without a Free Testosterone result, the reverse is not possible. Since both are necessary to determine results, both are therefore reported.

This is the same mechanics as that is employed in the Free PSA test, where the Total PSA must be run on the SAME blood drawing sample to allow determination of the % of Free PSA that is present as a ratio of the Total PSA.

This explains my question entirely and is why I resort to HW when I
can't understand anything pertaining to prostate cancer. The helpful and educated men on HW always come up with an answer. Many thanks to all of them!

PhilC
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