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Testosterone Increase

User
Posted 04 Jun 2024 at 18:47

Hi there

I am just over 18 months into ADT for life. My PSA was 0.05 today, the same as three months ago, which I guess might turn out to be the nadir. I finished my Radiotherapy just under a year ago. 3 months ago I got my testosterone tested for the first time and it came  in at 0.62 nmol/L, and today it was up to 1.11. My question is whether this kind of fluctuation is normal or a worry. Obviously the purpose of ADT is to reduce testosterone. Might it starting to edge up be a precursor to a PSA increase? Any experience of this would be welcome. I will speak to my oncologist in a couple of weeks, but just wanted to tap into the expertise on this forum in the interim. I had been for a run, but that was three hours before the test, so any short term impact from exercise on testosterone should have gone. I am at the same point in my zoladex cycle as the last time my testosterone was tested (ie a week before the next injection). 

User
Posted 05 Jun 2024 at 08:03

Hi P822,

Sorry I can’t  help you answer that, maybe you should speak to your CNS or maybe phone the Speicliast nurses on here, they are very knowledgable and will take time to explain things to you? I had my last-ever(hopefully🤞🤞) Prostap injection in April and persuaded my GP to give me a testosterone test to use as a baseline. It was 0.1. I wish I had it tested before I started on Prostap but I certainly want it tested coming off Prostap to see how things are recovering.

It’s encouraging that after 18 months on ADT you’re still able to go for a run…well done👏👏 I wonder if that’s because your testosterone hasn’t completely disappeared. After 2 years of Prostap I find even walking a strain at times. Fortunately my ebike gets me out and gives me exercise as it’s less impact on my aching joints.

Good luck,

Derek

User
Posted 05 Jun 2024 at 23:10

Testosterone levels vary in a 24hr cycle. For consistency, always have it measured as a fasting blood test first thing in the morning. I've no idea how much you might expect it to vary during the day when on ADT, so I don't know if that explains the difference.

It may vary during the injection cycle (particularly at the end), if the injection dose is marginal for you, or if it wasn't injected correctly causing it to run out faster than it should. We did have a member here who had to have the injections more often to keep his Testosterone low, although that's the only time I've heard of that being done.

There is no universally accepted castrate level, but 1.2 is sometimes held to be the castrate level, and is the level below which the hormone injections should be able to maintain Testosterone level. However, they often achieve better than this, 0.7 or lower being common. Sometimes one of the drugs doesn't work so well in someone, and changing to another works better. When you're on life-long ADT, getting the Testosterone level as low as possible may be more important than for those on time-limited ADT.

When ADT fails and you become castrate resistant, this isn't due to increasing Testosterone levels, it's due to the cancer growing in spite of low Testosterone levels. So what you're seeing isn't that. It may be that keeping Testosterone levels as low as possible helps make the time before you become castrate resistant as long as possible, so I think it is worth seeing if you can get Testosterone lower.

User
Posted 06 Jun 2024 at 06:06

Decho and Andy, thank you very much for replying with really helpful posts. Andy62, that post pretty pulls together various bits and pieces I found on the internet but to see them written down in one place is incredibly helpful. I had not seen that bit about it best being done as a fasting test first thing in the morning, so will take that on board. 

 
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