First blood test 3 months after initial ADT (Lupron) injection

Inquiring minds want to know...

Throw the BS penalty flag on your medical team and tell them to just write the order...

First, they're not paying for it.
Second, while you expect Lupron is doing it job and lowering your T, preferably < 20, you want affirmation.

After the first test then there can be negotiation and discussion about the frequency of future T checks.

Monitoring Schedule and Guidelines

Before treatment: A baseline measurement of both serum testosterone and PSA is recommended to establish initial levels.

During the first few weeks: Testosterone levels initially increase above baseline due to a "tumor flare" effect, before declining. Your physician may prescribe other medications (like Casodex, bicalutamide) to manage these temporary symptoms.

Within four weeks: Testosterone levels should decline to castrate levels (below 50 ng/dL). Monitoring around this time helps confirm the drug is working effectively.

Ongoing monitoring:

For 1-month formulations, response should be monitored regularly.

For multi-month formulations (3, 4, or 6 months), monitoring typically occurs before each subsequent injection or every 3 to 6 months after the initial dose.

Periodic monitoring of both testosterone and PSA is recommended, especially if the expected clinical or biochemical response is not achieved.

End of discussion.

Kevin

I always get PSA and testosterone together. If you are testing testosterone, make sure you test at the same time of day every time for compatibility. Your testosterone levels can change 50% from 8 am to 8 pm. 8 am being the highest and 8 pm the lowest.

@jimgaudette Excellent advice. And, per response from may doc testosterone is now included in the upcoming blood test. He said my T level was quite high at 852 and wants to get it to 50. A little over two months since the initial (6month) shot the main side effect has been hot flashes.

@jeffmarc

So why didn't my doctor put me on Casodex for two weeks to prevent testosterone spikes? Is doing so a standard or "intelligent procedure?"

Also, if I had an "every 3 months" ADT injection the first week in November, should the testosterone spike be over by now? I get these "hot flashes" that come and go, but from my informal research they're related to drops in estrogen that's normally converted from testosterone via aromatase.

@thanks4sharing
There are doctors that just don’t pay attention to the medical literature. A doctor that does this should be Considered iffy. I would find a different doctor if I had one that did that to me.

The spike is not a long-term thing after a few days/weeks it’s gone.

From AI

After the first Lupron shot without Casodex, the testosterone flare (a temporary surge in testosterone) typically peaks around day 3 and starts to subside by day 7, with symptoms often improving within 2-4 weeks, though it takes about 3-4 weeks for testosterone levels to drop significantly to castration levels and fully resolve the initial flare's effects.