Low Testosterone

I had a radical prostatectomy 10 years ago. Five years ago I had radiation to a single metastasis on my sacrum and was put on Lupron, Abiraterone and Prednisone for three years. I have been off for two years. My PSA has been <.1 for five years. I am 75 and still experience multiple issues from low T.

similar story, but I'm 76, No one would entertain testosterone supplementation in a gleason 9

You are the second person today that has asked about their testosterone going up and then down. This is a common occurrence and overtime. It usually does keep rising.

Every month I get a newsletter called PCa commentary where the doctor discusses different aspects of prostate cancer. This month he covered testosterone

Examples of the relationship of the duration of ADT exposure to subsequent recovery to their
original T levels after stopping ADT are as follows:
- After 3 - 9 months of ADT nearly all men fully recover by about 10 months;
- After 18 - 24 months of ADT only 60% fully recover by about 3 years; and
- After 36 months of ADT exposure only 50% fully recover by ~ 5 years.

Examples of the relationship of the duration of ADT exposure to subsequent recovery to their
original T levels after stopping ADT are as follows:
- After 3 - 9 months of ADT nearly all men fully recover by about 10 months;
- After 18 - 24 months of ADT only 60% fully recover by about 3 years; and
- After 36 months of ADT exposure only 50% fully recover by ~ 5 years.

I was diagnosed with PC in 2008 based on a DRE. My PSA was less than 1.0. I had an RP and my Gleason was 4+4 (I am a big advocate for the DRE as well as PSA because about 10% of PCs don't produce significant PSA elevation). In 2023 , my PSA reached the recurrence level. I was on Orgovyx for five months and had 37 external beam radiation treatments. During the ADT treatment, my testosterone fell to 13. The ADT and radiation ended nearly three years ago and my T is now around 200--better but still low. My PSA is undetectable. I am debating about a T supplement. My doctors recommend a topical gel if I do it, but of course it's ultimately my decision. I am inclined to go slow. My testosterone has been creeping up and, even three years after ADT, I hope this will continue without supplementation. I tire very easily but my doctor says a T supplement would not make much difference in stamina and it may be just an age thing (I'm 81). Also, I had a lot of PSA anxiety in the years between my RP and reaching the PSA recurrence level and, although I've read that a T supplement is very unlikely to cause a recurrence, I 'm very happy with the undetectable PSA, feeling pretty good, and don't want to tempt fate! I credit excellent care at UCSF for keeping me going.

Brownsf:
Thank you for your response. My T before treatment(March 2024, I was 88) was 328. I think I would be in heave, if my T goes up to 200! I read that gel has the least metabolic side effects. If it is just age related decline, You can improve with aerobic and resistance training. With T of 200 I would expect you should have fair amount of exercise tolerance. I get fatigue, not so much feeling tired like after a long run.
My mantra is "Fight through Fatigue"
Wish you the best

@jeffmarc Do you have the definition of fully recover? In the Orgovyx trials that was defined as > 280. I doubt that almost all men with 3-9 months ADT recover to their former testosterone level. More likely the recovery is above some definition of low testosterone.

@jim18
For adult men, the minimum normal testosterone level is generally considered to be 300 nanograms per deciliter (ng/dL). However, "normal" is highly dependent on age and the specific laboratory evaluating your blood work

@jeffmarc

+

Testosterone test results also depend on the time of day. If the test is taken early in the morning, the testosterone level will be max level, while if it's taken in the afternoon or evening, the result will be different (and lower).

@jimgaudette Jeff Marchi info. Is so so accurate. My last testosterone check was 91 ; 16 months after 28 months of ADT. I m 77 today. This month- 19 months after ADT I get my TESTOSTERONE checked again.Keep in touch - I ll tell ya the results July 22nd.