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Low Testosterone

Posted by ava11 @ava11, 2 days ago

It has been 15months since I stopped ORGOVYX after being on it for 1 year. My PSA stayed at 0.03. My Testosterone during ADT dropped to 8. But after I stopped ADT, it went up to 85. But now it is 46. PSA is 0.03 My Gleason Score 9 but cancer was in the gland and I was treated with 5 sessions of SBRT at UCLA. I am 90. Any one in this situation?

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Jeff Marchi | @jeffmarc | 20 hours ago
In reply to @pesquallie "@jeffmarc Studies I have read support your comments, but some studies also indicate that age is..." + (show)
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@jeffmarc

Studies I have read support your comments, but some studies also indicate that age is also a major influence. When above 80, like me, recovery from Lupron is less likely and slower. Some doctors question the use of ADT's after age 80.

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@pesquallie
Yep, you do bring up an important issue, The older you get the less likely your testosterone will come back at all, Much less to normal level levels.

As mentioned by by Doctor Weber in his PCa commentary

The extent to which T is suppressed depends on a patient’s age and the duration of anti-
androgen exposure, and both those factors also influence the rate of T recovery after ADT is
ceased. At a T level of <230 ng/dL a man is said to be “hypogonadal” and symptoms from a
diminished T commence - to different degrees in different men. After 3 - 6 months duration of
Lupron or Relugolix treatment 65% of men will still be below <230 ng/dL at 12 months after
stopping.

If someone has a serious case of prostate cancer at 80+ It may make sense to use ADT, It depends on the person, their health and their mental attitude. You can always give testosterone injections after treatment is completed.

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chippydoo | @chippydoo | 1 hour ago
In reply to @brownsf "I was diagnosed with PC in 2008 based on a DRE. My PSA was less than..." + (show)
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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.

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@brownsf Off the top of the head I think PSA returns on its own but, supplementation will fuel the fire once it does. I got up to 230 post adt and just dropped to 175 over the past 3 months. I will get retested in case it is a fluke. Have to say I am feeling run down with low energy and have to force myself to do anything. I was diagnosed Gleason 9 Grade 5. It is my understanding that those of us that do T therapy they test more frequently. At some point I would be willing to give it a try to see if it improves my quality of life. More research with doc's on my part needs to be done. One side of me thinks if it doesn't cause psa to return why not try it.

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retireddoc | @retireddoc | 11 minutes ago
In reply to @jimgaudette "I had a radical prostatectomy 10 years ago. Five years ago I had radiation to a..." + (show)
Profile picture for jimgaudette @jimgaudette

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.

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@jimgaudette
73 year old five years ago diagnosed with G9, had prostatectomy and then discovered a solitary met at T8 successfully treated with SBRT. Continued rise in PSA prompted triple therapy successful with PSA< 0.1 for 3 years. Only on Lupron for one year but T never got back above 40. Unlikely to return to normal at my age. A year a half ago my MO at Johns Hopkins put me on TRT. Complete reversal of all of the side effects of low T. Energy restored, muscle mass returned, no more hot flashes, mood improved, libido back (!) etc etc.

Complete ED after my surgery in 2021. Tried vacuum device and Trimix / Quadmix with diminishing efficacy. Had penile implant recently. I wish I had done it 5 years ago! Wonderful!

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