TRT post prostatectomy

A baby dose will not work. Have you been on ADT? It can take over 1 year to recover. There is a feedback loop that will reduce the testes production of testosterone with TRT. That results in shrinkage of your testes. To get to a testosterone level of 700 you just cannot add 250 since your production will fall, probably well below 300. Then as you increase TRT your natural production of testosterone will fall further. Now if your natural production was very low TRT might be a good strategy.

@jim18

Thank you for input ! Never needed ADT. Just a natural drop. Perhaps it will bounce back

I was diagnosed high-risk, and treated with ADT and radiation back in 2018. Went 6-years with non-detect PSA, before my Total-T climbed from 20 to 200. Physically weak and frustrated, I agreed to TRT injections early in the 7th year, and less than 8-months later, my Total-T went from <200 to 425+ and the PSA has slowly climbed to its present level of 20. Thus, I'm now in recurrence.

Were the supplemental testosterone-cypionate (TRT) injections the direct (or even indirect) cause for the return? Hard to say. I'm told by the 'experts' that they were likely not, but I'll still always wonder.

Thank you for sharing! As a result I will pause. Will keep
you in my prayers today 🙏🏽

Hmmm

Like most any lab, first question may be, "did you keep the conditions the same, pre-lab draw, time of day, same lab...!?"

Next question, "is one data point sufficient to act on or do you need several to constitute a trend!?"

Generally, T<300 is generally a point where one's medical team may initiate a discussion about TRT if you are showing symptoms such as you describe.

The Men's Health Clinic here in Kansas City floods the airwaves with commercials on "Low T" and stating you can regain your sexual performance of your youth along with better workouts...right..

Hmm, sounds like the fountain of youth, more T, feel like a man again...

If your only treatment has been surgery then your T level may not likely be an issue as a recurrence. What did your pathology report say?

After triplet therapy, later doublet therapy, my T recovered to 400+ within six months.

I felt fine, the symptoms of castration went away, replaced by just the normal things, going to the grocery store to get three things, then standing in the grocery store and asking myself, "what was I supposed to get " and drawing a blank.

Lifestyle wise I ride my bike, go to the gym, ski, hike.., because those are fun, I don't feel the fatigue, yard work, now that tires me out! I'm not saying that after riding 55 miles through the Flint Hills on gravel back roads that I'm not tired and stiff, but, my point is, I can do it with T in the 400s.

The old adage that T is fuel for the fire may not be accurate. The adage dies hard though in clinical practice.

Your call, discuss TRT with your medical team, what do they say, dosage, T level, other side effects of TRT, is there any gain in function?

Kevin

@jim18

My testosterone has always been around 280 but fell to around 100 by one-year after 4 months of Lupron treatment. My TRT dosage is 100 ml every 2 weeks which is a minimum dose, but it did immediately eliminate my Lupron side effects. In 3 weeks, I will have my first blood test after 3 months of TRT. I hope my PSA is still undetectable and that a higher dose of Testosterone will be given since I still have no erections. I am84 years old.

It is so interesting that your T fell after prostatectomy and since I never heard about that possibility I did some quick reading. It really can happen ! However, papers say that it is almost always transitory occurrence - it should return to the base level 3-12 mos. post surgery. Perhaps you can wait some more (if you had RP recently) and see if your T will return to your normal level ?

@surftohealth88

My doctor said I was hypogonadal and prescribed TRT. Older men do not typically recover from ADT treatment, especially Lupron. The side effects do not go away without testosterone treatment or recovery.

@surftohealth88 Although he was admittedly just one of tens of thousands of physicians, my RO indicated to me immediately following my ADT/Radiation treatments back in 2018, that in his experience, testosterone levels in men so-treated, slowly and significantly recover to the "95th" percentile, while approximately 5% of men so-treated, never recover their testosterone much above castration levels. Prior to my treatments, my Total -T was 575 and after 7-years, it rebounded from its 2018 castration level (<20) to 435 today.

@pesquallie
@toomany

Yes, thanks for your input : ) - but @tattodice had surgery and no ADT treatment which is completely different scenario.

It is well known fact that ADT can have lasting effect on man's testosterone production and for some T never returns to pre- treatment levels.

This person had T going down by just having a surgery and I did not know that surgery can have effect on T level. It had zero effect on my husband's T level so I was surprised to find out that it is actually something that can happen. For that reason I did some further reading and discovered that surgery itself (RP) can indeed effect T levels too.

I guess we learn new things every day.

BTW- @tattodice is 60 year old.