Unique problem with elevated PSA and Androgel

Posted by davenj @davenj, Nov 8 11:05am

I am 62 years old. About 13 years ago I had Addison's and Cushings disease from being put on steroids for too long by a neuro-surgeon in Florida. It completely shut down my adrenal glands and caused many other problems. I am over most of them now except for one. My body does not produced any testosterone at all. Literally none, zero, nadda. Back then when I went to an endocrinologist here in Lancaster, OH he tested my T level and it came back 1 (one). He was blown away. He said that he had never in all his schooling or years of practice seen a result that low. I have been on Androgel since then at five pumps from the bottle every day. That is about 100 mg of testosterone every day. Even with this large daily dose my T-serum levels are always around 300-320 (normal range 264-916). Here is my problem: In February of 2025 my PSA was 2.7 and November of 2025 it has risen to 4.1. My endo-doc immediately took me off of Androgel competely. I told him "remember I don't have low-T, I have no-T". It won't be long before I quit wanting a Dolphin's Cheerleader but instead want to go shoe shopping with them. But seriously, I remember the days when my level was 1 and it was horrible. The weakness and fatigue were devestating. He is sending me to a urologist in 4 weeks but by then I wil;l be a mess. Should I stay on one or two pumps of Testosterone gel or stop competely and go to pieces? Thanks for taking the time to read all of this. Dave

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jeff Marchi | @jeffmarc | Nov 8 12:29pm

That PSA rise due to testosterone could be related to having prostate cancer. Unfortunately, if you take somebody off testosterone and they have no testosterone it’s hard to figure out what’s going on.

You could get a PSE test. You could get an MRI. Either one of those could show whether or not you have a possibility of prostate cancer. The PSE test will say either you need a biopsy because something showed up or you don’t need it, no cancer seen.. The MRI can see if there’s actually tumors in your prostate.

Has your doctor discussed doing anything about your rising PSA besides stopping testosterone?

chippydoo | @chippydoo | Nov 9 5:36pm

I had considered having T therapy but ended up not having it and grateful for that decision. It would have been rocket fuel for my prostate cancer. When I did ADT earlier this year my T was down to 1. It was manageable. Each stage of treatment or during periods of rising PSA between was considered a "new me" thing. I would throw my Androgel in the trash as it is cancer fuel.