45 & Considering TRT: PCa Fam History: Rate My Labs

[JYD21]

Like the title says, I'm 45 and considering a lower dose TRT to start out. My father has PCa, removed his prostate, and lost functionality, so he's impotent and has been for 10 years, but he's alive. He's 80.

I'm 45 and in great health; workout, cardio, etc. Here's my labs over the last few years:

NAME	Sep-18	Sept 209	Aug-20	Aug-21	REFERENCE RANGE
	7:30AM Fasted	8AM Fasted	10am Fasted	8:45am fasted
PSA, TOTAL	1.12	1.4	0.99	1.29	<=4.00 (NG/ML)

I will say that I have tended to masturbate or have a pretty active sex life regularly. I want my PSA to be close to 0 for my age of 45. I've decided to lay off the masturbation to see if it goes down in 2-3 months and I want to check my PSA before considering TRT.

What do you all think of my situation? Cheers.

 

[Systemlord]

The data shows no connection between TRT or high testosterone fueling, causing prostate cancer. Your PSA is perfectly normal and I wouldn't be concerned about trying to lower it.

PSA is also a poor indicator of prostate cancer and those with higher testosterone have less aggressive prostate cancer when compared to those with lower testosterone.

So if you are destined to get prostate cancer, it's more protective and better to have higher testosterone.

 

[JYD21]

The data shows no correlation between TRT or high testosterone fueling or causing
prostate cancer. Your PSA is perfectly normal and I wouldn't be concerned about trying to lower it.

PSA is also a poor indicator of prostate cancer and those with higher testosterone have less aggressive prostate cancer when compared to those with lower testosterone.

So if you are destined to get prostate cancer, it's more protective and better to have higher testosterone.

Thanks. I have been collecting as many studies online as I can on this over the last two years. Do you have one you could point me to that supports this as it relates to men with it in their family history? BC of my history, my doc is vehemently against every considering TRT or at least anytime soon.

Cheers!

 

[Systemlord]

Thanks. I have been collecting as many studies online as I can on this over the last two years. Do you have one you could point me to that supports this as it relates to men with it in their family history? BC of my history, my doc is vehemently against every considering TRT or at least anytime soon.

I'll let the leading expert in testosterone and prostate cancer Urology professor Dr. Abraham Morgentaler calm your nerves and alleviate your fear.

 

[Vince]

I would also say your PSA is okay. Don't work out, have sex or masturbate. The day before and the morning of your PSA labs.

Why are you considering trt? Sounds like you're in perfect health?

 

[JYD21]

I'll let the leading expert in testosterone and prostate cancer Urology professor Dr. Abraham Morgentaler calm your nerves and alleviate your fear.

Thanks, I'll give this a listen. I've been reading that TRT is good for folks post PCa, but still looking for the study that shows no correlation between TRT and PRE Pca folks with a family history like myself.

But this should help so thanks for helping out and sharing info!

I would also say your PSA is okay. Don't work out, have sex or masturbate. The day before and the morning of your PSA labs.

Why are you considering trt? Sounds like you're in perfect health?

I'm doing better than most, but I am experiencing Low T symptoms, but it could also be my Low E, if you look at the number, it's not awesome.

And I want me PSA to be 'great' vs ok or 'in range', but that's just after watching my dad go through his PCa issues.

NAME	Sep-17	Sep-18	Sept 209	Aug-20	Jan-21	Aug-21	REFERENCE RANGE
	9:14am Fasted	7:30AM Fasted	8AM Fasted	10am Fasted	10:10am fasted	8:45am fasted
Test, Free, E2, ETC.
ESTRADIOL		24.2	31.4	18.1	29.3	17.7	<=60.7 (PG/ML)
Total TESTOSTERONE	522	581	627	434	534	536	300 - 890 (NG/DL)
SEX HORM BIND GLOBULIN		41.5	43.7	33	37.4	35	16.5 - 55.9 (NMOL/L)
CALC FREE TESTOSTERONE		108.4	114.6	89.3	105	109	47.0 - 244.0 (PG/ML)
PROLACTIN				9.3		13	4.0-26.0 (NG/ML)
FERRITIN				126		127	30-400 (NG/ML)
DHEA						129
PSA, TOTAL
PSA, TOTAL		1.12	1.4	0.99		1.29	<=4.00 (NG/ML)

 

[Vince]

Thanks, I'll give this a listen. I've been reading that TRT is good for folks post PCa, but still looking for the study that shows no correlation between TRT and PRE Pca folks with a family history like myself.

But this should help so thanks for helping out and sharing info!




I'm doing better than most, but I am experiencing Low T symptoms, but it could also be my Low E, if you look at the number, it's not awesome.

And I want me PSA to be 'great' vs ok or 'in range', but that's just after watching my dad go through his PCa issues.

NAME	Sep-17	Sep-18	Sept 209	Aug-20	Jan-21	Aug-21	REFERENCE RANGE
	9:14am Fasted	7:30AM Fasted	8AM Fasted	10am Fasted	10:10am fasted	8:45am fasted
Test, Free, E2, ETC.
ESTRADIOL		24.2	31.4	18.1	29.3	17.7	<=60.7 (PG/ML)
Total TESTOSTERONE	522	581	627	434	534	536	300 - 890 (NG/DL)
SEX HORM BIND GLOBULIN		41.5	43.7	33	37.4	35	16.5 - 55.9 (NMOL/L)
CALC FREE TESTOSTERONE		108.4	114.6	89.3	105	109	47.0 - 244.0 (PG/ML)
PROLACTIN				9.3		13	4.0-26.0 (NG/ML)
FERRITIN				126		127	30-400 (NG/ML)
DHEA						129
PSA, TOTAL
PSA, TOTAL		1.12	1.4	0.99		1.29	<=4.00 (NG/ML)

Do Certain Foods and Supplements Affect PSA and Prostate Cancer Risk?

Dietary Factors and Supplements Influencing Prostate Specific-Antigen (PSA) Concentrations in Men with Prostate Cancer and Increased Cancer Risk: An Evidence Analysis Review Based on Randomized Controlled Trials Abstract: The quest for dietary patterns and supplements efficient in...

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[madman]

Like the title says, I'm 45 and considering a lower dose TRT to start out. My father has PCa, removed his prostate, and lost functionality, so he's impotent and has been for 10 years, but he's alive. He's 80.

I'm 45 and in great health; workout, cardio, etc. Here's my labs over the last few years:

NAME	Sep-18	Sept 209	Aug-20	Aug-21	REFERENCE RANGE
	7:30AM Fasted	8AM Fasted	10am Fasted	8:45am fasted
PSA, TOTAL	1.12	1.4	0.99	1.29	<=4.00 (NG/ML)

I will say that I have tended to masturbate or have a pretty active sex life regularly. I want my PSA to be close to 0 for my age of 45. I've decided to lay off the masturbation to see if it goes down in 2-3 months and I want to check my PSA before considering TRT.



What do you all think of my situation? Cheers.

Like the title says, I'm 45 and considering a lower dose TRT to start out.

Looking over the other thread you started.....150 mg/week is not what would be considered a lower starting dose.



Regarding testosterone and the prostate!

post #5

TRT and prostate cancer

Introduction: It has been well established that male hypogonadism has a significant impact on patient quality of life and that replacement of testosterone can markedly improve symptoms and potentially offer a protective effect. The connection between testosterone replacement therapy (TRT) and...

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TRT in the Setting of Prostate Cancer

Abstract Since the 1940s, elevated serum testosterone (T) levels have been infamously suggested as a causal factor in the development of prostate cancer (PCa); this time was also the dawn of both surgically and pharmacologically induced castration. However, men suffering from primary or...

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[madman]

Canadian Urological Association guideline on testosterone deficiency in men: Evidence-based Q&A (2021)


Treatment risks

21. Does testosterone replacement therapy increase the risk of prostate cancer?

Despite historical teachings about the relationship between testosterone on prostate cancer biology and risk, there is now consistent evidence that testosterone therapy does not increase a man’s risk for developing prostate cancer. In the largest randomized controlled trial (RCT) to date (The Testosterone Trials), involving 790 men 65 years and older treated for 12 months with either testosterone gel or placebo, despite close surveillance, only one man developed prostate cancer during the course of the study.29 Supporting such observations, a meta-analysis of 22 RCTs involving 2351 men revealed no greater risk of developing prostate cancer among those who received testosterone therapy compared with those who received a placebo.53 There is no association between the risk of prostate cancer and serum testosterone concentrations. Men with the highest naturally occurring (endogenous) testosterone levels do not exhibit significantly higher prostate-specific antigen (PSA) levels or a greater subsequent risk of developing prostate cancer than men with the lowest levels of endogenous testosterone.54,55 Finally, the evolving literature suggests that among appropriately selected hypogonadal men with prostate cancer managed with active surveillance, radical prostatectomy, or radiation therapy, testosterone therapy does not appear to significantly increase the risk of biochemical (PSA) progression, local or metastatic progression, overall mortality, and cancer-specific mortality.56-58

Symptomatic men with TD who have been diagnosed with localized prostate cancer and treated (surgery, radiation) or followed with active surveillance without evidence of active disease can be considered for a medically supervised trial of testosterone therapy (low LE, weak recommendation). Consultation with a urologist is recommended. Patients with metastatic or high-risk prostate cancer who are likely to require androgen deprivation therapy should not be offered testosterone therapy (moderate LE, strong recommendation).5

 

[madman]

TRT after treatment for prostate cancer

In the spring of 2020 after being on TRT for 5 years, I stopped suddenly last year when I was diagnosed with prostate cancer with 9 of 12 biopsy cores were cancerous and Gleason score of 6. There was no abnormality detected in rectal exams. My PSA had gradually increased to 11 over a period of...

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[JYD21]

You guys rock. This is great info; thank you for sharing! I’m gonna look it all over and reply later after I’ve digested it.

I agree so far that a lower starting trt dose of 50mg every 3.5 days is a better approach. And doing that first without adding/pinning anything else. See how just the test cyp does.

Let’s keep this thread going and appreciate any more opinions and info y’all can share.
Much love.

 

[madman]

Androgen Society 3rd Annual Meeting Review (Day 2)

Androgen Society 3rd Annual Meeting Review (Day 2) – Summary: Abraham Morgentaler, MD, FACS, Associate Clinical Professor of Urologic Surgery at Harvard University, reviews the second day of the 3rd annual meeting of the Androgen Society, an international organization consisting of healthcare...

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[JYD21]

Patients with metastatic or high-risk prostate cancer who are likely to require androgen deprivation therapy should not be offered testosterone therapy (moderate LE, strong recommendation).5

I think this is the part that confuses me. I am considered 'high-risk' because of my family history. So does that mean I am not a candidate for ever using trt due to this? The conventional definition for years of 'high-risk' is a man that has it in his 'family history.'

What say you guys on this?

Thanks.

 

[Vince]

Some studies have contradicted it, finding a higher risk of prostate cancer among men with low testosterone levels. A 2016 meta-analysis of research found no relationship between a man's testosterone level and his risk of developing prostate cancer.Oct 30, 2017
Healthline: Medical information and health advice you can trust. › health
Testosterone and Prostate Cancer: What's the ...

 

[JYD21]

Some studies have contradicted it, finding a higher risk of prostate cancer among men with low testosterone levels. A 2016 meta-analysis of research found no relationship between a man's testosterone level and his risk of developing prostate cancer.Oct 30, 2017
Healthline: Medical information and health advice you can trust. › health
Testosterone and Prostate Cancer: What's the ...

Thanks, @Vince . So basically, the old definition of 'high-risk' = family history, is being debunked by newer studies.

 

[Systemlord]

Thanks, @Vince . So basically, the old definition of 'high-risk' = family history, is being debunked by newer studies.

Correct and any doctor not up to date in this particular area of medicine is going to regurgitate old beliefs and refuse TRT.

 

[madman]

I think this is the part that confuses me. I am considered 'high-risk' because of my family history. So does that mean I am not a candidate for ever using trt due to this? The conventional definition for years of 'high-risk' is a man that has it in his 'family history.'

What say you guys on this?

Thanks.

Look over post #12 (PCa)!

Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring

ABSTRACT The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age...

www.excelmale.com

*Therefore, prior to starting TTh, a patient’s risk of PCa must be assessed using, at a minimum measurement of serum prostate-specific antigen (PSA). Pretreatment assessment should include PCa risk predictors such as age, family history of PCa, and ethnicity/race. If suspicion of PCa exists, it may be reasonable to perform a prostate biopsy if warranted by clinical presentation. Testosterone therapy may be initiated in these men if a prostate biopsy is negative

*After initiation of TTh, patients should be monitored for prostate disease with measurement of serum PSA at 3–6 months, 12 months, and at least annually thereafter. In a subject with an increased risk of PCa urologist supervision is required

 

[madman]

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