TRT after treatment for prostate cancer

[madman]

I owe the forum an update on my situation. The urologist did finally come around on testosterone replacement therapy and I have been back on testosterone cypionate since Sept 29 and feel much better. On Nov 11, the blood test bfor my anny physical exam measured my PSA increased from unmeasurable to 0.2 and testosterone at 994 ng/dL. The urologist hasn't seen that test yet. Looks like the PCP tested only total testosterone level. I have noticed some swellling in my hands and feet. What are your thoughts of switching to testosterone enanthate? Its is over twice the price at Amazon pharmacy but worth it if it helps with the swelling.

What is your protocol (dose T/injection) frequency and when were labs drawn?

Testing should be done at the trough (lowest point) before your next injection.

You are hitting a higher-end TT 994 ng/dL.

If this is trough then keep in mind that the peak levels will be higher.

Even then we have no clue where your SHBG sits but you can be rest assured that with a TT 994 ng/dL that your FT is going to be high even if you have highish/high SHBG.

Increasing your FT will drive up estradiol let alone hematocrit.

Excess FT levels can result in acne/oily skin (genetically prone), accelerated balding (genetically prone), drive down HDL, increased RBCs/hemoglobin/hematocrit (common), overstimulation of the CNS (common), bloating/water retention due to androgens effects on the retention of electrolytes (common).

Let alone many end up trying to manage estradiol with the use of an aromatase inhibitor.

Some of the side effects are due to testosterone metabolites estradiol/DHT.

You need a more thorough set of labs FT, estradiol, SHBG let alone RBCs/hemoglobin/hematocrit.

As I have stated numerous times on the forum although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the beneficial effects.

Critical to know where your trough FT level sits on such protocol.

I would not even consider switching esters just yet as we have no idea where your trough FT let alone estradiol sits.

 

[madman]

Innovations in Testosterone Therapy in Men Treated for Prostate Cancer - Excel Male TRT Forum

Urology Times® is celebrating its 50th anniversary in 2022. To mark the occasion, we are highlighting 50 of the top innovations and developments that have transformed the field of urology over the past 50 years. In this installment, Amy Pearlman, MD, interviews Mohit Khera, MD, MBA, MPH on how...

www.excelmale.com

 

[Nelson Vergel]

PSA Testing in Men Receiving Testosterone Therapy With History of Prostate Cancer: A Matched Analysis of a Large Multi-Institutional Research Network - PubMed

In contrast to current guidelines, a large proportion of men receiving TT and with a history of PCa did not undergo PSA testing. Further studies are necessary to better characterize reasons why PSA testing rates are low even in this high-risk cohort.

pubmed.ncbi.nlm.nih.gov

 

[Nelson Vergel]

Testosterone Therapy after Prostate Cancer - Excel Male TRT Forum

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