PSA and testosterone different directions

Morning Dafna. Jacobs testosterone levels are still well within the levels where they would consider it to be a breakthrough. In the UK it is considered to be at the castrate state when the level is below 1.7 but there are better prognostic indicators when it is below 0.7. The testosterone levels, like the PSA levels, can fluctuate and there have been several studies to try and identify why such as the timing of the test in relation to the time since the last injection, the assay used..... The limitations of most of the information is that it refers to men purely on ADT and there is a paucity of information on men who have combined ADT and second generation antiandrogens, plus the time of follow up after initiation relates mainly to periods up to a year only.

This is the best summary of the information I can find.

https://www.auajournals.org/doi/10.1097/JU.0000000000000809#:~:text=There%20are%204%20major%20categories,of%20ADT%20with%20LHRH%20agonists.

We had a similar situation in that hubbies testosterone levels started to rise steadily from 14 to 20 over a couple of years ( our scale is 25 - 50 compared to 0.7-1.7). His last test suddenly dropped back to 14.5 with no apparent cause.

Don't overthink it. Jacob is doing well and trust the experts if they say they are not concerned.

Thank you AW. Have a lovely weekend!

Lots of love

Dafna

Hi !

Looked at your bio and from what the information your husband is in a very good place with a PSA <0.01 with current treatment with a extremely low level of 0.4 which by all studies is extremely good Testosterone suppression and with a PSA undetectable everything looks great and I really understand that medics is not worried at all if looking at the PSA levels which is the main indicator for how well the treatment works

So, really good results and you should enjoy and not worry at all for the moment anyway

Best wishes - Ulf

Thanks Ulf. I am not so much as worried but puzzled by the opposite directions these two values travelling PSA and T. It just make sense that when is one down the other one should follows.

Have a lovely weekend

Lots of love

Dafna

Hi Dafna !

I really don’t think you should be that puzzled at all because we are talking extremely low levels of Testosterone. In Sweden and Finland they just measure down to 0.4 nmol and after that it’s < 0.4. So a fantastic result for T-level suppression.

With this type of sensitivity your husband probably may perhaps have done some type excercise, perhaps took the test at a different time of the day or even ate something that may have triggered some tiny extra Testosterone molecules or whatever Testosterone is actually 

It’s actually the same with the PSA and less than 0.01 is so extremely minimal that it really summarizes what undetectable means. In Sweden and Finland they don’t even do ultrasensitive and we are considered ’undetectable’ at < 0.1

So enjoy the results, relax and have a very wonderful weekend yourself 

Best wishes - Ulf

Hi Dafna, glad to hear you are both doing well.  It is unlikely that PSA levels and T levels don’t keep in sync, so I think the explanation from Ulfhbg is most likely to be the reason.  However, you are talking such small levels I don’t think you should overthink it.  See what happens next time.  Have a good weekend. David

Thank you David. It is actually 3 tests in a row that the T is creeping up while PSA is undetectable. I know the values are so low and I am not concern but it is against all logic as these two values should be in sync. 

How are you doing on the Enzu?

Have a lovely weekend. It looks like we are all going to be blown out to the sea in Brighton! So here is staying at home weekend.

Lots of love

Dafna

Dafna, the wind was very strong overnight in the South West.  We moved this year and this is the worst we have seen so far. Surrounded by big trees so I am hoping they don’t go over.  Enzalutamide has knocked me over but now reducing to half dose, so hoping I might recover a little before heading off on holiday with the family next week.  Take care.  David