Dr. Abraham Morgentaler

So they all have all these names, right? Like testosterone, cypionate or enanthate, they're esters. But what happens is that when they hit the bloodstream, there are enzymes that cleave off those side groups and what circulates is testosterone. It's the same molecule. So that's one way to think about it.

So they all have all these names, right? Like testosterone, cypionate or enanthate, they're esters. But what happens is that when they hit the bloodstream, there are enzymes that cleave off those side groups and what circulates is testosterone. It's the same molecule. So that's one way to think about it.

So the most important thing to understand about PSA is that in order to interpret a PSA level, you actually have to know what the testosterone level is. And the reason I say that is PSA is its production. It's a normal prostate chemical that is androgen dependent. So you can take healthy volunteers, which has been done, and give them an agent that lowers testosterone.

So the most important thing to understand about PSA is that in order to interpret a PSA level, you actually have to know what the testosterone level is. And the reason I say that is PSA is its production. It's a normal prostate chemical that is androgen dependent. So you can take healthy volunteers, which has been done, and give them an agent that lowers testosterone.

So the most important thing to understand about PSA is that in order to interpret a PSA level, you actually have to know what the testosterone level is. And the reason I say that is PSA is its production. It's a normal prostate chemical that is androgen dependent. So you can take healthy volunteers, which has been done, and give them an agent that lowers testosterone.

Their PSAs will go down usually to zero. or close to it. When their own testosterone recovers because you've stopped that medication, as the testosterone rises, PSA will rise. until it reaches a maximum. If you give finasteride or dutasteride, we know the PSA drops by about 50%, right? We compensate for it.

Their PSAs will go down usually to zero. or close to it. When their own testosterone recovers because you've stopped that medication, as the testosterone rises, PSA will rise. until it reaches a maximum. If you give finasteride or dutasteride, we know the PSA drops by about 50%, right? We compensate for it.

Their PSAs will go down usually to zero. or close to it. When their own testosterone recovers because you've stopped that medication, as the testosterone rises, PSA will rise. until it reaches a maximum. If you give finasteride or dutasteride, we know the PSA drops by about 50%, right? We compensate for it.

So it's a testosterone sensitive chemical that we use to monitor men with prostate cancer or to assess their risk. But if you've got a testosterone less than 250, less than the saturation point, the PSA is going to be suppressed. It's not a real testosterone. It's not its real PSA. If they're less than 250, you don't know exactly what it's going to be if you raise it above 250.

So it's a testosterone sensitive chemical that we use to monitor men with prostate cancer or to assess their risk. But if you've got a testosterone less than 250, less than the saturation point, the PSA is going to be suppressed. It's not a real testosterone. It's not its real PSA. If they're less than 250, you don't know exactly what it's going to be if you raise it above 250.

So it's a testosterone sensitive chemical that we use to monitor men with prostate cancer or to assess their risk. But if you've got a testosterone less than 250, less than the saturation point, the PSA is going to be suppressed. It's not a real testosterone. It's not its real PSA. If they're less than 250, you don't know exactly what it's going to be if you raise it above 250.

This is true whether men have prostate cancer or not. So if you have a guy with prostate cancer and his testosterone is, let's say, 200, and he goes on testosterone, so there's two versions of this. One is, let's say, they've had radiation. Most guys with radiation have some measurable amount of PSA. The PSA will go up in that circumstance.

This is true whether men have prostate cancer or not. So if you have a guy with prostate cancer and his testosterone is, let's say, 200, and he goes on testosterone, so there's two versions of this. One is, let's say, they've had radiation. Most guys with radiation have some measurable amount of PSA. The PSA will go up in that circumstance.

This is true whether men have prostate cancer or not. So if you have a guy with prostate cancer and his testosterone is, let's say, 200, and he goes on testosterone, so there's two versions of this. One is, let's say, they've had radiation. Most guys with radiation have some measurable amount of PSA. The PSA will go up in that circumstance.

If their testosterone is above 250, it probably won't go up much at all or maybe zero. If they've had surgery and their PSA is a very low number, or let's say it's a sensitive assay, right? Let's say it's, I don't know, 0.01, right? Still below the sort of recurrence level if you want.

If their testosterone is above 250, it probably won't go up much at all or maybe zero. If they've had surgery and their PSA is a very low number, or let's say it's a sensitive assay, right? Let's say it's, I don't know, 0.01, right? Still below the sort of recurrence level if you want.

If their testosterone is above 250, it probably won't go up much at all or maybe zero. If they've had surgery and their PSA is a very low number, or let's say it's a sensitive assay, right? Let's say it's, I don't know, 0.01, right? Still below the sort of recurrence level if you want.

But there is a chance, especially with a very low testosterone, that the true value of that, which you'll find out when you give testosterone, might be above 0.02. Or 0.2. And so you have to see what that is. And it sometimes changes the status of somebody. But if somebody has a measurable PSA and their T is less than 250, it's almost certainly going to go up.

But there is a chance, especially with a very low testosterone, that the true value of that, which you'll find out when you give testosterone, might be above 0.02. Or 0.2. And so you have to see what that is. And it sometimes changes the status of somebody. But if somebody has a measurable PSA and their T is less than 250, it's almost certainly going to go up.

But there is a chance, especially with a very low testosterone, that the true value of that, which you'll find out when you give testosterone, might be above 0.02. Or 0.2. And so you have to see what that is. And it sometimes changes the status of somebody. But if somebody has a measurable PSA and their T is less than 250, it's almost certainly going to go up.