|Your doctor may not agree with us on this one, but we think it's very important to discuss the pros and cons on this issue so you can make a decision for yourself...|
We feel that a measurement of your Hormone
levels is an important part of the pre-treatment TC process.
Specifically, we (and the American Association of Clinical Endocrinologists) recommend that the following hormones are measured in order to determine a "hormone profile"
Pros: OK, we know this is not normally a life-threatening issue, but knowing your normal hormone levels can have a significant mental and physical impact down the road if you have testosterone problems after treatment. There are a couple of strong reasons why getting an initial check can help out later on:
What do you mean "What's normal?" - here's the deal: Testosterone is usually measured on a scale of 0-1000. If you fall within 300-700, you're average and OK - cool, right? Well, maybe not. Remember these are averages, and therefore not all guys are the same. So if you didn't have a baseline check done, and you come in at 400, but for you normal is 700, you could be experiencing some of the low Testosterone symptoms (see below) but have no basis for knowing where you should be (Note: testosterone can also be measured on a scale of 0-10 as well, depending on the denominator - but the same ratios apply).
Note that some guys are already at higher risk for low testosterone problems: If you had an undescended testicle(s), an atrophied testicle(s), a vasectomy and are going to have radiation therapy, or you are about to lose your only testicle(!) you should definitely press for this test. It is possible you will find out that your level is already low, and if so, you can get help earlier.
We all need a starting place for comparison, and this is how we get one. This simple blood test before the initial testicle removal operation (called an Inguinal Orchiectomy) will provide your medical team with a reference point should things go south later on. We realize that without this test, it may still be possible to figure out that you have a testosterone related problem, but you won't know how much it will take to get back to "normal" - having this info could easily save 3-6 months of experimentation.
Cons: To be fair, we will provide alternative points as to why you may not need to get a pre-IO Testosterone check. Note this does not change our recommendation, but we hope it will provide you better decision-making inputs.
While the jury is still out as to how many TCers have low testosterone problems, certainly not all guys who have had TC will have testosterone problems. The exact number who do is hard to quantify at this time - some doctors feel this is a very small number, others as high as 30%, thus many could feel it is not worth the expense or effort.
It is possible that the pre-orchiectomy testosterone level is already lower or higher than your "normal" level. If your doctors assume that this measurement is your normal level, and you have a problem later on, then you may end up trying to adjust your supplementation to the wrong level, or chasing a "red herring"...
We have been told it can cost $50-$100 for this test and may be viewed as an unnecessary expense.
This is important! Only a doctor, preferably an Endocrinologist, can diagnose these symptoms completely.
See your medical team before making any decisions or taking any medications.
What are the symptoms of low testosterone?
Source: American Association of Clinical Endocrinologists - details HERE (PDF file)
For more information, check out all the articles in the TC2 section of the TCRC as well as our hormone links page!