Are you at all concerned about prostate cancer with those high T doses?
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Not really… my prostate is about the size of a walnut… 20 year old size… due to daily finesteride for 30 plus years.
Been on this dose of testosterone for 6 full years… everything checks out. Again testosterone is natural to the body… high normal… is still normal zone. So risk is less than that of high steroid abuse 1000 mg upwards.
Just got my PSA last week .93 not even 1.
Soooo. I think all good… family genetics no cancers or CVD.
Just a pup compared to you. 
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I used TRT off and on for a few years, stayed in the 600-1000 range. T is below 300 when not on TRT. Have some BPH and PSA 2.5 so ok for 75 yrs. Just started Rapamycin so optimistic about prostate cancer chances. But still cautious. Been on Finasteride 2 years.
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I had not heard of this as a risk factor so I checked on it.
Testosterone Levels and Cancer Risk
1. Claim: Testosterone therapy does not increase the incidence of prostate cancer in men without a prior history.
- Evidence Level: Level B (Human Randomized Controlled Trial)
- Verification: The TRAVERSE trial is the definitive, large-scale (n=5,246) study mandated by the FDA to assess this exact risk. It found no significant difference in prostate cancer incidence between the testosterone and placebo groups over a mean duration of 33 months.
- Source: Lincoff, A. M., et al. “Cardiovascular Safety of Testosterone-Replacement Therapy.” The New England Journal of Medicine, 2023.
- Link: 10.1056/NEJMoa2215025
2. Claim: The “Saturation Model” indicates that prostate cancer growth is insensitive to testosterone concentrations above a low threshold (approx. 250 ng/dL).
- Evidence Level: Level C (Review of Human Observational Studies & Mechanistic Data)
- Verification: This model, proposed by Dr. Abraham Morgentaler, unifies clinical observations that while castration (low T) reduces prostate volume, supraphysiological T does not increase it further. It explains the lack of dose-response relationship in clinical trials.
- Source: Morgentaler, A., & Traish, A. M. “Shifting the paradigm of testosterone and prostate cancer: the saturation model and the limits of androgen-dependent growth.” European Urology, 2009.
- Link: 10.1016/j.eururo.2008.09.024
3. Claim: Low serum testosterone is associated with more aggressive (high-grade) prostate cancer.
- Evidence Level: Level A (Human Meta-Analysis)
- Verification: A systematic review and meta-analysis confirmed that low preoperative total testosterone is an independent predictor for Gleason score upgrading (finding more aggressive cancer than expected) after radical prostatectomy.
- Source: Piao, S., et al. “Low serum total testosterone level as a predictor of upgrading in low-risk prostate cancer patients after radical prostatectomy: A systematic review and meta-analysis.” BMC Cancer, 2022.
- Link: 10.1186/s12885-022-09859-8
4. Claim: Testosterone injections (particularly intramuscular) can elevate PSA levels, potentially causing detection bias.
- Evidence Level: Level A (Human Meta-Analysis)
- Verification: This meta-analysis of 15 studies confirmed that while TRT does not increase cancer risk, it does cause a statistically significant increase in PSA levels (0.271 ng/mL for IM injections), which often triggers biopsies that might otherwise not have happened.
- Source: Cui, Y., et al. “The effect of testosterone replacement therapy on prostate-specific antigen (PSA) levels in men being treated for hypogonadism: a systematic review and meta-analysis.” Medicine, 2015.
- Link: 10.1097/MD.0000000000000410
5. Claim: Supraphysiological doses of testosterone (Bipolar Androgen Therapy) are used to treat Castration-Resistant Prostate Cancer (CRPC).
- Evidence Level: Level B (Human Clinical Trial / Phase II)
- Verification: Trials demonstrate that rapid cycling between supraphysiological (high) and castrate (low) levels of testosterone can induce DNA damage in cancer cells and restore sensitivity to anti-androgens.
- Source: Teply, B. A., … & Denmeade, S. R. “Bipolar androgen therapy in men with metastatic castration-resistant prostate cancer after progression on enzalutamide: an open-label, phase 2, multicohort study.” The Lancet Oncology, 2018.
- Link: 10.1016/S1470-2045(17)30906-3
Key Takeaway on “Supraphysiological” Doses
Current data supports the counter-intuitive finding that prostate cancer cells are vulnerable to extremes: they thrive in a “normal” androgen environment but can be suppressed by castration (zero T) or supraphysiological shock (high T). The danger zone appears to be chronic low-normal levels, which may select for aggressive cell lines, rather than the high peaks seen in injection protocols.
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Thanks RapAdmin for that!
My urologist and GP physicians think all is fantastic… and not likely to get prostate cancer due to my small, tight prostate… size… and low PSA… under 1.
A large prostate is not good.
Below is what I am concerned about, if you have some cancer and don’t know it, then adding T could be a problem.
Part 4: Actionable Intelligence
-
Safety & Toxicity Check:
- Prostate: Does not cause cancer, but will accelerate growth of existing androgen-dependent tumors.
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Also thanks RapAdmin for that.
I’ve talked to urologists that say the same thing. Of course, we can’t know for sure in every situation and all the Urologists said to check PSA annually when on TRT.
My n=1 (not myself) is the story of this arrogant colleague who had several ex wives who got into the hormone pushing racket. He died at 68 of metastatic prostate CA.
His urologist (forget HIPAA) told me he wasn’t checking his PSA and was like 300 on presentation. He died fairly quickly after the back pain started.
You can’t get around that the prostate is a cancer waiting to happen and that testosterone is the growth stimulant. But just like breast cancer in women, HRT is not as big an issue as feared. Perhaps saturation effect but wouldn’t want to bet my life on that effect being infinite - ie if you go really high, there is probably some increased risk.
Also heard that low PSA levels are very reassuring including trends - like if you were 2 at a young age and stay 2 - that is very reassuring. I’m in the stable .7 to .9 range so feel like T is a relatively safe option. If I was 4 and getting MRIs and biopsies, I wouldn’t chance it - or would have a much lower target range.
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Thats exactly my point DavidC that you can never be certain. Like the saying goes, most men will die with cancer but not OF it. I have bloodwork and appts coming up shortly. Testosterone is a growth stimulant for prostate cancer IF you already have some. The older one gets the more likely it is. I am 75 so I got to be more careful than you younger guys.
My PSA has always been < 1.5 my whole life up until a year ago, but it has varied from .6 to 1.5 regardless of TRT usage. A year ago it went up to 2.5 when I started on Metformin so that may be a clue. A Uro told me that Finasteride lowers the PSA reading.
When I heard about the protective effect of Rapamycin and Autophagy as well as Longevity claims I thought that would be a good way to go. I just started Rapa this month. Does Rapa effect PSA?
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Hey Dave… on both high normal weekly 200 mg TRT score 1400 and a daily 25 mg Jardiance SGLT2 Inhibitor. And, HGH 3.5 iu daily for 1 year.
Even with all those – my hematocrit is in the almost normal range for adult males 42% - 52 % - I am at 53.6 my doctor says is fine for me, my muscles, weight and overall great health.
Overall… all blood cells look good.
I think your doc is being a bit cavalier , maybe even reckless saying that 53.6 hematocrit is ok when the evidence clearly says the opposite. At least it sounds like, from your previous posts, that your other cardiovascular risk factors are low, so hopefully they offset the elevated hematocrit. I’m more conservative due to my calcium score, high Lp(a) and fam history.
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I can see your point, unlike most on here, I have a 20 year friendship and a 6 year patient relationship… with blood panels and physicals every 3-4 months due to the longevity and healthy benefits I seek.
Long thoughtful approaches. Using current research… and a lot has changed in the past 6 years. More, openness… grey areas… as opposed to black and white… never attitudes… some things turning 180 degrees opposite.
Being seen as a unique person… and planning… monitoring regularly. With years of TRT… slight elevated hematocrit expected… we will discuss options.
True, having a Coronary Calcium Scan score of zero… 2 tests past 5 years… test 3 in a few weeks. Let’s see were it lands.
Just out of curiosity, do you have records of what your hematocrit was before you started empagliflozin?
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Sure Dave,
I can check at home. Did last blood panel in June 2025.
Started Jardiance right after maybe in August 2025.
Just curious, why not give blood? - maybe you are and I missed it. That is what I would do.
Just so you know, I am certainly not anti-T - just going through due diligence.
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Unfortunately, you can’t donate blood if you take finasteride. Bad for women and kids.
Was a regular donor in my younger years.
You can do “therapeutic phlebotomy”, which requires a prescription but you just go and donate blood and they dump it.
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Appreciate the advice.
I might just offer it to @desertshores 
Parabiosis… I am old… but he’s 20 years older.
My supplement infused blood might just bring him back a decade.
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@Jay I should report back in 2 mo. Currently injected 2x the variant of klotho publicly available off biolongevitylabs.com, a modified variant with 2 week half life. Have 2 more doses, used 2 doses. Both my wife and I can’t say we noticed anything. Like alot of rejuvination protocols if you aren’t weak in XYZ then you may not benefit. We both have not noticed any benefit of the 2 week half life version. IMHO one should try to see. And health conditions like CKD are big factors.
BUT like hope and a prayer protocols like rapa is it still benefiting us if you don’t feel it? I can’t say.
I just recived 6 mo or so worth of a better variant, closer to human, Klotho-1. I can’t quote the peptide chain sub set each of these are vs the nutural much longer human version… But this privately sourced version is dosed daily at 100mcg. Some kidney patients are dosing 100mcg 2x / day, another 300mcg every other day. Seems kidney disease is very klotho sensitive for repair. I haven’t tried this version yet. Maybe next week.
One can access this daily version by joining this $200/mo group: TPC ARMY . This is all I should say publicly… Like TRT, rapa, SLGT-2, this new glucose lowing drug; should klotho replacement be theraputic for the general aging, it’ll be added to the forever protocols, or could be if this experiment pans out.
Best to all, curt
curt504, Good luck. I hope it works for you. My research with ChatGPT could never give me great clarity on dosing. At times it noted around 50 ug daily and other times a bit greater than 200 ug in mouse trials.
You likely have read the thread below, but if not it may be useful. And, just for the heck of it did an AI search for Klotho doses used in primates and the equivalent human doses. A table of that is also listed below.
Summary Table — HED for 60 kg and 70 kg Adults
| Primate Dose (µg/kg) | HED (mg/kg) | 60 kg Human | 70 kg Human |
|---|---|---|---|
| 10 µg/kg | 0.00324 mg/kg | 0.194 mg (194 µg) | 0.227 mg (227 µg) |
| 20 µg/kg | 0.00648 mg/kg | 0.389 mg (389 µg) | 0.454 mg (454 µg) |
| 30 µg/kg | 0.00972 mg/kg | 0.583 mg (583 µg) | 0.680 mg (680 µg) |
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