Do you recommend ADT for a patient with hypogonadism with unfavorable or high risk prostate cancer whose PSA dropped to <1 after cessation of supplementation?

When I encounter this situation, I will measure the testosterone level off supplementation. If the testosterone is castrate level (<50 ng/dL), then I would not add ADT, as the target testosterone level has already been achieved. If the patient's testosterone level remains above the castrate threshold off supplementation, then I will add ADT. The only exception I have made to this practice is if the patient's PSA became undetectable (<0.1) simply by stopping supplementation.

Not testosterone is at castrate level.