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Author Topic: Post-TRT PSA Increase  (Read 6147 times)

Tiffer

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Post-TRT PSA Increase
« on: April 28, 2015, 08:22:08 am »
I have just got my bloods back after being on TRT for 10 months:

Total Testosterone   899.14   ng/dl
Free Testosterone   293.37   pg/ml
Estradiol (E2)      23.98   pg/ml
SHBG         14.70   nmol/L
S-Prolactin         6.00           ng/mL
DHEA-S         215.50   ug/dl
Vitamin D 25      35.40   ng/mL
S-Cortisol         7.79           ug/dl
S-PSA         2.57           ng/mL

So they seem good - SHBG is getting better, DHEA is down a lot but that is probably because I haven't been able to get hold of DHEA tablets for ages and I'm not sure this is necessary.
The one thing that concerned me is that PSA is up - do I need to address this? Prior results were 1.28 in 2012 and 0.97 in July 2014.
I am going to drop from 50 mg to 40mg test cyp E3D as my levels seem high anyway.
Otherwise I do 250 iu HCG E3D and 0.25mg Adex E4D or so (the Adex is hard to dial in).
« Last Edit: April 28, 2015, 04:59:06 pm by PeakT »

Steady

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Re: Post-TRT PSA Increase
« Reply #1 on: April 28, 2015, 02:38:42 pm »
I have just got my bloods back after being on TRT for 10 months:

Total Testosterone   899.14   ng/dl
Free Testosterone   293.37   pg/ml
Estradiol (E2)      23.98   pg/ml
SHBG         14.70   nmol/L
S-Prolactin         6.00           ng/mL
DHEA-S         215.50   ug/dl
Vitamin D 25      35.40   ng/mL
S-Cortisol         7.79           ug/dl
S-PSA         2.57           ng/mL

So they seem good - SHBG is getting better, DHEA is down a lot but that is probably because I haven't been able to get hold of DHEA tablets for ages and I'm not sure this is necessary.
The one thing that concerned me is that PSA is up - do I need to address this? Prior results were 1.28 in 2012 and 0.97 in July 2014.
I am going to drop from 50 mg to 40mg test cyp E3D as my levels seem high anyway.
Otherwise I do 250 iu HCG E3D and 0.25mg Adex E4D or so (the Adex is hard to dial in).
PSA can be elevated for many reasons. Don't freak out. Sexual activity or exercise prior to the blood draw can cause an increase. You may want to consult a Urologist but be careful many will want to biopsy right away. A biopsy is expensive uncomfortable and has significant risks. If it were me I would discuss with a Urologist and suggest we wait 6 months and test again. If it continues to rise I would then find a Urologist willing to do an MRI prior to a biopsy.
Here is the thread on my recent experience with high PSA.
http://www.peaktestosterone.com/forum/index.php?topic=6700.msg56457#msg56457
« Last Edit: April 28, 2015, 04:59:14 pm by PeakT »
2/12/12 - TT=212, FT=5.3
7/15/13 - TT=876, FT=26.5, E2=17.8
9/19/13 - TT=534, FT=12.5, E2=12
12/5/2013 - TT=701, FT=18.3, E2=15.1
4/21/14 - TT=1002, E2=10.4
6/6/14 - TT=752, FT=18.1, SHBG=28, E2=14.2
7/28/14 - TT=1093, FT=30, E2=65.6b & 46s
10/22/14 - TT=1104, FT=32.6, E2=10s
4/24/15 - TT=945, FT=20.2, E2=48.6s
Prior to last labs SubQ (11/3):
TCyp 34mg & HCG 250iu M/W/F
Current Protocol SubQ:
TCyp 36mg & HCG 250iu & 0.04mg AI - M/W/F

Peak Testosterone Forum

Re: Post-TRT PSA Increase
« Reply #1 on: April 28, 2015, 02:38:42 pm »


PeakT

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Re: Post-TRT PSA Increase
« Reply #2 on: April 28, 2015, 04:58:44 pm »
I have just got my bloods back after being on TRT for 10 months:

Total Testosterone   899.14   ng/dl
Free Testosterone   293.37   pg/ml
Estradiol (E2)      23.98   pg/ml
SHBG         14.70   nmol/L
S-Prolactin         6.00           ng/mL
DHEA-S         215.50   ug/dl
Vitamin D 25      35.40   ng/mL
S-Cortisol         7.79           ug/dl
S-PSA         2.57           ng/mL

So they seem good - SHBG is getting better, DHEA is down a lot but that is probably because I haven't been able to get hold of DHEA tablets for ages and I'm not sure this is necessary.
The one thing that concerned me is that PSA is up - do I need to address this? Prior results were 1.28 in 2012 and 0.97 in July 2014.
I am going to drop from 50 mg to 40mg test cyp E3D as my levels seem high anyway.
Otherwise I do 250 iu HCG E3D and 0.25mg Adex E4D or so (the Adex is hard to dial in).

You will get different opinions on this.  I think you should pay attention to it - absolutely.  Steady is right that exercise and ejaculating can raise PSA.  But you can test that theory but abstaining from both for about 3 days - yeah, white knuckling time! - and then pull it yourself:

http://www.peaktestosterone.com/testosterone_labs

If it is still elevated, then I would pay attention to it, because it generally indicates one of three things:

1.  Inflammation / prostatits (this is usually the issue)
2.  Prostate Cancer (this is usually slow growing but not always)
3.  BPH.  (this is usually not a problem with HRT but occasionally: http://www.peaktestosterone.com/testosterone_bph)

So, if you have any of the above 3, then imo you want to know about it and starting working on it.

Also, I have quite a bit of info here if you are int'd:

http://www.peaktestosterone.com/Hdr_Prostate_Vasectomy_Fertility
« Last Edit: April 28, 2015, 05:05:35 pm by PeakT »
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

TRT

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Re: Post-TRT PSA Increase
« Reply #3 on: April 28, 2015, 10:42:06 pm »
Good advice above. Don't freak out but don't ignore. I'd repeat the test in 6 months. One other question. Did the doc do a digital rectal exam? Any findings there? I know it's subjective but can still be informative.
Currently
40 yo male, ~255 lbs @ 6'1" with 43 inch waist
Playing weight in college football was 215 lbs.
Weights (starting strength) x 2/week, conditioning 2/week
Diet SUCKS
Maintaining on 200 mg/week IM --> switched to every 3.5 days at 100 mg
Edema that has NOT gone away
HCTZ tried at 12.5 without success (with 160 valsartan as also have HTN).
Valsartan/HCTZ bumped to 160/25 3/30/15.
Initial improvement in erections and libido but has waned.

History
Free testosterone 368 with lab cutoff of 348 in late 2014
Free testosterone >600 in 2010.
Sxs of decreased nocturnal tumescence, fatigue, nonexistent libido, etc.
Started on testosterone cyp at 200 mg IM once weekly for 10 weeks.
Brought free testosterone up to 720 with estrogen of 37 at trough.

Peak Testosterone Forum

Re: Post-TRT PSA Increase
« Reply #3 on: April 28, 2015, 10:42:06 pm »


Tiffer

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Re: Post-TRT PSA Increase
« Reply #4 on: April 29, 2015, 05:22:18 am »
Thanks for the great advice - things do feel a bit tight down there and I have noticed a strange urine odor of late so I will go to the doc and check for infection.

PeakT

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Re: Post-TRT PSA Increase
« Reply #5 on: April 29, 2015, 04:50:43 pm »
Thanks for the great advice - things do feel a bit tight down there and I have noticed a strange urine odor of late so I will go to the doc and check for infection.

Let us know what happens.  I'd be curious.  By the way, most prostatitis is non-bacterial:  they don't know what causes it.  One theory is that the prostate is poorly vascularized and can't properly detox itself at times.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Tiffer

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Re: Post-TRT PSA Increase
« Reply #6 on: April 30, 2015, 05:48:01 am »
Ok so I went to the GP and showed him my results. He didn't seem too concerned. He checked a urine sample and said it was fine. He then gave me the latex glove treatment (grrrr) and said my prostate felt quite small.
So he prescribed a course of Augmentin SR to be sure in case it was infected. He  also gave me Uroxatral which is an alpha-1 blocker meant to reduce prostate swelling. I took a tablet of this and felt a bit weird so am not sure if I will continue but I will finish the Augmentin and retest in a while.

PeakT

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Re: Post-TRT PSA Increase
« Reply #7 on: April 30, 2015, 02:21:15 pm »
Ok so I went to the GP and showed him my results. He didn't seem too concerned. He checked a urine sample and said it was fine. He then gave me the latex glove treatment (grrrr) and said my prostate felt quite small.
So he prescribed a course of Augmentin SR to be sure in case it was infected. He  also gave me Uroxatral which is an alpha-1 blocker meant to reduce prostate swelling. I took a tablet of this and felt a bit weird so am not sure if I will continue but I will finish the Augmentin and retest in a while.

I took a number of anti-inflammatories for a few weeks and this seemed to help.  This also helped a well-known financial blogger names "Mish."  In his case, he may have had the beginnings of prostate cancer:

Scan through these articles as they are all about lowering PSA:

http://www.peaktestosterone.com/Prostate_Cancer_Cure

http://www.peaktestosterone.com/How_To_Lower_Your_PSA

http://www.peaktestosterone.com/Flaxseed_Prostate_Cancer (flaxseed lowered PSA in this study)

http://www.peaktestosterone.com/How_I_Improved_My_PSA_Score
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Peak Testosterone Forum

Re: Post-TRT PSA Increase
« Reply #7 on: April 30, 2015, 02:21:15 pm »