%freePSA is a better biomarker than PSA. It’s not more sensitive but more specific and that’s a major advantage as many biopsies based on PSA turn out to be false positives.
Another promising candidate is EPCA, but this assay is not available commercially at the moment.
My PSA went from 0.93 pre TRT to 1.8 now one year later. Anything to be concerned about? 43 yo, no symptoms of anything. Strangely 3 months in, PSA test showed 0.77 and psa free and psa free total was 35% and 45%… could this current 1.8 be just fluctuations?
If you ejaculate and etc Before the test it can and usually is elevated.
What I have is several great hormone doctors and a urologist who all agree that prostate issues does not mean remove trt right away.
How is it healthy for the body to remove a healthy hormonal balance in a man??? The cars making noise. Drain the oil and transmission oil. Just to make sure that’s not the problem. That is essentially how I see trt being removed when men are on trt. Kinda sad anyone actually still thinks it’s a smart idea. In some cases sure maybe… but a slight elevation in psa ? Remove trt?
The run of the mill urologists do not understand testostorne.
My buddy dr grant does. You can find him on a couple videos. You can find Jeffery rutherbusch on video. Including jay cambell and many more . Many more. So many posted above.
Regarding fluctuation. Assay and biological variability taken together are about 30%, which means that a true PSA of 1 can turn out somewhere between 0.7 and 1.3 (measured in the same lab with the same assay!). Eg in 1 study PSA raised by appr 25% 5h after ejaculation returning to baseline 24h later. Another study confirmed that 24h after ejaculation PSA was not elevated from baseline. Yet in another study they showed that PSA levels in summer can be elevated by 30% compared to winter.
The conclusion is that a single measurement is always associated with an appr 30% uncertainty. So if you had 0.9 and now 1.8 i would at least conclude that the increase is real. Best is to get another test so that at least you have a better understanding of the precission of your PSA values.
In terms of risk of a prostate carcinoma, its most likely benign growth of the gland (BPH) as your %fPSA initially was good. Maybe you can discuss with your urologist if an ultrasound scan would be an option to assess structure and volume. She/he will know what to do in your case.
Further reading, free to download
https://www.researchgate.net/publication/7780922_Biological_Variation_of_Total_Prostate-Specific_Antigen_A_Survey_of_Published_Estimates_and_Consequences_for_Clinical_Practice
Just for clarification, I was taken off TRT not only because of the jump in PSA, but also urinary and ED symptoms along with DRE that showed enlarged prostate. This was done by the HRT Doc. The Docs I am currently seeing are Washington University Urologists, one who specializes in cancer treatment and one who specializes in hormone and fertility treatment.
I hope everything will turn out fine for you! You are in good hands, they have the education and the experience to take good care of you.
Can chronic prostatitis or pelvic pain syndrome increase psa only slightly? I hear prostatitis usually increases psa levels by quite a lot not by a tiny amount.
It can, dependent on the level of inflammation. Chronic is usually lower because a higher level of inflammation (with the pain that comes with it) will get you to some treatment sooner than later.
If acute, yes. You typically won’t see high levels of inflammation go for months untreated.
Could this be a possibility for mine going from 0.77 to 1.8? I’m always super constipated and my rare bowel movements are always painful and cause some fissure. I think I have a mild case of something as I have a burning pain internally and a dull discomfort in the perineum area and under the scrotum (right after bowel movement). No urinary symptoms.
