T Nation

PSA Spike - Concerned


Hello all. Have been doing TRT for 6 months now and recently had my PSA tested as part of my workup. My reading is still within norm for my age but it went up substantially which has me very concerned.
Although I feel great being on testosterone, I am considering stopping due to this. I’ve read that the level tends to drop back down after stopping TRT.
I’ve been doing a ton of reading on it and most of the new research says that a little spike is normal but there is a lot of conflicting information on the topic also. Nobody seems to know what a safe level is.
Can anyone share anything or shed light on this in order to help me make the most informed decision?
I am 49 years old if it helps


It’s critical to also base ur decision on how you feel. Are you suffering from frequent urination? Getting up all night long? Lots of things can throw off your PSA, including a recent orgasm. You can always get a digital exam. Don’t stop your TRT until you have better information


Are you and how are you managing E2 levels?

The prostate is responsive to T levels. With low T, the prostate is smaller and less vital. With youthful T levels, the prostate can release more PSA.

PSA is released during orgasms, so you should not do labs soon after. A digital rectal prostate exam also releases PSA, so doing that and PSA labwork after during a office visit is wrong.

PSA can increase from inflammation. If is important to be having orgasms that clear seminal fluid. With TRT that is rarely a concern.

A step increase is not unexpected and you need to see where things go from there.

Prostatitis can increase PSA. That is a non cancerous issue and different from general BPH.

Those are my general comments without knowing anything about you or your PSA lab results.