T Nation

PSA Spiked with TRT

I’m 58 years old.

My PSA spiked from 1.58 within 12 months to 3.8 while on TRT. Is this normal for new TRT patients?

I sought two opinions. I have since discontinued TRT, I get another PSA next month. My DREs, from two different Doctors came back normal and they are confident I have BHP. I have also completed a Tesla 3 MRI as of yesterday and await the results now. In addition I have had a CT scan of the lower pelvis, with and without contrast, with normal results and a slightly enlarged prostate.

No blood in urine, no ED issues, no pains, no burning with urination or overt problems.

Have any of you seen this before?

Thank you in advance for any validation and or verification of this pattern.

DHT and E2 should be in check.

From what I understand. high DHT is not such a bad problem, but if you have high E2 also, it can cause prostate issues.

Whats your protocol and labs look like?

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PSA is such a poor diagnostic tool because it’s so poorly understood, I’ll bet in the years to come we will laugh at our overreactions to PSA spikes seen in TRT. There are men on TRT who has prostate cancer and are fine.

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That will tell the story. Going forward, run free PSA with PSA.

Yes, BPH most likely.

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For what it’s worth, my psa doubled when I started trt. (.4 to .8 which I realize isn’t the same as your situation). After a while it went back to where it was. I take either pine bark or saw palmetto now all the time. I have a scheduled blood test next month. I’m interested to see if psa has remained the same.

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Thank you very much for your response. The problem was my urologist didn’t advise me of anything and just showed me how to inject the T. I was totally dumb and unsophisticated with regard to T. His care and caution was minimum as I have learned. I have since switched Urologists to a much more known and professional caregiver. But I have to drive 2 hours and 35 minutes to see him. But it’s worth it.

Thank you for the great feedback! I don’t have the answer and I don’t really know. I have since stopped T and changed my diet as well as reduced animal protein from it. I have now lost 27 lbs and working to get another 10 off. I stopped drinking , smoking (occasional cigar) and reduced coffee to a cup a day. I was drinking 3 nights a week and consuming a pot of coffee a day.

Thank you very much for the input. Most excellent

Thank you very much for the feedback

Thank you very much. I’m now taking supplements as well and changed my eating patterns. Of course my age and I also had prostatitis twice previously 5 years ago, which kind of adds to the problem. My Doctors are convinced this is BPH but I’m just running as much as possible to rule out things. I don’t want any ugly surprises later on.

If your wife/partner gets a little exploratory back there it can raise PSA values. As well as blood work following a DRE.

You obviously discontinued TRT a while back if you’ve already lost 30 pounds. How are you feeling now? Have you had blood tests to see if maybe your HPTA restarted?

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Thank you everyone for the comments and feedback. I can tell you this scared the crap out of me.

Thank you for asking! I’m feeling great now and the prostate is working well with no problems. My stream is better now and the BPH symptoms have subsided over the last month…basically gone away. I had an acute attack of prostatitis / BPH over a heavy load of stress by a traumatic event. I work out regularly. I formerly lifted heavy but have now reduced my muscle mass. I’m now going to start medium distance running. Lighter weights and more reps. I would love to be big again, but I’m getting too old to support that with my size. As well the strain on the kidneys eating large amounts of protein. My wife thinks my T will go up with the weight loss and increased workouts.

Have you had your LH and FSH tested since stopping. I would imagine if you are feeling great then your body may have restarted its HPTA. I assume you didn’t take any post-therapy drugs to restart your system?

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I’m not taking anything except supplements, eating really clean and hydrating. My biggest problem now is lack of sleep from occasional stress over this stuff.

I’m just a little older than you(59) and have been on trt for 7 years. My psa rose a bit when I started .8 to 1.8. I have bph an occasionally get prostate infections. At one point my psa rose to 3.49. I started taking pumpkin seed oil capsules and my numbers dropped at my next psa(3 months later) to 2.20. It has stayed at that 2.0 range for over a year now.

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Thank you for the response, I appreciate your insights.

Make sure you don’t orgasm, cycle, or in fact train the day before your bloods are taken. Any of these massively increase my PSA.

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I’m happy to report: The medical staff contacted me. They reported I definitely do not have cancer. I have BPH and previously had Prostatitis when I was 51. Before that a very extreme UTI at age 19. So I have BPH at 58, just wonderful, what fun…

Congrats.

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