Carnitine for PSA

Your MD should have known better re the sequencing of multi-parametric MRI (mp-MRI) versus the timing of a biopsy (if indicated). It takes 5 weeks after a biopsy for any bleeding due to the biopsies to resolve. If the mp-MRI is done in a shorter interval of time it will compromise the interpretation of the study. Moreover, and this is important re a flaw in current care of men in such a context, many urologists use ultrasound to "target" the prostate and do not have the skill or the quality of equipment to target the lesions seen on ultrasound. Therefore, in such a situation many biopsies may miss prostate cancer (PC). The prostate MRI should not be confused with mp-MRI. These are not synonymous. The official report, and not the dummied-down patient version (DDPV) on so-called patient portals, should say: Multi-Parametric MRI. And the reading should relate to Prostate Imaging Reporting and Data System (PI-RADS) scoring of the study. Moreover, the strength of the MRI magnet, measured in Tesla units should be 3.0, and not 1.5.

Your gland size of 50cc is not very large pending your age. And yes, you are perfectly correct in calculating the PSA density (PSAD) = weight per unit volume or in this case PSA ÷ gland volume. The threshold of concern for PSAD is ≈ 0.15. Much lower PSAD readings are of less relative concern. The PSAD also correlates with volume of PC when PC is indeed present. The biopsies you had done would show chronic inflammation in the detailed description of the pathology report indicating that prostatitis is likely been or is still present.

Thank you Doctor! I just sent you a direct message.
 
Urologist called me. He is prescribing Bactrim again for 3 weeks and a f/u with labs in 4 weeks. He feels that I have a recurring or deep infection since my prostate always seems normal on DRE. He did say that I respond well to the antibiotics which drops my PSA down to a level which is normal for me. He also lowered by Test dose from 140mg (.7cc) to 100mg (.5cc) to lower the HCT and Estradiol.
 

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TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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