disturbing PSA test

[Shanem]

Didnt see anything on PSA so thought I would ask. this is the history:

PSA 5.9 01/11/2017

Began TRT 12/04/2016

PSA 1.6 10/31/2016
PSA 1.2 04/10/2015
PSA 1.4 03/01/2014

Any information you can give would be appreciated

 

[Vince]

Did you start TRT. Your PSA is very high, I would have it checked again. Remember refrain from ejaculation for 48 hours before PAS test.

 

[johndoesmith]

Didnt see anything on PSA so thought I would ask. this is the history:

PSA 5.9 01/11/2017

Began TRT 12/04/2016

PSA 1.6 10/31/2016
PSA 1.2 04/10/2015
PSA 1.4 03/01/2014

Any information you can give would be appreciated

Get the PSA test with free PSA.

Age? Did you do anything prior to this test like ejaculate, ride a bicycle, or even deadlifts?

 

[Shanem]

Get the PSA test with free PSA.

Age? Did you do anything prior to this test like ejaculate, ride a bicycle, or even deadlifts?

54 yo. May have ejaculated the night before. I will test again

 

[johndoesmith]

54 yo. May have ejaculated the night before. I will test again

Any prostate symptoms?

If not, I'd say it's just from ejaculation. 48 hours without when retesting.

I'd still get it checked by a doctor though just to be safe especially at your age(no offense).

 

[davidrn]

Depending on the rest of your general health, you could order a CRP (C Reactive protein) this measures inflammation. I had a very high CRP (R/T my Rheumatoid Arthritis) and my PSA went to about 7. My TRT MD was talking about a biopsy, I let him know I would consider it after my RA flare was over. After I straightened things out, my PSA dropped to 1.6, my MD dropped the biopsy talk. There isn't a great deal of info available on the relationship between PSA and inflammation, but I did find a few studies last year when this happened to me.

 

[Vince Carter]

I would relax and just retest, that's got to be lab error. You have three years of very normal tests as recent as Oct and now it's gone astronomical???? Doubt it. Retest and as Vince said refrain from sex/ejaculation at least 48hrs prior, and I like to recommend to guys that you be fasted at least 10 hours before your testing.

 

[Gene Devine]

What Vince said or unless you have a prostate infection like Prostatitis which would cause the same.

Just get retested and talk to your Doctor...any serious pathology would take longer to get to those levels.

 

[Shanem]

I would relax and just retest, that's got to be lab error. You have three years of very normal tests as recent as Oct and now it's gone astronomical???? Doubt it. Retest and as Vince said refrain from sex/ejaculation at least 48hrs prior, and I like to recommend to guys that you be fasted at least 10 hours before your testing.

my PCP who did not prescribe TRT but who ordered the labs talked to the hospital urologist. Urologist told my MD to give me two choices: stop TRT completely and retest in a month, or refer me to urology. going to contact Defy and see what they say. I mentioned that if I stop I will crash and she just said it was my choice.

 

[CoastWatcher]

my PCP who did not prescribe TRT but who ordered the labs talked to the hospital urologist. Urologist told my MD to give me two choices: stop TRT completely and retest in a month, or refer me to urology. going to contact Defy and see what they say. I mentioned that if I stop I will crash and she just said it was my choice.

She's practicing medicine defensively, and knows very little about androgen replacement. The urologist that weighed in is likely doing the same thing - he sees your score and knows a PSA above 4.0 is a contraindication for TRT. A retest is a sensible response, but to stop TRT prior to it, for four weeks, is hardly reasonable at this juncture. Lab error or prostatitis make the most sense. Are you presenting with any symptoms that suggest prostatitis?

 

[johndoesmith]

my PCP who did not prescribe TRT but who ordered the labs talked to the hospital urologist. Urologist told my MD to give me two choices: stop TRT completely and retest in a month, or refer me to urology. going to contact Defy and see what they say. I mentioned that if I stop I will crash and she just said it was my choice.

Why not take the second option and visit urology?

Or does that mean you must receive TRT through urology? If it's only a consult about the PSA then what's the big deal?

 

[Dr Justin Saya MD]

Large jump in short period of time equals likely prostatitis +/- some of the other factors mentioned above. Would retest PSA with %free, urinalysis with reflex culture, abstain from exercise and ejaculation X 48hrs prior and re-evaluate in timely manner before jumping to extreme measure of cold turkey discontinuation of TRT.

 

[Shanem]

Large jump in short period of time equals likely prostatitis +/- some of the other factors mentioned above. Would retest PSA with %free, urinalysis with reflex culture, abstain from exercise and ejaculation X 48hrs prior and re-evaluate in timely manner before jumping to extreme measure of cold turkey discontinuation of TRT.

Thank you Doctor. I just sent an email to your office asking to pass the PSA info on. My PCP withheld it from my lab work to tell me personally.

 

[Gene Devine]

OT: But I just got my labs back today. I totally forgot about not having sex for 48 hours prior to my pull. The day before my new girlfriend of 7 months and I had sex a few times the morning the day before my pull ... about 24 hour gap.

PSA?

1.0

Go figure LOL

 

[Dr Justin Saya MD]

The day before my new girlfriend of 7 months and I had sex a few times the morning the day before my pull ...

Oh stop bragging Gene ;-)

 

[Shanem]

So PSA came back 4.3 and urinalysis was negative. Discontinuing TRT as per protocol and have an appointment with a urologist next Tuesday. We will see where this leads

 

[CoastWatcher]

So PSA came back 4.3 and urinalysis was negative. Discontinuing TRT as per protocol and have an appointment with a urologist next Tuesday. We will see where this leads

I'm sorry you have to deal with this. To the extent you're comfortable doing so, please keep us posted. All the best.

 

[Dr Justin Saya MD]

So PSA came back 4.3 and urinalysis was negative. Discontinuing TRT as per protocol and have an appointment with a urologist next Tuesday. We will see where this leads

Don't be too anxious, if possible, Shanem. There is still a better than not chance that there isn't anything concerning going on, but better to be safe than sorry. If it turns out to be that which we will not speak of, the consolation is that it is likely detected very early which optimizes chances of favorable outcome.