PSA of 4.38

[Runnerman]

Hi All,

Did some labs last week for my annual with my primary doctor. My PSA came back at 4.38 ng/mL which is a bit over the reference range: < OR = 4.00 ng/mL. This test was done at Quest. Looking back over time, it's been 2.8 -> 3.0 each year since 2018. I'm 57. Previous DRE's didn't raise any red flags. No history in my immediate family of prostate cancer.

My current TRT has been 80mg per week, split between two subq injections.

One thing though...I did not remember to abstain from ejaculating a few days before the lab draw. I also may have done some moderate running just before the lab draw as well. Not sure how much that could factor in.

For those that have dealt with something similar, what is my doctor likely to suggest? Maybe we retest in 6 months and see how things look? Probably a DRE as well?

Thanks!

 

[Systemlord]

One thing though...I did not remember to abstain from ejaculating a few days before the lab draw.

If you didn’t abstain from ejaculation for 24 hours prior to the lab test, then it’s a good bet this is why your PSA is elevated.

The guy that invented the PSA test stated it’s the most unreliable and creates soo many false positives.

The elevation in PSA could be from a urinary tract infection.

 

[Fortunate]

Hi All,

Did some labs last week for my annual with my primary doctor. My PSA came back at 4.38 ng/mL which is a bit over the reference range: < OR = 4.00 ng/mL. This test was done at Quest. Looking back over time, it's been 2.8 -> 3.0 each year since 2018. I'm 57. Previous DRE's didn't raise any red flags. No history in my immediate family of prostate cancer.

My current TRT has been 80mg per week, split between two subq injections.

One thing though...I did not remember to abstain from ejaculating a few days before the lab draw. I also may have done some moderate running just before the lab draw as well. Not sure how much that could factor in.

For those that have dealt with something similar, what is my doctor likely to suggest? Maybe we retest in 6 months and see how things look? Probably a DRE as well?

Thanks!

A gradual rise in PSA with a level like yours, should be investigated. At a minimum, repeat the labs now, after abstaining for the proper amount of time.

 

[Sly]

Repeat labs. No ejaculating or strenuous exercise, especially riding bike for 72 hours prior to the test.

 

[Runnerman]

Thanks all. I will see how things go and retest.

 

[Nelson Vergel]

I would read this

Understanding High PSA Levels: A Prostate Health Guide

Understand high PSA levels and their potential causes. Don't jump to conclusions about prostate cancer. Learn more on our blog.

www.discountedlabs.com

 

[BadassBlues]

Hi Runnerman,

About 15 years ago, my PSA test came in at 6. The doctor immediately wanted to do a biopsy. If you have ever researched a prostate biopsy you will know that they are not at all a pleasant experience. I declined, but it sent me into a real panic at the time.

I have learned since then that I have naturally high DHT. I am on TRT and tend to convert to DHT over E2. DHT can cause a higher level of PSA. Ejaculation 24 hours prior definitely elevates PSA as well. Also, you could have a mild bacterial infection.

A test of 4.8 isn't a serious red flag. Give it a few weeks and have it retested. Labs are a snapshot in time. If it continues to rise, then take the next steps and have it evaluated.

 

[gallant]

When I started TRT 15 years ago my PSA was 2. Gradually rose over the years and now hovers between 4 and 5 for the past 3 years. Sometimes dips into the 3's. Ejaculation before a blood test definitely makes a difference

 

[Runnerman]

Thank you. I appreciate all the comments and appreciate the info that Nelson provided. I definitely don't want to rush into a biopsy. I don't think my doctor will either.