Q: I have low testosterone, but my PSA is kind of elevated.

Is this a red flag to start TRT?


Elevated PSA is an inflammatory marker.

It increases under irritation of the gland.

It doesn’t have to be a scenario for malignancy.

Ejaculation, cycling and riding a motorcycle are factors that can elevate it. Also, infection of the prostate gland, prostatitis, increases PSA.

Hence, under a course of antibiotics, it may lower it.

Also, men after age 50 tend to have elevated PSA – this is called benign prostatic hyperplasia (BPH).

It is a casual phenomenon that occurs to middle-aged men and usually gives symptoms such as frequent urination, urination in the middle of the night, the feeling that bladder is not empty after urinating, and shorter length of urine during urination.

A prostatic gland can me assessed during digital rectal examination by urologist in order to estimate whether it’s soft and small, while ultrasound can show the size and scar tissue of the prostate.

Pelvic MRI is the most accurate description of BPH, while a biopsy reveals the tissue itself under microscopic evaluation.

For men up to 60, a normal PSA should be <4.

Men on TRT with prostatic cancer use dutasteride to block DHT hormone that feeds the prostate.

Also, the use of DIM is useful to lower bad estrogens, known as estrone (E1).

Testosterone doesn’t lead to prostate cancer; actually, it’s the opposite that happens.

Supplements that help with BPH are saw palmetto, and lycopene is a carotenoid (rich in tomato paste) that prevents prostatic cancer.

Also, stay away from trans and saturated fats. Instead, eat plenty of antioxidants from vegetables and unsaturated fats (fatty fish, walnuts, avocado, olive oil) that are anti-inflammatory.

Make sure you test PSA under normal circumstances.


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