Update: I had labs on 3/31 and am just thinking through the current situation and possible next steps. Appreciate any thoughts/input
Pertinent from CBC:
-RBC Minor variation in size and shape.
-Hemoglobin 18.2 HIGH Reference Range: 13.0-17.7 g/dL
-Hematocrit 52.5 HIGH Reference Range: 37.5-51.0%
-RDW 16.2 HIGH Reference Range: 12.3-15.4%
Hormones:
-Testosterone, Serum 879 NORMAL Reference Range: 264-916 ng/dL
-Free Testosterone(Direct) 20.9 NORMAL Reference Range: 7.2-24.0 pg/mL
-Estradiol, Sensitive 45.0 HIGH Reference Range: 8.0-35.0 pg/mL
-PSA Total+% Free
Prostate Specific Ag, Serum 5.9 HIGH Reference Range: 0.0-4.0 ng/mL
Roche ECLIA methodology.
-PSA, Free 1.38 NORMAL Reference Range: N/A ng/mL
Roche ECLIA methodology.
-% Free PSA 23.4 NORMAL
The table below lists the probability of prostate cancer for men with non-suspicious DRE results and total PSA between 4 and 10 ng/mL, by patient age (Catalona et al, JAMA 1998, 279:1542).
% Free PSA 50-64 yr 65-75 yr
0.00-10.00% 56% 55%
10.01-15.00% 24% 35%
15.01-20.00% 17% 23%
20.01-25.00% 10% 20%
>25.00% 5% 9%
So, the current concerns:
-High Hemoglobin and HCT, now with slight RDW changes: T cyp was lowered last revision Feb 5. Luckily HCT did not rise further since previous labs. I am going to ask
Dr saya about possibly lowering total weekly T cyp dosage and going to daily injections to try to lower the HCT further ( and possibly E2)
Not sure what to think about the RDW issue, last bloods had slightly high MCV (RBC size). Something going on with RBC production.
-I think most concerning at this point is that systolic BP is up 10-12 points. This is kind of freaking me out (which doesn't help the BP!)
-Total and free T are in what I consider to be good range. I have not felt as super, but could also be due to high E2. First time I have had bloating coming and going. I haven't shed the extra 10 pounds which I don't know whether is partly water weight or new belly fat, my outer belly fat has become softer and a bit jiggly. Never had this happen before. I have been climbing and hiking a lot recently and my upper leg muscle mass has also increased, so ???
-Also have been having a lot of joint pain in fingers and toes. These tend to get a bit inflamed when I am climbing a lot, but this has been out of the ordinary. One toe in particular has become swollen and lost mobility. Could be arthritis or gout, though not the degree of an acute gout attack. I'm a little confused here, I know low E2 can cause these symptoms, but high? Anyway, first time I am concerned about E2 being high.
Dr Rand McClain also posted about some estrogens contributing to prostate issues.
-PSA: I'll see the PCP again tomorrow to discuss these results.
I started self treating for the PSA issue with diet and supplement changes to reduce inflamation and increase anti cancer benefits, partly based on the late Lee Meyer's info about his bout with PSA, plus some of my own research. Actions include:
Change diet:
-Close to eliminated dairy to help lower IGF-1 and casein which can fuel cancer. Only eating @ an ounce of cheese on salads for flavor
-Added soy (isoflavones), higher amount of cooked tomatoes (lycopene) and flax (lignans) all which show efficacy in reducing PSA (Note: quite concerned about effect of all of these on E2, with the current level at 45.)
-Broccoli sprouts daily for sulforaphane (anti-cancer) (strong crucifer effect could also help lower E2)
-Pomegranate juice minimal amount due to sugar.
Supplements:
-dropped glutathione, dropped amino acid supps which are controversial, can prevent cancer prior to cancer growth, but can fuel growth once cancer cells are present. Still using some whey protein which does not raise IGF-1.
-added curcumin, quercetin and green tea extract
-also will be adding boswelia and *** oil asap for joint pain and further anti inflammatory effect
General comment: Except for the joint issues, I am feeling more even physically and mentally overall on an ongoing basis, though still not super despite the concerns.