TorontoTRT
Active Member
Yeah stopped it completely. Will continue just the Pregnenolone 100 mg.
PSA numbers increasing on testosterone- Should I stop TRT?
- Thread starter k.a.reese
- Start date
tropicaldaze1950
Well-Known Member
@TorontoTRT: 1.8 is still well within the lab values. I had 1.4 when the test first came out and long before I was on TRT. From what I've read, PSA rises when on TRT but your increase is, in IMO, nothing to be alarmed about. As I posted, mine hit 4 and I emailed my urologist. He told me not to worry and asked me to retest in three months. With about 30 years experience and many years prescribing T, I trust him.
Scors60
New Member
Well, my fortunes have certainly changed since my previous post from 2014 on this thread. I had a fluctuating PSA for over a year. 2.5 to 6.1 and back down and back up. I'm 65. My Urologist finally ordered an MRI for me. Unfortunately, it came back with 3 spots, one with a PIRADS 4 and two with PIRADS 3. A 4 indicates most likely cancer, a 3 might be, might not. With that, I stopped TRT and had a biopsy performed. Sure enough, that small spot at PIRADS 4 ended up being a lesion with a Gleason score of 3+4 (intermediate risk cancer). I am now deciding on treatment, will probably go with Cyberknife.
Although my Uro agrees with me that it was NOT the TRT that caused the cancer, the jury is, frankly, out on whether or not it can feed an existing cancer. That is why I stopped and, to tell you the truth, after 3 months plus off cold turkey, I still feel OK--I mean, I can notice certain differences, but it is nowhere near the living hell I was expecting. I am quite sure my T is back down to where it was when I was first diagnosed 6 years ago (180) or possibly lower, so any suggestion of Androgen Deprivation as a treatment is automatically off the table for me.
My Uro has said that, after I am treated and show a year of consistently low PSA and no findings via MRI or follow up biopsy, he would begin to treat me with TRT again if I so wished. He's on it himself, so he knows the deal. As I would be nearing 70 at that point, I will have to see if I want to.
My point is, don't f#@k around with this. If you have suspicions, and you are over 45, get whatever test you need to at least rule it out. Even if you DO have it, if it is caught early and you get treated, you can still go back to TRT if you want to. I had zero indicators that this would happen other than that bouncing PSA--each of those tests was a 4K, and each said I had a 4 to 7 percent chance of finding cancer on biopsy, which is very low risk. Oops. Surprise.
If you are younger than 45, I doubt you have to worry, especially since you are still in the normal range and your free PSA is very high (that's a good thing). But guys over 45, if it starts to creep steadily up, especially if you have a family history or are in a profile group with higher risk (African American men are at much higher risk, for example), please get yourself checked if for nothing else to rule it out. It takes a long time to develop and grow and prognosis for 10 or 15 year survival is excellent, but if you just ignore it, you're playing Russian Roulette with 3 bullets in the chambers.
Although my Uro agrees with me that it was NOT the TRT that caused the cancer, the jury is, frankly, out on whether or not it can feed an existing cancer. That is why I stopped and, to tell you the truth, after 3 months plus off cold turkey, I still feel OK--I mean, I can notice certain differences, but it is nowhere near the living hell I was expecting. I am quite sure my T is back down to where it was when I was first diagnosed 6 years ago (180) or possibly lower, so any suggestion of Androgen Deprivation as a treatment is automatically off the table for me.
My Uro has said that, after I am treated and show a year of consistently low PSA and no findings via MRI or follow up biopsy, he would begin to treat me with TRT again if I so wished. He's on it himself, so he knows the deal. As I would be nearing 70 at that point, I will have to see if I want to.
My point is, don't f#@k around with this. If you have suspicions, and you are over 45, get whatever test you need to at least rule it out. Even if you DO have it, if it is caught early and you get treated, you can still go back to TRT if you want to. I had zero indicators that this would happen other than that bouncing PSA--each of those tests was a 4K, and each said I had a 4 to 7 percent chance of finding cancer on biopsy, which is very low risk. Oops. Surprise.
If you are younger than 45, I doubt you have to worry, especially since you are still in the normal range and your free PSA is very high (that's a good thing). But guys over 45, if it starts to creep steadily up, especially if you have a family history or are in a profile group with higher risk (African American men are at much higher risk, for example), please get yourself checked if for nothing else to rule it out. It takes a long time to develop and grow and prognosis for 10 or 15 year survival is excellent, but if you just ignore it, you're playing Russian Roulette with 3 bullets in the chambers.
TorontoTRT
Active Member
Can constipation affect psa levels? I read that really tough big bowel movements can irritate the prostrate and increase PSA levels. In my case it’s always like that and I think before the 1.8 Psa test I had a fairly uncomfortable bowel movement from which I’m in slight pain still a few days later.
TorontoTRT
Active Member
Reading every article online can cause some serious anxiety.
Scors60
New Member
Amen to that. Reading every book and article and getting anecdotal info from people as to what treatment I should choose has been even more anxiety producing.
Deleted member 16042
Member
Have you received treatment? If not is focal treatment appropriate for you? Have you considered HIFU or TULSA PRO? They'd be my choices over radiation if focal treatment is warranted, especially TULSA PRO. Problem is TULSA PRO is not yet widely available. If you have 3+4 isolated lesion(s) fully within capsule not super close to margins or neurovascular bundle, it may be worth your while to consider.
MRI-TULSA-PRO (for Gleason 7) Ultrasound Prostate Ablation Now in USA - @Virginianorthern - Prostate cancer - 20190828 - Inspire
Search results for TULSA PRO - Inspire
Actually foremost, have you had a second opinion on your pathology from someone like Epstein at Johns Hopkins or the Cleveland clinic second opinion pathology service? There are many circumstances where Gleason score is downgraded, and if 3+3, watch and wait is really warranted since it is not even true cancer nor is there great liklihood it will become so.
Pathology Second Opinion-J.Epstein,M.D. Pathologist-Johns Hopkins - Prostate cancer - Inspire
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TorontoTRT
Active Member
For the guys using boron, do your labs confirm or show that it has an effect on lowering PSA?
SilverSurfer
Active Member
ive seen lots of anecdotal remarks and claims of boron of lowering PSA and lowering SHBG, but absolutely no proof. It’s one of the more “bro-sciency“ claims I’ve read.
There‘s dozens and dozens of links I’ve seen, but they all date back to either a tiny study from the 80s with 13 postmenopausal women, whom the authors then transpose to males. Or, a study of 8 men for 1 week from a decade ago. Yes, just 8 men for 1 week. As if you can gain anything from that.
DragonBits
Well-Known Member
I do take boron, initially it seemed to boost my FT and E2, decrease PSA and SHBG a bit.
I started a threads about it, here is the details of my first thread about boron.
The boron supremacy
I still take boron, but any effects it had were transitory and at the time I was not on TRT. IMO drugs like testosterone vastly change the hormonal landscape while mineral like boron only have a small effect and then only if you are in a low range boron in your body.
My PSA rose in the year after this post while still taking boron but starting TRT, recently my PSA went as high as 4.8 then backed down to 3.8 and SHBG went as high as 73 but now 57.. Since I take a lot of supplements, it's hard to say exactly what affects what.
You might try life extension ultra prostate formula, it seemed to help with lowering PSA at the time, though it also seemed to have caused a rise in SHBG and drop in DHT. The drop in DHT might have been the true cause of lowering of PSA. I stopped taking the ultra prostate formula since if really was having an effect it was lowering my FT/ER2 also.
I never had any symptoms of BPH / prostate problems, just an elevated PSA level with no signs of cancer.
Scors60
New Member
Getting genomic testing to make sure. I have decided on Cyberknife, as one of the foremost practitioners is right here on Long Island, and it is only 5 sessions with minimal downtime and minimal side effects.
Deleted member 16042
Member
chad386
New Member
Would love to hear an update on how you're doing, Scors. Thanks for sharing your experience up to this point.
Hoping you had a speedy recovery.
I haven't posted here before ( don't think) but been a lurker for a few years and the info on this forum helped me start TRT a little over 2 years ago with Defy. I figured I'd chime in with actual numbers.
Baseline PSA was already elevated before I started at 3.6.
6 month PSA was 3.9
12 months PSA was 4.3 so Defy stopped my prescription until I could address the the PSA and get the go ahead from my primary or urologist.
Primary wanted a followup after 3 months off TRT and my PSA was 5.3 (but I had sex the night before). I got retested two days later and PSA was down to 4.6. My primary wanted me to get a TRUS biopsy because I also had a family history of prostate cancer on both sides. While my research led me to better options such as MRI and MRI guided biopsy I had the TRUS because my insurance wouldn't cover other options. Positive 3+4 in 3 cores. At that time (1 year ago), my insurance (Kaiser) would only OK a radical prostatectomy at my age (52) but I might have been able to get radiation covered. As I still enjoy my sex life and have read numerous horror stories on impotence and other side effects I decided to switch insurance to something that would allow me to pursue more options. Luckily my government employment allows insurance changes during open season even with pre-existing conditions so I switched to BCBS. I am in MD and Johns Hopkins is local. Plus they were starting up another clinical trial for Tulsa-Pro and that was the option I was seeking. The doc told me the trial would start in March-April and of course COVID hit. My doc was certain the trial would eventually get going and told me he had no problem with me doing nothing until he knew for sure.
Fast forward to last month and the trial was back on. Unfortunately the trial sponsor was not going to pick up the tab so I will be on the hook for 30% of the total. That was OK with me and I have since gone through all the blood work and signed on the dotted line. I had to get another MRI guided biopsy to confirm the cancer was still 3+4 per the trial guidelines. It is so I am simply waiting to schedule the procedure. The other Tulsa-Pro options are getting the procedure done out of pocket at 3 locations in the US currently for $30K or flying to Germany or Finland and getting it done for closer to $20K. Unfortunately I am not sure of the current flight restrictions for Europe.
Which brings me back to why I showed up here after being off TRT for a year. My blood work for the trial included total T and it has cratered to 160. My baseline prior to TRT was 400 with 8 Free. TRT bumped me up to 1000 with 25 free. I was on a typical Defy prescription which included T Cyp 200, 500 iu HCG and .125 anastrozole.
So now that my T is in the toilet I will be looking to fix it after I get the procedure taken care of hopefully this month.
The initial withdrawal was not too bad but I have been dealing recently with a lack of energy, poor sleep, mild depression, lower sex drive and of course an overall strength decrease. I attributed most of it to the cancer diagnosis itself plus chronic knee arthritis which will require a total knee replacement so I am in constant pain and not sleeping very well. Looks like that was only part of the story.
Anyway, I'm done rambling. Just figured I'd throw out my experience for anyone looking for another data point.
Baseline PSA was already elevated before I started at 3.6.
6 month PSA was 3.9
12 months PSA was 4.3 so Defy stopped my prescription until I could address the the PSA and get the go ahead from my primary or urologist.
Primary wanted a followup after 3 months off TRT and my PSA was 5.3 (but I had sex the night before). I got retested two days later and PSA was down to 4.6. My primary wanted me to get a TRUS biopsy because I also had a family history of prostate cancer on both sides. While my research led me to better options such as MRI and MRI guided biopsy I had the TRUS because my insurance wouldn't cover other options. Positive 3+4 in 3 cores. At that time (1 year ago), my insurance (Kaiser) would only OK a radical prostatectomy at my age (52) but I might have been able to get radiation covered. As I still enjoy my sex life and have read numerous horror stories on impotence and other side effects I decided to switch insurance to something that would allow me to pursue more options. Luckily my government employment allows insurance changes during open season even with pre-existing conditions so I switched to BCBS. I am in MD and Johns Hopkins is local. Plus they were starting up another clinical trial for Tulsa-Pro and that was the option I was seeking. The doc told me the trial would start in March-April and of course COVID hit. My doc was certain the trial would eventually get going and told me he had no problem with me doing nothing until he knew for sure.
Fast forward to last month and the trial was back on. Unfortunately the trial sponsor was not going to pick up the tab so I will be on the hook for 30% of the total. That was OK with me and I have since gone through all the blood work and signed on the dotted line. I had to get another MRI guided biopsy to confirm the cancer was still 3+4 per the trial guidelines. It is so I am simply waiting to schedule the procedure. The other Tulsa-Pro options are getting the procedure done out of pocket at 3 locations in the US currently for $30K or flying to Germany or Finland and getting it done for closer to $20K. Unfortunately I am not sure of the current flight restrictions for Europe.
Which brings me back to why I showed up here after being off TRT for a year. My blood work for the trial included total T and it has cratered to 160. My baseline prior to TRT was 400 with 8 Free. TRT bumped me up to 1000 with 25 free. I was on a typical Defy prescription which included T Cyp 200, 500 iu HCG and .125 anastrozole.
So now that my T is in the toilet I will be looking to fix it after I get the procedure taken care of hopefully this month.
The initial withdrawal was not too bad but I have been dealing recently with a lack of energy, poor sleep, mild depression, lower sex drive and of course an overall strength decrease. I attributed most of it to the cancer diagnosis itself plus chronic knee arthritis which will require a total knee replacement so I am in constant pain and not sleeping very well. Looks like that was only part of the story.
Anyway, I'm done rambling. Just figured I'd throw out my experience for anyone looking for another data point.
Hey, I’m also with Defy for two years. 49 years old. Baseline PSA to start 12/21/18 was 1.0, 3/18/19 3.2, 10/3/19 1.6, 3/25/20 5.1, 4/7/20 3.2 and today 5.0. Made appointment with the urologist and clearly Defy will stop the script. I did tons of research 6 months ago when my PSA was 5.1 but had a false sense of security when re-tested 2 weeks later it was a 3.2 with 15% free. My urologist appointment is a month from today but it seems like I may be following your path.
Make sure you avoid strenuous activity (leg workouts, bike) and sexual activity for a couple days before the next test. It sucks but good to get on top of it now. Yours is fluctuating quite a bit. There are other alternatives your urologist might recommend because of the fluctuation.
Tried boron, again, this year, for dental issues. After about about 10 days, I was getting daily low grade headaches. When aspirin several times a day didn't help, I started to wonder if it was the boron. Stopped it and headaches disappeared. Maybe a lower dose instead of the 6-12 mg I was taking.
I am on Trt for almost two years now.
Originally my psa was 1.4
After starting it went to 1.72 or something close to this.
After stabilizing I went down close to 1.4.
Just now I tested and got 1.94.
I am not sure if I had sex before it. I think I did. Do people usually have an increase in psa value as they use trt or psa stabilize after some time ?
Originally my psa was 1.4
After starting it went to 1.72 or something close to this.
After stabilizing I went down close to 1.4.
Just now I tested and got 1.94.
I am not sure if I had sex before it. I think I did. Do people usually have an increase in psa value as they use trt or psa stabilize after some time ?
madman
Super Moderator
Take-home point
*The increase in PSA will be greatest in men with marked TD and least (or absent) in men with milder degrees of TD
post #12
Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring
ABSTRACT The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age...
www.excelmale.com
*An initial increase of prostate-specific antigen (PSA) and prostate volume with TTh is frequently seen over the first 2–6 months because the prostate is an androgen-dependent organ. The increase in PSA will be greatest in men with marked TD and least (or absent) in men with milder degrees of TD. The PSA level at 6 months after initiation of TTh should be used as the new baseline
Testosterone and Prostate Effects
7.1 Introduction Historically, testosterone (T) was thought to be involved in negative prostate events such as the growth of benign or malignant prostate tissue. This notion stems from the seminal 1941 article by Huggins and Hodges, which demonstrated that in men with metastatic prostate cancer...
www.excelmale.com
7.2 Prostate-Specific Antigen (PSA) Changes
In summary, the above data are inconclusive and somewhat contradictory. Results seem to suggest a possible effect of TTH on increasing PSA, although the overall effect is likely minor and appears to be more prominent among men with lower baseline TT levels. Larger, adequately powered series dedicated to specifically evaluating changes in PSA is required to definitively address whether TTH truly increases PSA, particularly in men with normal baseline TT levels.
7.3 Prostate Volume Changes
These findings are consistent with the previously described saturation model, in that, at lower baseline TT levels (i.e., below the saturation point), increases in TT result in concomitant increases in prostate volume.
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