PSA Increase - Should I be concerned

[Tiffer]

I have just got my bloods back after being on TRT for 10 months:

Total Testosterone 899.14 ng/dl
Free Testosterone 293.37 pg/ml
Estradiol (E2) 23.98 pg/ml
SHBG 14.70 nmol/L
S-Prolactin 6.00 ng/mL
DHEA-S 215.50 ug/dl
Vitamin D 25 35.40 ng/mL
S-Cortisol 7.79 ug/dl
S-PSA 2.57 ng/mL

So they seem good - SHBG is getting better, DHEA is down a lot but that is probably because I haven't been able to get hold of DHEA tablets for ages and I'm not sure this is necessary.
The one thing that concerned me is that PSA is up - do I need to address this? Prior results were 1.28 in 2012 and 0.97 in July 2014.
I am going to drop from 50 mg to 40mg test cyp E3D as my levels seem high anyway.
Otherwise I do 250 iu HCG E3D and 0.25mg Adex E4D or so (the Adex is hard to dial in).

 

[PrinceDianabol]

The one thing that concerned me is that PSA is up - do I need to address this? Prior results were 1.28 in 2012 and 0.97 in July 2014.

Are these both pre-TRT results? It's normal for PSA to go up a bit when going from hypogonadal to normal/high levels. What you want to watch is that it doesn't keep going higher. If your really concerned daily Cialis (5-10mg) supplementation will bring it down a bit.

Perhaps try upping your hCG dose to raise DHEA...

 

[Tiffer]

So November 2011 it was 0.79 - that's when I first found out I had low t. At that time I tried 1 shot of Nebido (1000mg). Perhaps that's why the June 2012 was 1.28. The 0.97 was July 2014 and in the interim I had tried Clomid. But yes, only long term TRT for the last 10 months.
Ok I will monitor it going forward.
What would you recommend upping the HCG to - currently I'm on 250iu E3D - does upping this not mess with your E2?

 

[Mprtz]

How old are you? I would be a bit concerned about that increase. Do you have any BPH symptoms?

 

[Tiffer]

I am 42 and haven't noticed any symptoms?

 

[halfwit]

I'm honestly surprised given your estradiol. I agree with cialis use, but I'd also investigate the possibility of an infection. See what those neutrophils and their buddies are up to. PSA can easily be influenced by this (even a small bacterial infection), which is easy enough for a urologist to rule out.

My .02c

 

[pdelta]

I've been on TRT for over two years. Initially my T was 183 and my PSA 1.4. Within the first 6 months my T increased to 683 and my PSA to 2.1. It has been as high as 2.6 and as low as 1.7 while on TRT. There are several things that I have found affect my PSA. Sex a day or two before giving blood increases PSA. Bicycle riding increases PSA but not as much as sex. All things being equal, I can raise and lower my PSA by monitoring my DHT. As DHT increases so does my PSA, to a point. The same with lowering DHT. When my PSA was 2.6 my DHT was over 3000. As I lowered DHT my PSA came down as well. The last time I had it checked my PSA was 1.9.

 

[TRTnooby]

Certainly should be investigated but its not a reason to freak out.

The PSA is a very misunderstood and improperly used test. This is what its discoverer had to say about it: http://www.nytimes.com/2010/03/10/opinion/10Ablin.html?_r=0

 

[Tiffer]

Thanks for the great advice - I will go to the doc and check for an infection as it does feel a bit tight down there and coming to think of it my urine has had a strange odor of late.