What Does A High PSA REALLY Mean?


PSA, or prostate-specific antigen, is often thought of as an immediate signal of prostate cancer—but is it really? Doctors have discovered that a high PSA level does not necessarily correlate to prostate cancer. There could be other health and lifestyle factors impacting your PSA test results.

What do PSA levels mean and what could cause an elevated level that isn’t prostate cancer?

What is PSA?

Prostate-specific antigen (PSA) is a protein produced by the prostate cells. The PSA test is used as a simple blood test to screen for prostate cancer. It’s also used to monitor men who have previously undergone prostate cancer treatment to reevaluate where they stand.

At your yearly checkup after age 50, your doctor will likely run a PSA test in your blood panel. PSA is generally reported as nanograms of PSA per milliliter of blood (ng/mL). Often, a PSA test will be performed in conjunction with a digital rectal exam (DRE) to test for potential prostate cancer.


There seems to be a link between PSA level and incidence and aggressiveness of prostate cancer. However, there are still small amounts of PSA found in the blood of healthy men, and doctors don’t yet have evidence of what a “normal” PSA looks like.

If you have “high” PSA levels, your doctor may want to do a biopsy to check for cancer. However, elevated or rising PSA doesn’t necessarily mean prostate cancer—as we’ll explore further below.

Read: Does My Husband Have Prostate Cancer?

What is considered a “high” PSA level?

The average PSA level that is a “cause of possible concern” is above 3 ng/mL. Some studies have shown that biopsy-detected prostate cancer is “not rare” in men with PSA levels over 4.0 ng/mL. For younger men, PSA levels should be much lower.

However, an elevated PSA doesn’t automatically mean you have prostate cancer. In fact, 13% of men over 55 have a PSA level of greater than 4 ng/mL without necessarily having prostate cancer.

One study wanted to better understand what a “normal” PSA looks like. Researchers followed 4,383 healthy men for 28 years. They found the 10-year absolute risk for developing prostate cancer was 11-22% for men with PSA of 4.01-10.0 ng/mL and 37-79% for those with PSA of greater than 10.0 ng/mL.

In this case, 10.0 ng/mL seems to be the significant point at which PSA could prove a higher incidence of prostate cancer.

This study insinuated that PSA level is directly correlated to prostate cancer risk, especially at a higher PSA.

But does this always hold true?

This link between PSA and prostate cancer is good to keep in mind as you follow your health. Knowing that there’s a correlation between PSA and prostate cancer risk, aggression, and mortality rates can help you catch possible cancer while it’s small and less aggressive.

More importantly than even the PSA level is the PSA velocity. Your PSA levels shouldn’t rise more than 0.5 year to year. If so, this could indicate a change in the prostate—like prostate cancer.

Does PSA cause prostate cancer?

PSA doesn’t cause prostate cancer. PSA is simply a protein made in the prostate.

However, PSA could be a result of prostate cancer. Cancer might cause the prostate to create this protein at a higher rate, leading to higher PSA levels.

But cancer is not the only thing that causes the prostate to make this protein, thus raising PSA levels. Also, cancer doesn’t necessarily boost PSA levels.

This means that PSA and prostate cancer are not causal. Although prostate cancer and PSA are linked, there could be other factors going on that we don’t yet understand.

It’s important to note the difference between correlation and causality here because an elevated PSA does not always mean prostate cancer and prostate cancer will not always result in increased prostate levels.

Your PSA test can result in a false positive or a false negative.

A “high” PSA test is a good cancer warning sign, but it is not a death sentence.

So what other factors can cause an elevated PSA and what can you do about it?

What are the reasons for an elevated PSA?

There are only three reasons for an elevated PSA: BPH, prostate infection, or cancer.

Benign prostatic hyperplasia (BPH) is one of the most common causes of an elevated PSA level. BPH is an enlarged prostate, and it’s a common concern for older men. This prostate enlargement causes the prostate to make more protein cells and raise PSA levels. There is no proven link between BPH and prostate cancer.

Learn more about BPH here.

Prostatitis, an infection in the prostate, can cause the prostate to create more PSA to help fight off the bad bacteria. Prostate infection also often leads to prostatitis, which is an inflammation of the prostate gland (similar to BPH).

Prostatitis is a common problem, especially for men under age 50. It is generally from an infection or bacteria that irritate the prostate. Symptoms include pain with urination, fever, pressure in rectum, difficulties ejaculating, and change in sexual function. Thankfully, prostatitis is usually treated with a round of antibiotics.

Read: Prostate Health Foods For Men – Add These 3 To Your Diet

And then there’s prostate cancer.

There may be other “influencers,” like trauma or medications, but these don’t typically raise the PSA enough to influence testing.

How do you know if it’s BPH, prostate infection, or cancer?

First, your doctor will try to figure out if you have BPH or a prostate infection. You can diagnose these much easier than prostate cancer. For example, you can usually tell from blood or a urine sample if there’s an infection in the system.

However, it’s not always easy to diagnose BPH. You could show up clean as a whistle with no sign of infection, and your doctor may not be able to determine if it’s BPH or cancer.

That’s when additional testing may be necessary.

Thankfully, “additional testing” isn’t as scary as it used to be. Learn more about our updated prostate cancer screening methods here.

Do I need a PSA test?


The PSA test won’t tell you why your levels are increased. Thus, a lot of men get unnecessarily worried or stressed after a “high” PSA result. A high PSA often calls for a biopsy, which can have unpleasant side effects.

To avoid this, the United States Preventative Services Task Force (USPSTF) used to recommend against testing for PSA in healthy men. (“Healthy” men are those with no known risks, symptoms, or family history of prostate cancer.)  
However, the USPSTF made a few changes to this position in 2017. The new USPSTF screening draft encourages doctors to discuss the benefits and harms of the PSA test to allow men to determine whether or not they would like to include it in their workup.

If you are above 50, I recommend a PSA test on a yearly basis. I discuss with my patients how an elevated PSA does not necessarily mean cancer and there is no need to worry. Nevertheless, it can be a useful means of potential detection in the early stages of prostate cancer.

As Benjamin Franklin said, “an ounce of prevention is worth a pound of cure.”

Testing your PSA levels is an ounce of prevention that can help stop prostate cancer in its tracks.

If you have an elevated PSA level, follow-up with a doctor but do not assume you have cancer.

When do I need a PSA test?

I recommend a PSA test for all men over age 50 at your yearly checkup. It’s a simple, minimally invasive blood test just like your other screenings.  

You should also get your PSA levels tested if you show any symptoms of prostate cancer:

However, it’s important to note that a lot of the symptoms of prostate cancer are also symptoms of BPH, urinary tract infection, or prostatitis.

If you’re showing the above symptoms, it’s time to see a doctor—but it’s not time to stress.

Did you know you can reduce your risk of prostate cancer with lifestyle changes and diet?

Bottom line

The PSA test is not 100% accurate in its ability to predict risk or aggression of prostate cancer. It can be a sign of infection or BPH, and it’s no use worrying about—yet.

Nevertheless, a PSA test is a harmless way to get an idea of where your sexual health stands. Don’t be afraid of a PSA test…and don’t be afraid of the results.

If you want support with a recent PSA result, check out our Male 90X program to learn how to handle stress and change your lifestyle for ultimate health and wellness!

It’s time to take control of your physical and mental wellbeing. Don’t wait to live— GET MALE 90X today!

 

Want more tips to optimize your health and testosterone?

Listen to the latest podcasts. Click HERE

 

Tracy Gapin, MD, FACS – Board Certified Urologist in Sarasota, Men’s Health Optimization Expert and Medical Director of Sarasota Apeiron Center for Human Potential. Founder of www.SmartMensHealth.com    

 

What’s The Deal With Weight Gain And Low Testosterone?


If you’re struggling to see the results you want in your weight loss program, you may be dealing with a testosterone imbalance.

Have you been noticing that the number on the scale keeps increasing recently?

Is your midsection growing at a faster rate than the rest of your body?

Are you struggling to lose those pesky pounds?

Are you dieting and exercising but still not seeing the results you want?

Weight gain is a primary symptom of low testosterone.

If you have low testosterone, you’re more likely to have increased body fat.

And if you have increased body fat, you’re more likely to suffer from low testosterone.

This becomes a vicious cycle that can cause weight gain and prevent weight loss—no matter how hard you diet and exercise. This cycle can also impact other areas of your health, including stress, libido, fertility, energy, and risk for disease.

Let’s go through the basics of testosterone, how T is related to weight, and what you can do about breaking the cycle this week.

What is testosterone?

Testosterone is the “male sex hormone.” It’s the primary hormone that makes a male “manly.” Testosterone is necessary for the initial development of the testes and prostate as well as the ongoing production of sperm and semen.

Along with its sexual function, testosterone has other important purposes in the body as well. It plays a role in everything from libido to muscle development and brain health. Check out these 10 crazy and surprising effects of testosterone here.

A number of factors can cause low testosterone. This includes lifestyle, diet, and exercise. Age also plays a role, as testosterone levels naturally decline with age especially after age 50.

Because testosterone is so critical for sexual and overall health, low levels of testosterone can cause serious health concerns. Symptoms of low testosterone include:

  • Weight gain
  • Minimized libido (sex drive)
  • Low fertility
  • Loss of muscle mass
  • Weak bones
  • Lowered energy
  • Brain fog
  • Moodiness
  • Depression
  • Anxiety
  • Low self-esteem
  • Less body hair

In this post, we’re going to focus on the first symptom: weight gain.

Testosterone has a direct impact on your weight. Higher testosterone means less fat and more muscle. Lower testosterone means more fat and less muscle.

That means that testosterone not only impacts the way we look and feel, but it’s also an important aspect of overall health. Testosterone affects our weight, and weight is a proven indicator of future wellness. Being overweight is directly linked to a number of health problems, including high cholesterol, high blood sugar, type 2 diabetes, heart disease, stroke, and more.

So how does this work?

What is the relationship between weight gain and low testosterone?

A number of studies have proven that weight and testosterone are intimately linked.

Research has shown that low testosterone can cause weight gain. Thus, improving testosterone levels can help with weight loss. A 2013 study found that men taking testosterone supplements saw weight loss as a side effect. Over five years, they each lost an average of 36 pounds and 3.5 inches off the waist. Similar results were iterated in a 2016 study as well.The reverse is also true. Obesity or holding extra weight can actually reduce testosterone levels. One study found that 75% of men who qualified as obese also had hypogonadism, which is when the body produces lower amounts of testosterone.

Losing weight, then, actually shows an increase in testosterone levels—even without testosterone replacement therapy.  

So where does this link between weight gain and testosterone come from?

Below are the five primary ways testosterone impacts your weight.

  1. Testosterone plays a role in metabolism.


Testosterone plays a key role in your metabolism, which is the process that turns your carbs, fats, and proteins into energy and fuel.

This is likely because testosterone interacts with insulin and glucose. High levels of testosterone can “eat up” extra glucose. Otherwise, that glucose would be stored as fat cells in the body.

Higher levels of testosterone eat up more of your free-floating sugar to prevent weight gain.

In fact, one study found that men undergoing testosterone treatment showed a significant increase in basal metabolic rate, which is associated with a decrease in lean body mass.

In opposition, fat cells actually metabolize testosterone at a fast rate. The more fat you carry around, the faster you burn through your free testosterone.

So low testosterone causes weight gain… and then that extra fat actually minimizes your free testosterone even more.

  1. Testosterone builds muscle.

Muscle is an important part of weight loss. Your body has to burn up its fat stores in order to build the muscle that you’re creating. Plus, muscle actually burns more calories throughout the day than fatty tissue does.

Having more muscle on your body puts you in a positive cycle of maintained weight.

And testosterone is a key hormone in the process of muscle construction and protein synthesis.


Studies show that testosterone levels increase muscle mass by boosting the body’s ability to produce protein.

This means that higher testosterone can help increase muscle, which minimizes fat storage.

Testosterone also boosts HGH, the human growth hormone. This hormone is used to build or “grow” your muscle.

Studies have shown that men with low testosterone are more likely to have less muscle mass than men with normal T levels. Similarly, men with less muscle mass are at a greater risk for low testosterone levels.

If you want healthy and attractive muscles, you need testosterone.

  1. Testosterone regulates fat-storing estrogen.

Body fat contains an enzyme called aromatase. Aromatase converts testosterone to estradiol, which is a type of estrogen. Aromatase turns T into estrogen, which increases estrogen levels. This then signals the endocrine system to slow the production of testosterone.

Basically, fat tissue creates estrogen. Estrogen stops the production of testosterone.

Thus, reducing fat tissue helps minimize the extra estrogen caused by stored belly fat.

The reverse is also true. When testosterone is low, it increases the production of estrogen.

Estrogen then signals your body to store fat. That’s why women tend to have “softer” features and extra weight, especially around their midsection. The goal of this in females is to store fat so women have extra reserves in case they need to care for a fetus or baby.

Estrogen works the same way in a male. It tells your body to hold on to your fat “in case of emergency.” But in most cases, you’re not all that interested in holding on to extra fat tissue in case the apocalypse hits.


Body fat increases estrogen and lowers T.

And low T increases body fat storage.

Talk about a cycle of weight gain!

Thus, boosting testosterone levels can help minimize fat-storing estrogen. And losing weight can help reduce estradiol, allowing for more free-floating testosterone.

Find out more about the relationship between testosterone and estrogen, especially with regards to the estrogen in your food.

  1. Testosterone reduces cortisol levels.

Cortisol, the “stress hormone,” is proven to increase weight gain. You’ve likely found that during stressful periods of your life, you hold on to a little more poundage than you typically would.

This is because cortisol is released in response to stress and low blood sugar. The goal of cortisol is to suppress inflammation and raise blood sugar levels. This increase in blood sugar actually promotes fat storage, especially around the abdomen.

Cortisol also causes gluconeogenesis, which is when your body transforms its protein reserves into glucose. This basically transforms the protein within your muscles into fatty tissue. You’ll start losing muscle mass and gaining fat—which links back to #2 on this list.  

Testosterone and cortisol have an inverse relationship. High cortisol levels cause low levels of testosterone, and high testosterone levels cause low levels of cortisol. Low testosterone allows cortisol to run free, causing an increase in fat storage and gluconeogenesis.


Raising your testosterone levels reduces cortisol, which then minimizes the risk of extra fat storage.

You want high T and low cortisol for optimal health.

  1. Testosterone impacts energy and stamina.

Low energy is a symptom of low testosterone. Fatigue and sluggishness are common indicators of a hormonal imbalance.

Energy is an important part of losing weight. Men with low testosterone often find they don’t have the energy or motivation to workout. When they do exercise, their stamina is so low that the workout isn’t as productive or effective as it could be.

Plus, low energy tends to lead to a more stagnant lifestyle. This means fewer calories burned throughout the day—often accompanied by an increase in the consumption of calories.

This creates a discouraging effect for men looking to lose weight. They can’t bring themselves to the gym no matter how much they want to lose the weight.

Stagnation causes a quick uptick in poundage.

How can you lose weight and increase testosterone?

Because the relationship between weight and testosterone goes both ways, it can be challenging to answer the chicken or the egg question:

Am I gaining weight because of low testosterone or do I have low testosterone because I’m gaining weight?

But the answer to this question ultimately doesn’t matter.

You don’t want weight gain or low testosterone.

So how can you break the cycle?

You have to start by boosting your testosterone.

Whether your weight gain was the cause or effect of low testosterone, losing weight starts by increasing testosterone.

Click here to discover the 13 ways to increase testosterone naturally. You’ll also want to learn about the 7 testosterone boosting myths, so you can make sure your training regimen is on the right track.

Testosterone replacement therapy might be a solution for some men, but it can also have a number of associated risks. There are other healthier ways to try increasing testosterone while losing fat.

Below are a few of the best ways to increase testosterone while losing weight—kill two birds with one stone!

  1. Lift weights. Resistance exercise builds muscle faster than cardio. As discussed, lean muscle burns fat faster and triggers testosterone production.
  2. Use high-intensity interval training. Studies show that interval training boosts testosterone better than steady endurance exercise. Interval workouts also tap into fat reserves to eat away at the pounds you’re struggling to lose.
  3. Stress less. The more you stress, the more cortisol you have in your body. More cortisol means less testosterone. Minimizing your stress is crucial to maintaining a healthy hormone balance. I recommend yoga, because it helps reduce stress while growing muscle mass.
  4. Maintain a consistent routine. You need to be exercising regularly in order to have a long-term impact on your testosterone levels. The most effective routines include both cardio and weightlifting to boost muscle mass and burn fat simultaneously.
  5. Don’t shy away from fats. Healthy fats are actually an important part of testosterone production. Study after study shows that low-fat, high-protein diets kill testosterone, minimize muscle mass, and increase fat storage. A balance of fats, carbs, and protein is critical for hormonal health and balance.

 

Learn more about the Carnivore Diet and Fat Loss here. 

Learn other testosterone boosting methods here.

Conclusion

If you’re struggling to get rid of those pesky pounds, low testosterone may have something to do with it. The intimate relationship between testosterone and weight gain can create a vicious cycle that can be hard to break.

But if you boost your testosterone, you’ll increase muscle mass and strength, encourage weight loss, improve energy and stamina… and enrich your overall health and vitality!

I have the ultimate solution to breaking the cycle.

Because I’ve done it myself.

During a routine physical exam, I found out I was 25 pounds overweight. My cholesterol was 245. My doctor showed me my life expectancy chart based on my medical history and health… and it scared the crap out of me.

So I decided to make a change.

I decided to break the cycle.

And I’ve been helping men lose weight and boost testosterone ever since.

Now it’s your turn.

Ready to take the next steps?

Schedule a Call

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In Male 2.0™, Dr. Tracy Gapin has turned everything we once thought we knew about men’s health and performance upside down. The old model of how to be “a man” is broken. A man who works himself to death.  Unfortunately, a man who tries to NOT get sick but isn’t really healthy either.  And a man who takes a pill for every ill but is never really cured. That was Male 1.0. Now, imagine being THE MAN ─ owning your performance in the bedroom, the weight room, and the boardroom. Living a fully optimized life. Becoming limitless. This is Male 2.0!

Tracy Gapin, MD, FACS  is a board-certified Urologist,  world renowned Men’s Health & Performance Expert, Author, and Professional Speaker. Using state-of-the-art biometric monitoring, nutrition and lifestyle intervention, Dr. Gapin coaches Fortune 500 executives and evolutionary leaders of business, sports medicine, and high performance. He specializes in cutting-edge precision medicine with an emphasis on epigenetics, providing men with a personalized path to optimizing health & performance. www.GapinInstitute.com

Want more tips to optimize your health?  Listen to the latest podcasts. Click HERE