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PSA from 1.5 ng/ml to < 0.1 - does this make sense?

60 yo white male. BMI of 26.   I eat very well and exercise moderately.  

Due to a couple of PSA spikes (from < 2 to about 4 ng/ml, then back down) in recent years have been seeing my urologist every 6 months and getting more frequent PSA tests.  

lowest ever PSA, in my late 40s, when I started testing, was 0.7 ng/ml

more recently:

9/12   1.9 ng/ml
4/13    1.1
12/13   1.5
5/14     < 0.1  

all done by LabCorp.  When questioned the lab said they are confident of the result.    

I am puzzled by this and asked my urologist this week during my normal visit if this made sense.   He said it is possible and didn't see a need for a follow-up test and actually set my next visit for a year out.  He said the prostate can actually get smaller but did not do a digital to confirm.  He looked over my short list of supplements and didn't comment.    I have made no lifestyle changes during this time, having started on a high quality near vegetarian diet in early 9/12 due to cardiac issues.  Actually, I have made one change - my eating pattern for last two months is now confined (most days) to a 6 to 8 hour window as there seems to be good research pointing to global health benefits of daily intermittent fasting.

While I welcome a very low PSA, do these results make sense?  What is happening physiologically for this to happen?    

thanks,

peter
4 Responses
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563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,
Thanks for posting your query.

I can understand your concern for the low PSA levels. First of all, PSA levels are not diagnostic of prostate cancer and you shouldn’t worry about it. There is no specific normal or abnormal level of PSA in the blood. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. More recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer. Hence alone PSA levels cannot confirm the presence of prostate cancer.

Considering your low PSA levels, there are certain conditions that may make PSA levels low, even when a man has prostate cancer. This can occur if a person is taking drugs used to treat BPH or other conditions like Proscar or Avodart, when a person is taking certain herbal medicines or supplements or in obesity.

Men with very low PSA levels may need to be tested every two years. Hence you just need to get your PSA levels checked every year or two years and if you show any symptoms of prostate cancer like nocturia ( increased frequency of passing urine at night), difficulty passing urine, including straining to pass it or stopping and starting, sense of incomplete bladder emptying and pain when passing urine or at tip of penis or blood in urine or semen then get it evaluated from a urologist. Prostate cancer is confirmed by summarizing the results of presenting symptoms, digital rectal examination, PSA levels and prostate biopsy.

Hope that this information helps and hope that you get better soon.

Wishing you good health.






Helpful - 0
Avatar universal
Thank you.  Yes, I understand the points you make about the PSA and it's relation (or not) to cancer.   I mainly wanted to know if it made physiological sense for PSA to drop like that to an immeasurable level.  As I noted, I have not changed supplements or diet over this period.   Only the way in which I eat, confining food to a 6 to 8 hour window.
Helpful - 0
Avatar universal
I am sorry doctor.   I forgot to mention that I stated taking Losartan, an angiotensin receptor blocker, in January, just after measuring 1.5 ng/ml PSA  The literature suggests that Losartan can effect BPH and lower PSA.  
Helpful - 0
563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,
Thanks for writing back to me with the additional details. As I have mentioned earlier, studies suggest inverse associations between obesity and PSA with low PSA levels found on obese people. However it has also been suggested that PSA concentrations are lower among men with higher BMI or with higher energy intake.  Since you have increased the time gap between your diet, it is less likely to be the reason for your low PSA levels.

I sincerely hope that helps. Take care and regards.






Helpful - 0

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