Peter Attia· MD
if you have a man who starts out with a testosterone level of 190 and you put him on testosterone his PSA should go up
The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
if you have a man who starts out with a testosterone level of 190 and you put him on testosterone his PSA should go up
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we were taught that the higher the testosterone the greater the PSA we were taught it was linear and the higher the testosterone the greater the go that is not true at some point it saturates we did a study in 2011 we said the saturation was around 250 nandram per deciliter
if you give someone Lupron that P testosterone goes down but the PSA goes down y right but if you raise the testosterone it's not the more I raise it the more the PSA goes up so the tricky part for me is when patients come to me after radiation therapy because they've been given Androgen deprivation therapy the testosterone's 50 and their oncologist spent all this time taking away the testosterone that's right and when you get it from 50 past 250 you're going to see that rise until you hit saturation
if he's at 290 and you put him on testosterone it should not go up and if you take the guy from 290 and take him to 3,000 should not go up because it's sat at right so it it plateaus
we were taught in medical school that the higher the testosterone the greater the PSA we were taught it was linear and the higher the testosterone the way to go that is not true at some point it saturates
if I give someone Lupron that testosterone goes down but the PSA goes down right but if you raise the testosterone it's not the more I raise it the more the PSA goes up
we did a study in 2011 we said the saturation was around 250 in the underground per deciliter so if you take a guy that's pretty low it's pretty low but that's where the satch inflection point was and others have shown the same thing roughly around 250 but we're all different