another PSA thread

**Baxter35** · 01-29-2015, 12:08 PM

I didn't want to hijack another thread, but after reading the other two recent prostate threads I have some questions. For those who don't know, my trt is handled through a urologist, and I am also hypothyroid which I see an Endo for. My Endo is very anti-trt, and wants to start screening me for PSA along with my thyroid screening because in his words trt treatment is very likely to cause increased risk of prostate cancer. I haven't done the bloodwork yet, and now I'm wondering if I even should. I'm 35, and have no symptoms or indications of possible prostate problems. According to the links I read from 2sox, psa screening isn't even recommended for men under 40. Knowing that my Endo is basically digging for a reason to discourage trt, I don't know if I'm comfortable going down this road of psa screening with him. What do you all think?

**BallSak** · 01-29-2015, 12:31 PM

Let your TRT doc handle your psa, then you don't have to deal with his anti TRT bs.

Even in our 30s I think its a good idea to at least get serum psa on an annual basis.

**Baxter35** · 01-29-2015, 06:29 PM

That's probably best. I'm considering getting a new Endo as well, but for now I'll ask that he sticks to just the thyroid monitoring.

**2Sox** · 01-29-2015, 06:53 PM

FORGET about testing for PSA until you're in your sixties - unless there are symptoms early on and/or some family history. That your endo wants to test for PSA at your age is asinine. I think it's irresponsible and I wonder if he has even read the guidelines for testing! That's my opinion. End of story. This test - as is ANY test - is completely at the patients discretion. Would you believe that Medicare covers for PSA only ONCE a year? If you've been reading the threads, you know why.

**Beethoven** · 01-29-2015, 07:20 PM

I started having mine tested after forty. Once a year is plenty IMO unless there is history of prostate problems.

**OingoBoingo** · 01-29-2015, 07:23 PM

The test itself isn't harmful, and if nothing else provides history.

Been having an annual test for years.

**Beethoven** · 01-29-2015, 07:25 PM

Why specifically do you see an Endo for your thyroid? Most gp's handle that as well. Most Drs that are anti trt are not knowledgeable on the subject. We hear the horror stories in here all the time about these Endos that haven't a clue. Most of these guys are in the dark ages when it comes to trt.

**Baxter35** · 01-30-2015, 07:21 AM

Originally Posted by Beethoven

Why specifically do you see an Endo for your thyroid? Most gp's handle that as well. Most Drs that are anti trt are not knowledgeable on the subject. We hear the horror stories in here all the time about these Endos that haven't a clue. Most of these guys are in the dark ages when it comes to trt.

Funny you ask. Getting stuck with this Endo is really my fault. When first diagnosed hypothyroid my gp was handling it. But, I didn't feel that I was getting the results I wanted, and I felt the time my Dr. wanted to wait before adjusting my levothyroxine dose was too long. I took it on myself to get some private blood work done and increased my dose accordingly. It worked, but when I told my gp what was doing he got upset and decided he preferred to refer my thyroid treatment to someone else. Generally speaking, my gp is pretty good, including being open to trt. It was mostly my fault for handling it that way. Now I'm stuck with this Endo who is stuck in the dark ages and thinks trt is a death sentence and dealing with low T is just part of the aging process. I haven't followed through yet, but I've been meaning to reach out to my gp and see if he'll take back over my thyroid monitoring. Ironically, the dose I'm now dialed in on is the same dose I had self prescribed.....

**Baxter35** · 01-30-2015, 07:28 AM

Originally Posted by 2Sox

FORGET about testing for PSA until you're in your sixties - unless there are symptoms early on and/or some family history. That your endo wants to test for PSA at your age is asinine. I think it's irresponsible and I wonder if he has even read the guidelines for testing! That's my opinion. End of story. This test - as is ANY test - is completely at the patients discretion. Would you believe that Medicare covers for PSA only ONCE a year? If you've been reading the threads, you know why.

That's what I was thinking. I'm really nervous that worst case scenario would be to get a single PSA result with a questionable number and have this Endo want to start down a path of increased treatment that may be completely unnecessary and possibly dangerous due to his preconceived notion that I feel like he almost wants to find a problem.

**2Sox** · 01-30-2015, 07:48 PM

Originally Posted by Baxter35

That's what I was thinking. I'm really nervous that worst case scenario would be to get a single PSA result with a questionable number and have this Endo want to start down a path of increased treatment that may be completely unnecessary and possibly dangerous due to his preconceived notion that I feel like he almost wants to find a problem.

Let me clarify and revise my previous statement. Most men over 50 have BPH. (I was in my mid fifties when I developed it.) At that age, it's not uncommon to have a DRE done and a test for PSA to see if there is cause for any concern. If not, and if symptoms of BPH are present, common medications are prescribed to alleviate symptoms. And they work marvelously well. After that, it is the patients choice as to IF and how often he would like a test for PSA done.

Remember, you can refuse any test a doctor recommends. And in this case, you have good cause to refuse a PSA test because you are so young and you present with no symptoms. Also remember that it's your insurance that will be paying for this test along with a possible co-pay. Based on what you have described your endo sounds sadly misinformed about TRT. First course of action I would advise is to find a new one.