If you are a man over the age of 50, you will probably have heard of the PSA test.
When it comes to prostate cancer screening and raising awareness, PSA testing has an important role.
A raised PSA level can be a sign of a problem, and a PSA blood test can help diagnose that problem.
An elevated PSA level is not the cause of these prostate conditions, but only an indicator of the underlying disease.
Other factors such as age, prostatitis, and BPH have been shown to elevate PSA levels.
However, a low PSA level is a good indicator of a healthy prostate.
In this article, we will be discussing what causes PSA to spike, what you can do to naturally lower PSA levels, and whether there is really such a thing as a ‘normal’ PSA level for men.
What is a PSA Test?
PSA is a protease, which is a group of enzymes that break down proteins into smaller peptides or amino acids.
It is released by the prostate gland, promoting the movement of sperm. However, a small amount escapes into the bloodstream and can be used to monitor prostate activity.
The measurement of serum PSA is commonly used for the early detection of prostate cancer and monitoring of treatment response.
Healthy men have low levels of serum PSA, but they are often elevated in the presence of prostate disorders, including an increased risk of prostate cancer.
If your prostate biopsy was negative for prostate cancer, a PSA test can determine if there is a need for a repeat biopsy.
However, serum PSA lacks clinical specificity as it can be elevated by noncancerous conditions.
The methods implemented most often include:
- PSA velocity measures the extent of change in serum PSA over time. An increase of 0.75 ng/ml/y or more can associate with the presence of prostate cancer (Carter et al., 1992). Unfortunately, this approach is limited by time and multiple measurements.
- PSA density measures PSA levels relative to the prostate volume. Studies show PSA density values greater than 0.10 strongly associate with prostate cancer (Nordström et al., 2018). However, reproducible calculation of prostate volume is a concern and may reduce the usefulness of this method.
- Age-Specific PSA normal ranges use different age-specific cut-offs to interpret the results of PSA tests. However, negative biopsies can still occur even after adjusting for age, especially in men over 70 years of age (Catalona et al., 2000).
- Percentage of free total PSA measures the ratio of the different forms of PSA.
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What Does a High PSA Mean?
PSA levels can be affected by several factors, and a rise in PSA may indicate:
- prostate inflammation
- urinary infection
- prostate cancer
- recent ejaculation
Alone, PSA levels are not good measures of prostate health so your medical team will need to assess other risk factors.
They may also perform a DRE (digital rectal exam) and/or a multiparametric MRI in order to make an accurate diagnosis.
PSA is not a unique indicator of prostate cancer because PSA screenings can be confounded by other prostate conditions.
For instance, age does not only increase prostate cancer risk but can also increase risk of BPH and urinary tract infection. Thus, patients may present with prostate cancer, BPH, and prostatitis simultaneously.
Both prostate cancer and BPH elevate PSA levels, while prostatitis and trauma may cause fluctuating PSA levels.
Often, levels of PSA gradually return to normal levels with immediate treatment of noncancerous prostate conditions.
Causes of High PSA Levels
Here are 8 things that can cause a high PSA level.
Age
PSA levels may increase with age and potentially with age-associated BPH.
BPH
An enlarged prostate, which is common in older men, can increase the levels of total PSA due to the effect of BPH on the bladder.
UTI
Urinary tract infections may elevate your PSA levels.
Prostatitis
Men under the age of 50 often develop prostatitis. Prostatitis-associated inflammation and prostate irritation can increase PSA levels.
Recent Ejaculation
Some men experience elevated PSA levels after ejaculation. This may persist for 24 hours.
Prostate Injury and Surgical Procedures
An injury to the groin caused by an accident or surgical procedure may spike PSA levels. You should inform your doctor if you had a recent fall, impact or accident.
Prostate Cancer
Prostate cancer often elevates your PSA levels, especially hormone-dependent prostate cancer.
However, digital rectal examination and prostate biopsy are required to make a diagnosis of prostate cancer. High PSA level likely links with prostate cancer if you have multiple known risk factors of prostate cancer.
Parathyroid Hormone
This is a hormone that regulates calcium levels and may raise PSA levels because parathyroid hormone can promote prostate cancer growth.
What Are Normal PSA Levels By Age?
The definition of physiological PSA levels remains an active debate. 2.5 ng/mL is safe. 2.6 to 4 ng/mL is safe in most men, but talk with your doctor about other risk factors. 4.0 to 10.0 ng/mL is suspicious. Although this is not always the case.
Men with high PSAs do not always have prostate cancer, while men with very low PSAs sometimes DO have prostate cancer. The prostate gland increases in size and produces more PSA as you get older.
If your PSA test result is high for your age or persistently increasing, your doctor may recommend a prostate biopsy.
Your healthcare provider should consider conditions that can elevate PSA levels before recommending a prostate biopsy.
How to Naturally Lower Your PSA Level
Though you cannot control all of the risk factors of the discussed prostate conditions, lifestyle changes are still the most effective way to maintain a healthy prostate and naturally lower PSA levels.
This includes regular physical activity, a healthy diet, and natural supplements (including vitamin d and omega-3 fatty acid supplements). All of these may help improve your prostate health and can help you maintain an overall well-being.
Further, you can make positive choices to avoid the eventual radical prostate cancer treatment, such as radical prostatectomy.
Regular Physical Activity
Regular physical activity can help you maintain a healthy prostate and reduce the risk of prostate conditions.
Several lines of evidence suggest that regular exercise may reduce PSA levels in men. Weight gain links to the development of BPH, prostate cancer, and prostate inflammation.
Weight gain also increases the levels of estrogen, which links to poor prostate health (Prezioso et al., 2007).
Healthy Diet
In addition to physical activity, lower daily calorie intake may help to reduce PSA levels. A low-fat diet that’s rich in fruit and vegetables has been linked to a healthy prostate.
Consume More Plant-Based Antioxidants
Tomatoes
Inflammation and oxidative stress play a central role in the development of several prostate conditions. Interestingly, tomatoes cooked in oil release lycopene a potent antioxidant.
Pomegranate
Pomegranate juice/extract has proven useful in reducing the risk of several prostate conditions through its antioxidant compounds.
A phase II clinical trial involving patients with rising PSA showed 8 oz of oral pomegranate juice significantly reduced PSA levels (Pantuck et al., 2005).
This positive effect is also replicated when pomegranate extract is used in multicomponent food supplements (Paller et al., 2017).
A randomized clinical trial of a polyphenol-rich multicomponent food supplement that included a 31.25% pomegranate extract found a significant slowing of PSA increase in the food supplement arm vs placebo in men on active surveillance and those experiencing biochemical recurrence (BCR).
Consider Taking a Prostate Health Supplement
It may be challenging to get all your nutritional requirements from dietary sources.
If that is the case, you should talk to your doctor about using a prostate health supplement.
Read our Guide to Prostate Supplements.
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