As men age, their prostate health may deteriorate.
That’s also when they tend to take medications for some health-related problems.
Some medications increase PSA levels, which can indicate serious prostate issues, including prostate cancer.
Below, you will learn more about medications that increase PSA, the meaning of high PSA, and how to reduce them.
What is PSA?
Prostate-specific antigen (PSA) is a protein made by the prostate gland. Both cancerous and noncancerous tissue in the prostate produces PSA. The greatest amount of PSA is present in semen (1).
The main function of PSA protease is to break down the seminal coagulum’s high molecular weight protein into smaller polypeptides. As a result, semen becomes more liquid. While most PSA is in semen, this protein is also present in serum.
Analyzing serum PSA levels is one method to detect localized prostate cancer and monitor its treatment.
In order to analyze PSA levels, a medical technician or nurse needs a blood sample. Regular PSA screening is recommended for all men older than 40.
What are normal PSA levels?
Generally speaking, there is no such thing as a normal PSA level. Back in time, 4.0 ng/ml or lower PSA levels were considered normal. But, some men with PSA below that limit had prostate cancer, whereas those with PSA between 4.0 and 10 ng/ml didn’t have prostate cancer.
While there is no normal PSA range per se, the higher the value, the bigger the risk for prostate cancer. For example, someone with PSA 10 ng/ml or higher is more susceptible to developing prostate cancer than counterparts with lower levels of this protein.
It’s important to mention that high PSA levels don’t always indicate cancer. Sometimes, elevated PSA could indicate problems such as inflammation and benign prostatic hyperplasia (BPH) or enlarged prostate.
Men whose PSA levels test scores are low may be encouraged to get another test in two to three years. On the flip side, the doctor may recommend yearly testing for men whose PSA test scores are higher.
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What medications can increase PSA levels?
Although PSA levels increase with age, various factors speed up this process. Inflammation, infection, recent prostate biopsy, vigorous exercise, and other factors can slightly increase PSA, even temporarily.
Some medications do too. By elevating PSA in blood, these medications could falsely indicate the presence of prostate cancer. Below, you can learn more about medications that increase PSA levels.
1. Betamethasone
Betamethasone belongs to a class of drugs called corticosteroids. The medication works to activate natural substances in the skin to decrease swelling, itching, and redness.
Healthcare professionals usually prescribe betamethasone to treat severe allergic reactions, arthritis, sudden attacks of multiple sclerosis, eczema, psoriasis, and others.
The medication comes in different forms, including injections and topical products like ointments, creams, foams, and sprays.
Studies show that betamethasone can elevate PSA levels (2). Scientists believe that betamethasone induces PSA expression through transactivation of the mutated androgen receptor (3).
Besides higher PSA levels, betamethasone can induce other side effects. The most common adverse reactions include acne, burning/itching/irritation of the skin, redness, skin color changes, unwanted hair growth, and white or red bumps on the skin.
If you’re using betamethasone and are worried about its impact on PSA levels, feel free to consult your healthcare provider.
2. Dexamethasone
Dexamethasone is a glucocorticoid medication that doctors prescribe to treat inflammation, adrenal problems, allergies, arthritis, asthma, bone marrow problems, skin conditions, kidney problems, and other health issues. This medication was first synthesized in 1957 and approved for medical use a year later, in 1958.
Evidence shows dexamethasone can induce PSA response, but this subject requires further research (4). Interestingly, dexamethasone isn’t necessarily bad for PSA. When administered in lower amounts, PSA can lead to regression of PSA, and it could be helpful for patients with hormone-refractory prostate cancer.
Other side effects of dexamethasone include stomach irritation, upset stomach, vomiting, headache, insomnia, dizziness, depression, anxiety and restlessness, increased hair growth, acne, and easy bruising.
3. Testosterone replacement therapy
Testosterone replacement therapy (TRT) is a treatment for men with symptomatic hypogonadism, i.e., low testosterone.
Millions of men have low testosterone because the levels of this hormone decrease with age. However, not every man with low-T needs testosterone replacement therapy.
The doctors recommend TRT only for patients whose testosterone levels are abnormally low and symptoms can’t improve with other approaches such as healthy lifestyle measures.
The main purpose of TRT is to manage all the symptoms that low testosterone causes. Men on TRT experience an increase in their libido, energy boost, and muscle mass, among other benefits.
The TRT treatment could also increase PSA levels. A study from the journal Medicine found that testosterone replacement therapy increased PSA levels when it was given intramuscularly. The change in PSA was minimal, though (5).
Reviews in Urology published a paper that confirmed that TRT could increase PSA levels, but it doesn’t necessarily mean a man has prostate cancer. The same paper reported that TRT could aggravate obstructive symptoms associated with enlarged prostate (6).
Even though testosterone replacement therapy increases PSA levels, it doesn’t necessarily harm the prostate. For example, one meta-analysis found no increased risk of prostate cancer with TRT use.
How can I reduce my PSA levels?
High levels of PSA indicate problems with the prostate. In some cases that’s prostate cancer, but it could also be a sign of prostate enlargement and prostatitis.
Since the risk of prostate conditions increases with age and so do PSA levels, it’s important to be proactive about this subject.
There’s a lot you can do to put PSA levels to normal. Here are a few useful tips to lower your PSA levels:
- Eat more tomatoes – abundant in lycopene, which lowers PSA and reduces prostate cancer risk.
- Focus on healthy protein sources – avoid fatty or processed meats, and opt for lean proteins such as chicken, fish, and soy.
- Take vitamin D – men with higher levels of sunshine vitamin tend to have lower levels of PSA.
- Exercise regularly – normalizes PSA levels and may also reduce the risk of prostate cancer and other prostate-related conditions.
- Drink green tea – abundant in antioxidants, which lower PSA and reduce prostate cancer risk.
- Manage stress – unmanaged stress increases PSA.
Some medications can reduce PSA levels. These include tamsulosin, non-steroidal anti-inflammatory medications, high blood pressure medications, and others.
However, taking these medications just to lower PSA isn’t a good idea. Instead, consult your doctor about the best way to normalize PSA levels.
Conclusion
Doctors monitor PSA levels when patients have prostate cancer. The levels of this protein could speak volumes about the treatment and progression of this disease.
At the same time, higher PSA levels could indicate the presence of cancer or other prostate problem.
Various factors could influence PSA, however. Some medications could increase the concentration of this protein and thereby lead to false-positive results.
That said, some medications can lower PSA and cause false-negative results. These include NSAIDs, cholesterol-lowering statins, hypertension medications, and others.
If you’re worried about your medications and their impact on PSA levels, make sure to consult your healthcare provider.
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