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 High PSA, Inflammation, What to Do? 
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Joined: Thu Mar 26, 2020 1:26 pm
Posts: 4
Post High PSA, Inflammation, What to Do?
Hello Everyone,

I had my first PSA test 3 years ago of a number over 5. Concerned, did an MRI exam and found no cancer but large areas of inflammation. I used to have an UTI more than 10 years ago, not treated, faded away and with no lingering symptoms. In 2017, I had a mild urinary frequency which triggered the first PSA test. All urine tests came back clean and was put on doxycycline for a few weeks only able to bring down the PSA by 15%. Fast forward 3 years later, had a bout of urinary frequncy and pain in the testicles. Did the PSA again which stays almost the same as 3 years ago. Urine analysis and culture are also negative. My symptoms and questions are:

1) Flare up a little after sex or masterbate but usually go away by itself.
2) Symptom free most of the time even if MRI shows large area of inflammation.
3) Notice foamy urine after recent flare-up.

1) What causes my PSA being so high? Could it be any residual infection from the infection not being treated 10 years ago? If yes, why symptom free the entire time only exhibite until recent years? Could it be for psychological reasons?
2) What I can do to find out the cause of the prostate inflammation and elevated PSA.
3) Anyone can share any successful stories to treat similar cases and successfully lowering down the PSA?

I am very much confused, appreciated if anyone could share any thoughts or advice.

Best regards

Mon Mar 30, 2020 3:07 pm

Joined: Sat Dec 08, 2012 4:30 am
Posts: 837
Post Re: High PSA, Inflammation, What to Do?
How old are you? PSA numbers rise with age as does size of prostate. Mine dropped in half many years ago after going on soy milk. Not saying that was the cause but it was the only thing I was doing differently.

Mon Mar 30, 2020 5:55 pm

Joined: Thu Mar 26, 2020 1:26 pm
Posts: 4
Post Re: High PSA, Inflammation, What to Do?
Hi Madcap,

Thanks for the response. I am 52. Agree diet can help but hard to say it is the root cause. Something must be going on as the underlying cause. I hope together we can figure out the culprit and direct an effective treatment.

My current understanding of it is a mix of bacteria, psychological and muscle tension etc. We need more inputs and data to support any theories above. I hope people can share on this thread to help us clear up the doubt. One of the hypothesis is that CP/CPPS with no or insignificant PSA elevation is non bacteria and the opposite has bacteria in the play. Can anyone give examples with testing result in any of the advanced form not the regular urine analysis to either support or against it?

Your response is very much appreciated.

Best regards

Mon Mar 30, 2020 6:43 pm

Joined: Thu Jun 28, 2018 9:36 pm
Posts: 60
Post Re: High PSA, Inflammation, What to Do?
Hi hk:

From my extensive reading on this subject, I'd say it is the inflammation which can cause steep rise in PSA--for some people-- into that grey zone 3-12. As far as I know, it is not the bacteria , but the inflammation, which causes this. So it should not make much difference if bacterial or non-bacterial prostatitis. I have not heard that the presence bacteria is the decisive factor here. This might explain why the doxycycline only brought it down by 15%. The underlying inflammation might've still remained

My guess as to why it causes the rise is the increased permeability of inflamed prostate tissue allowing more of the PSA--which only the prostate can produce--to enter the bloodstream. But this part is only a guess on my part..

I had the same experience ~2years ago. Went to my PCP with extreme difficulty urinating. Had told him of my long history of prostatitis. But he went ahead and ran PSA test against my wishes, after I had conveyed my concern that such results would be skewed by prostatitis. Possibly by prostate enlargement as well. My result was elevated. The symptoms subsided with alpha-blocker. The later with Quercetin alone. I see little reason as of now to repeat the PSA test. But that is my personal choice. I think its a misleading test for many reasons. It is even more misleading when the patient is suffering from LUTS=lower urinary tract symptoms. As PSA tends to be elevated then

Its good they did MRI without rushing you into prostate biopsy, if I understood you correctly? as prostate biopsies have their own fallacies in terms of distinguishing between indolent cancer and cancer which is likely to grow fast. And many find their prostatitis worsened by such biopsies.

You do mention "psychological, muscle tension.." as possible cause of elevation. I haven't seen this mentioned in the literature. But its very interesting if true.. Possibly those factors increase in inflammtory repsonse in prostate? I'm curious what this might be based on?

If you're interested in more details, I'd suggest a book by Otis Brawley, former chief of the American Cancer Society:

How We Do Harm: A Doctor Breaks Ranks About Being Sick in America

There's chapter in there about the pitfalls of PSA testing.

Thu Apr 09, 2020 11:17 pm

Joined: Thu Mar 26, 2020 1:26 pm
Posts: 4
Post Re: High PSA, Inflammation, What to Do?
Hi elias,

Appreciated about the response and being supportive. Sorry about not being able to get back earlier. I think your thoughts makes very good sense in figuring the cause of our prostatitis. I begin to think that the bacteria infection may not be the casue of our prostate inflammation and the elevated PSA count.

As far as "psychological, muscle tension.." cause of prostatitis, I actually saw many literatures mentioned about this, one of them being the Standford protocal which you can look it up on Google and very much against the idea that bacteria is the cause for most chronic prostatitis cases. Base on their theory, prostatitis symptoms such as pain and frequent urination has something to do with the psychological stress and pelvic muscle tension or malfunctioning. I can very much relate to their theory as I found many anxiety or excessive masterbation sufferers in this Internet porn age have higher incidence of the disease suggesting that neurological facters and muscle disfunctioning maybe a cause.

That said, there seem to be a huge debate on this and some other sites over the role of bacteria in chronic prostatitis cause. Personally, I feel baffled about the fact that there is still not a conclusive opinion to settle the dust. To me, this really shouldn't be too difficult to find out if some approperiate tests and well designed epidemiogy studies are conducted to track down if there is a correlation between certain bacteria/virus count and level of inflamations indicated by PSA count within the prostate of prostatitis sufferers. It may be that the stakes are not high enough for the industry to make such as a devotion but to us as sufferers may mean a great deal, which is not a supprise if you consider how much sugar and soft drink do to obesity and chronic disease and there is less of a conclusive opinion to that topic either.

I've noticed that many sufferers have an urinary infection in early life and subsequently report chronic prostatitis symptoms after the infection goes away. A lot of these patients went on doing the prostate fluid culture or DNA tests, receiving targeted antibiotic treatments and successfully getting rid of the bacteria if any is found. However, I have yet seen even a handful of people reported that their prostatis symptoms are cured as a result of the treatment or bacteria being killed, particularly, a lowered the PSA count as an evidence of reduction of inflammation, indicative of an improvement of prostatitis recovery. Would this be in supportive of the neurological cause of the chronic prostatitis or any other considerations?

Just some of my thoughts. Would appreciate if you can offer any inputs.


Sat Apr 18, 2020 7:40 pm

Joined: Thu Jun 28, 2018 9:36 pm
Posts: 60
Post Re: High PSA, Inflammation, What to Do?
Hi again, hk:

I misunderstood your original post here and thought your questions pertain mostly to causes of elevated PSA... Rather than to causes of prostatitis in the more general sense.

Here's my oversimplified view on this:

Prostatitis syndromes are very common and are multifactorial in their many causes. My understanding is that its etiology is some spectrum of infectious, inflammatory, and muscle tension factors, and varies much from one individual to another.

I've suffered from this most of my adult life. It began with an acute urinary infection early on, which seemed to heal completely with short term antibiotics. A few years later, during a period of severe stress, it flared up badly and continues to relapse during periods of stress and sleep deprivation. Another odd precipitating factor are flareups in my IBS -Irritable Bowel Syndrome. Medical science has noted this as well. It's now thought that the GI system and the urogential system are more intertwined than most think.

Early on, I had a very difficult time accepting that there's a strong psychological factor to all this, because urologists kept finding high level of inflammatory cells in my prostatic secretions. They were oriented to thinking in terms of an infectious cause. But the many courses of antibiotics they put me on did not help. I had much difficulty accepting that emotional stress can cause this type of inflammation. It was however finally explained to me by a specialist (not a urologist though..) that in fact muscle spasms of the prostate can very well cause such an inflammatory response. The explanation she proposed was that the prostate is both glandular and muscular, so that a severe rise in smooth muscle tension there is bound to elicit an inflammatory response in the glandular aspect. I'm oversimplifying much here. But it did make much sense to me. And the acceptance of this was the first step in the healing process. She did use a combination of acupuncture, breathing techniques and exercises to help me gain control over it.

But as I said-- I continue to get frequent flare-ups when stressed, sleep-deprived, or when the IBS acts up. I'm finding that the more intense aerobic type exercises help me more now than the more meditational exercises-such as Tai Chi which I used to use for this. More recently, I'm also finding that Quercetin combined with Bromelain helps many aspects of this syndrome for me. I take it in half the recommended dosage. But it does help.

As you can see, my own case is a combination of early infection, inflammation and smooth muscle spasms/tension. In some people different factors predominate. So unfortunately, there isn't one single cause for the syndrome. I'd say that in my own case, the tension in the involuntary muscles is the predominant factor. And this is very tricky to treat medically. Seems it requires a multimodal approach

Sat Apr 18, 2020 8:37 pm

Joined: Thu Mar 26, 2020 1:26 pm
Posts: 4
Post Re: High PSA, Inflammation, What to Do?
Again thanks for your response again elias.

Reading your story really amazes me in that a few of the people suffering with CP whom I know of all went through almost exactly the same journey as yours which includes intial infection, recovery, flare-up due to stress, negative test result and not respond to antibiotics. It seems that chronic prostatis really need to be managed over a long period of time if not cured completely, which is understandable if thinking it as you have a knee joint injury and the inflammation may stay with you and prone to flare-up if streched again or during the cold weather. I sometimes concern the elavated PSA and PCa risks, but based on my research, it seems that these are two seperate causes and research has shown that there is no causition relationship between the two.

Please stay healthy and let's be posted with each other.

Good luck!

Sun Apr 19, 2020 12:25 am
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