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Low PSA? Don’t Celebrate Until You Check Testosterone · Intellectual Medicine

• 0:00
  Why are we still stuck in the cycle of a 1980s approach to
• 0:04
  prostate health and cancer? We've been groomed to believe
• 0:07
  that a low PSA is universally good.
• 0:10
  PSA is a natural substance. It is not a cancer marker unto
• 0:15
  itself. It's normally there in all men.
• 0:18
  You're a lot more than your prostate gland, guys.
• 0:26
  Never should you ever get a biopsy of your prostate.
• 0:30
  And if you've had one, just stop already.
• 0:34
  This is an act of futility. It's all built on your PSA.
• 0:40
  It's built on the false notion that what they gather from the
• 0:44
  biopsy can help protect you. Well, what if your PSA level is
• 0:51
  too low? Is there such a thing?
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  We've been groomed to believe that a low PSA is universally
• 0:58
  good. And if it's low, you're happy.
• 1:02
  And if it goes up, you're sad. And your doctor wants to make it
• 1:06
  lower, regardless of evidence of benefit or lack thereof,
• 1:11
  regardless of the effect it has on your well-being and your
• 1:15
  vitality. So let's break it down a little
• 1:18
  bit. Here's what we know for sure.
• 1:21
  Conventional treatments are a miserable failure.
• 1:24
  Prostatectomy, radiation, I don't care how much they promote
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  it, We're going to do targeted radiation.
• 1:32
  There's no proof it's going to help, and it absolutely causes
• 1:35
  harm. So what about the PSA?
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  Here's what we know. Men with low testosterone levels
• 1:43
  have a higher incidence of developing prostate cancer.
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  Low testosterone is bad. Not only is it bad for your
• 1:52
  health, but it's bad for your prostate.
• 1:56
  What is a low testosterone? Good question.
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  Nobody really knows, but they make up some numbers.
• 2:03
  The low testosterone is the level at which it starts to
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  affect your vitality, your sense of well-being, your sex drive,
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  your energy. Tired in the afternoon, can't
• 2:15
  recover from workouts. Typically at risk for men past
• 2:20
  50. It can't happen younger.
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  I started my testosterone at 48. But how about the PSA?
• 2:28
  Suppose you feel good, but your PSA level is low.
• 2:32
  Without knowing your testosterone level, it's hard to
• 2:35
  determine if that's good or bad, and here's why.
• 2:39
  PSA is a natural substance. It is not a cancer marker unto
• 2:44
  itself. It's normally there in all men.
• 2:49
  In order for your prostate to make PSA in a natural manner, it
• 2:53
  needs testosterone. Testosterone is the essential
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  precursor. No testosterone.
• 3:01
  The PSA level drops abnormally low.
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  So if your PSA level is low, you need to know what your
• 3:09
  testosterone level is. If that's low, that low PSA may
• 3:12
  not be a good thing because low testosterone increases lifetime
• 3:17
  risk of prostate cancer. When or if you choose to go on
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  testosterone therapy, and I'm going to say when because you
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  really ought to consider this. No, you should do it.
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  Especially if you're past 60. For God's sakes men, those
• 3:30
  testicles are not coming back on their own and being normal in
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  the eyes of your doctor is not relevant to your well-being.
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  Most doctors define normal based upon antiquated age parameters.
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  I do not want the normal testosterone level for a 60
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  something year old man. Nor do you.
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  You want the level at which you are feeling your best.
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  That just is logical. It's biologically consistent.
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  So let's go back to your PSA. Let's say your PSA is 0.8.
• 4:03
  Hooray. But suppose your testosterone
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  level is 320. Total testosterone.
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  By the way, the average testosterone for a 35 year old
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  man is somewhere in the neighborhood of 720.
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  You should never aspire to achieve a predetermined level of
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  testosterone in the blood. If a doctor is judging how much
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  testosterone to give you strictly on a blood level, find
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  another doctor, because that is blunt force not fully
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  manifesting the deepest level of knowledge regarding managing
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  your hormones, and you deserve that.
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  Suppose, however, it is absolutely low.
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  When you go on your testosterone, then the PSN PSA
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  levels going to go up. It's not going to go up because
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  you're developing cancer. In all likelihood, it's just
• 4:54
  going up because it's achieving its natural balance.
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  Given a healthy testosterone level, it will go up, then it'll
• 5:02
  hit a plateau. This is the part where your
• 5:05
  doctor needs to be knowledgeable or your nurse practitioner.
• 5:08
  Yeah, there's some excellent ones managing hormones these
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  days. If they panic because your PSA
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  went up, it's more likely a manifestation of their limited
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  knowledge regarding hormone therapy then it is your health
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  condition. Oh, by the way, this is true
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  even for those of you with prostate cancer.
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  Yes, those of us with advanced knowledge and skill and
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  experience are treating men with prostate cancer with
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  testosterone. You don't just do this blindly,
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  it needs to be done in a unique manner.
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  Let's go back to the person who otherwise feeling good.
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  You go to your doctor. Your PSA is 2.1 good number.
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  What about the testosterone level then?
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  The PSA is going to go up when you're on your testosterone to
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  its natural level. You never let them scare you
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  into getting a biopsy. Always make them do an MRI
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  first. The MRI will in all likelihood
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  not be totally normal. Look, you're an older man.
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  You have an elevated PSA. You probably have prosthetic
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  hypertrophy. You probably have some nodules
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  in there. Do not panic.
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  This does not mean that you're going to benefit from radiation,
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  from surgery, from any of those other conventional treatments
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  that have been demonstrated not to help you avoid death from
• 6:35
  prostate cancer. Why do we still do this?
• 6:39
  Why are we still stuck in the cycle of a 1980s approach to
• 6:44
  prostate health and cancer? I believe in large measure it's
• 6:48
  inertia and it's a paradigm. It's an indoctrination on the
• 6:53
  part of the urologist who have taken possession of prostate
• 6:56
  health. We need and you need a more
• 7:00
  broadly trained clinician, primary care with experience in
• 7:04
  prostate cancer treatment. That's the way to go.
• 7:07
  Why? Because you're a lot more than
• 7:09
  your prostate gland, guys. And that prostate gland of all
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  the focus is on your PSA. You're going to miss the target.
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  What is the target? The target is not dying
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  prematurely from cancer or any other disease.
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  The target is avoiding harm and damaging you in the vain pursuit
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  of some abstract extension of life that's been proven, proven
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  not to happen. So yes, I like getting Psas
• 7:37
  checked. I don't like how they're
• 7:38
  currently interpreted. You really need a doctor with
• 7:42
  unique training and interest to take the time to talk to you and
• 7:47
  discuss what this means. Join my community.
• 7:53
  The Doctor Petriti Prostate Vitality Group is an online
• 7:57
  community of of men who have the same concern and interest.
• 8:02
  Most of them, many of them are my patients.
• 8:05
  But you don't have to be my patient.
• 8:06
  You join the community. Here's what happens.
• 8:09
  The fee you pay helps to fund what we do.
• 8:13
  We take no sponsors. We have no money from any
• 8:16
  source. When I talk about anything, it's
• 8:19
  because I believe in it and there's no dark money behind it.
• 8:23
  That's kind of unique. So that's cool, you get to fund
• 8:26
  that, but it's not a charitable endeavour.
• 8:28
  You're entering a community with a library, with ongoing
• 8:31
  information, with mutual discussion amongst the the men
• 8:36
  within the community, an honest place for older men to talk
• 8:40
  about sensitive topics and share their experience.
• 8:43
  And once a month go to meeting that I host question and
• 8:48
  answers. This is a big win.
• 8:50
  Look, we're trying to do nothing less than save older men from
• 8:55
  harm and change the paradigm of prostate cancer treatment.
• 9:00
  I don't think that what we're offering through my protocol is
• 9:05
  to be done concurrent with conventional therapy.
• 9:08
  I think conventional therapy needs to stop what they're
• 9:11
  doing, stop hurting men, and rethink the equation.
• 9:15
  Now. You owe it to yourself to get
• 9:17
  full information. So, yeah, listen to my podcast.
• 9:20
  Yes, listen to your conventional doctors make your best decision.
• 9:24
  We are all stuck in the same dilemma, men.
• 9:27
  Me, you, your spouse, the country at large, the doctors.
• 9:33
  We're trying to do 2 things at once.
• 9:34
  We're trying to treat you when we don't really have the answers
• 9:38
  we want. That's common in medicine.
• 9:41
  We have to do it concurrently. It took 15 years for the Protect
• 9:46
  T trial to prove that conventional treatment does not
• 9:50
  alter death rate from prostate cancer. 15 years.
• 9:54
  Well, guess what, you and I, we don't have another 15 years.
• 9:58
  We have to take information at hand, apply it, or we continue
• 10:01
  to study outcomes. This goes beyond your
• 10:06
  downloadable treatment pathway. In most cases, you know there
• 10:09
  are things you can gain. Read my book.
• 10:11
  That's fundamental. Join the community that's
• 10:15
  supportive. Then if you're not sure what to
• 10:18
  do, get your percent body fat to 20 or less.
• 10:21
  If you can do it, 20 is a threshold.
• 10:24
  Losing weight is not the trick, Losing fat is.
• 10:28
  That is an unequivocal accelerant or instigator of all
• 10:33
  forms of cancer, including prostate.
• 10:35
  So the PSA, if it's too low, get a testosterone level.
• 10:39
  If the testosterone is low, get it treated.
• 10:42
  Is there a threshold at which I would recommend you get
• 10:45
  testosterone therapy even if you feel great?
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  Yes, I think if your total testosterone is below 400, you
• 10:52
  absolutely should be on testosterone therapy.
• 10:55
  Now you can argue against that recommendation, but it'll be
• 10:59
  hard to do that. I'll debate you and I'll win the
• 11:03
  the free testosterone is worth looking at.
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  I don't want to get too much into those details.
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  I'll leave that to you and your functionally trained,
• 11:12
  intellectual medicine oriented clinician.
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  This is best done with a Doctor Who's leading the parade.
• 11:21
  I don't think you should download testosterone off the
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  Internet and hope for the best. That is a blunt tool to address
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  something very nuanced. You want to have a doc, Somebody
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  can guide you through everything.
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  Risks, benefits. What about estrogen?
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  What about? Well, we'll continue this
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  conversation then. Why?
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  Because I'm out there to save older men, right?
• 11:45
  Starting with me. But by extension, my enlightened
• 11:49
  self-interest will shed benefit unto you all.
• 11:53
  So thanks for being part of this community.
• 11:54
  Thank you, if you haven't already done it, for considering
• 11:57
  to join the Prostate Vitality, Dr. Petruti's prostate vitality
• 12:01
  community, a robust source of information in a way that you,
• 12:06
  you can become part of the solution, right?
• 12:08
  We're going to fund this ourselves.
• 12:10
  We're not taking big pharma money.
• 12:12
  We're not taking money from institutional entities that
• 12:17
  promote equipment. They're out there, and they
• 12:20
  typically hide their funding behind shell companies.
• 12:25
  And then you're going to buy my book.
• 12:26
  Man or woman, this information has universal benefit.
• 12:30
  Look, either you got a prostate or you know somebody who does
• 12:34
  and you love them and you want to know what that book contains.
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  All right, check the PSA. If it's too low, do not
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  celebrate before you look at your testosterone level.
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  Do not let them tell you death is imminent unless you do what
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  they say. That is a scare tactic that is
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  not bound in truth in 99% of the cases.
• 12:56
  Well, thanks for being part of the journey and thanks for
• 12:58
  tuning in this podcast. Look forward to our next time
• 13:00
  together. Bye now.