Feeling Fine Is Not a Lab Result

PSA awareness, hormone monitoring, and the men's health checkup you should not keep postponing

By Dr. Steve Tieche

Men are interesting about maintenance.

We will change the oil in a truck on schedule, rotate the tires, replace a filter before a long trip, and notice a new engine sound from three lanes away. Then someone asks when we last had labs drawn, and suddenly we become very relaxed about preventive maintenance.

“I feel fine, Doc.”

I am glad you feel fine. I would like to help you keep feeling fine. But feeling fine does not tell me your blood pressure, glucose, cholesterol, hematocrit, testosterone, kidney function, liver function, or PSA. Many health problems are quiet before they become expensive, complicated, frightening, or difficult to treat.

That is why regular medical care matters even if you do not have ED, low energy, urinary symptoms, or any other obvious complaint.

Your Body Does Not Always Send an Early Warning

High blood pressure can be silent. Diabetes and insulin resistance can progress before a man feels sick. Cholesterol problems do not usually announce themselves. Early prostate cancer often causes no symptoms.

Even ED can be more than a bedroom problem. In some men, it may be one of the first noticeable clues of vascular, metabolic, hormonal, medication-related, or neurologic disease.

The point is not to scare you into ordering every test available. More testing is not automatically better medicine. The point is to have a physician who knows you, understands your risks, orders the right labs at the right intervals, and notices when something changes.

A single lab result is a photograph. A well-maintained medical record is a movie. Trends are important.

PSA: Important, Useful, and Often Misunderstood

PSA stands for prostate-specific antigen. It is a protein produced by prostate tissue, and a PSA test measures the level in the blood.

PSA is prostate-specific, but it is not cancer-specific. A higher result can occur with prostate cancer, but it may also rise because of benign prostate enlargement, prostatitis, a urinary infection, recent ejaculation, certain procedures, or other factors. A PSA result does not diagnose prostate cancer by itself.

That means two things:

First, do not panic over one number.

Second, do not ignore it either.

The value of PSA is in interpreting it in context: age, risk factors, family history, race, symptoms, medications, prostate history, prior results, and the pattern over time. Sometimes the right next step is simply repeating the test under appropriate conditions. Sometimes it is additional testing or referral to a urologist.

National recommendations are not identical for every man. The decision to begin or continue PSA-based screening should be individualized through a discussion of benefits and possible harms. Men with higher-risk factors, such as a strong family history or Black ancestry, may need that conversation earlier. Older age, overall health, and life expectancy also change the balance.

What I do not recommend is reaching the age when prostate health should have been discussed and discovering that no one has ever established a baseline or reviewed your risk.

A Patient Whose Trend Changed the Plan

Here is a situation I have seen in different forms many times. A man came in for routine follow-up and felt well. No pain. No major urinary complaint. No dramatic change that would have forced him to make an appointment.

His PSA, however, had risen compared with his previous baseline.

That did not automatically mean cancer. We reviewed factors that can temporarily affect PSA, repeated the test appropriately, and made sure he received the follow-up and specialist evaluation the situation called for. The important part of the story is not a frightening diagnosis. The important part is that we had a previous result for comparison and a physician paying attention to the trend.

Without regular labs, there would have been no trend to notice.

If You Use Testosterone, Monitoring Is Not Optional

Men sometimes treat testosterone like a gym supplement: find a dose that feels good and keep using it indefinitely. That is not responsible hormone care.

Testosterone therapy should begin with a proper diagnosis and an evaluation of whether treatment is appropriate. Once treatment starts, follow-up will include symptoms, testosterone levels, estradiol levels, a complete blood count and hematocrit, and prostate monitoring. Other testing may be needed based on the individual.

Why check the blood count? Testosterone can increase red blood cell production. If hematocrit rises too much, the treatment plan may need to change.

Why discuss PSA? Prostate risk should be considered before and during therapy according to the patient's age, risk, symptoms, prior results, and screening preferences. A concerning PSA result or prostate finding may require urologic evaluation.

Why do we check estradiol? Some testosterone naturally converts to estradiol. If the level becomes too high—or a man develops symptoms—we may adjust his treatment plan. In select cases, we may use a carefully dosed aromatase inhibitor, sometimes called an estrogen blocker. Men need estradiol too, so the goal is balance—not eliminating it.

Why review symptoms? Because the goal is not simply a higher testosterone number. We want to know whether energy, libido, mood, strength, cognition, and overall quality of life are improving without creating unnecessary risk.

This is why experience matters. Hormone therapy is not always straightforward, and follow-up should not be an optional add-on after the sale. 

What Labs Might Be Part of a Men's Health Review?

The answer depends on the man. Based on age, symptoms, medical history, medications, and treatment, a physician may consider:

Complete blood count, including hemoglobin and hematocrit

Comprehensive metabolic testing, including kidney and liver markers

Fasting glucose and/or A1C

Cholesterol and triglycerides

Testosterone labs

Estradiol labs

Thyroid labs

PSA 

Iron and ferritin labs

Additional hormone, nutrient, cardiovascular, or metabolic testing based on the individual

This is not a shopping list to order on your own. It is a starting point for a medical conversation.

Men's Health and Women's Health Belong in the Same Conversation

Cynthia's women's sexual-wellness series makes an important point: intimacy can change because of hormones, dryness, discomfort, sensitivity, stress, health conditions, or aging-related changes—and help may be available.

The same is true for men. When both partners understand that sexual wellness is part of health, the conversation becomes less about blame and more about solving the problem together.

Read her series. Share this series with your spouse. Then stop having two separate silent problems in the same marriage.

Cynthia Tieche's Women's Sexual Wellness series

• Hormones. PRP. Scream Cream. Vaginal Laser. No whispering required!
• Yes, I Tried the PRP Sex Shot - and Scream Cream Too!
• The Vaginal Laser Her Husband Noticed - and She Never Told Him!

Recharge Clinic's previous men's hormone, PSA, and “normal vs. optimal” blogs]

Build a Relationship With a Physician Before You Need One

The best time to establish care is not after five years of ED, after a frightening lab result, or after an urgent problem. It is while you feel well enough to be proactive.

At Recharge Clinic, we look at the whole patient. We can review symptoms, health history, medications, hormone concerns, sexual performance, and appropriate labs. If something requires a specialist, we help identify that next step.

I have treated thousands of men, and I can tell you this plainly: the men who do best are not always the men who started with the best numbers. They are often the men who stayed engaged, followed up, asked questions, and adjusted the plan when their health changed.

Recharge Clinic offers free consultations for men's hormone and sexual-wellness services. You do not need to wait for a problem—or know exactly which labs or treatments you need—to start the conversation.

Book a FREE consultation and receive a $20 Recharge credit!

Frequently Asked Questions

1. Do I need regular labs if I feel healthy and have no sexual symptoms?

Yes, you should still have regular medical care, but the exact tests and intervals should be individualized. Blood pressure, diabetes, cholesterol problems, prostate disease, and other conditions may be present before symptoms become obvious. Your physician can recommend testing based on age, history, medications, family risk, and prior results.

2. Does an elevated PSA mean I have prostate cancer?

No. PSA can rise for several reasons, including benign prostate enlargement, inflammation, infection, recent ejaculation, and prostate cancer. The result must be interpreted in context and may need to be repeated or evaluated further.

3. How should I prepare for a PSA test?

Ask your provider for instructions. Recent ejaculation and some activities, infections, procedures, and medications may affect a result. Tell your provider about urinary symptoms, recent procedures, and every medication you take. Do not stop a prescription unless your provider tells you to.

4. How often should PSA and testosterone be checked?

There is no single schedule for every man. PSA screening decisions depend on age, risk, overall health, prior results, and personal preferences. Men receiving testosterone need a monitoring plan based on their baseline evaluation, treatment method, symptoms, lab response, and risk factors. Your provider should tell you what will be checked and when.

5. Where can I get men's health labs and a free consultation at Recharge Clinic?

Recharge Clinic serves men in Ocala, Lady Lake/The Villages, and Clermont. We offer free consultations for men's hormone and sexual-wellness services, and our team can explain which visits, labs, or in-person evaluations may be appropriate.

External References

U.S. Preventive Services Task Force: Prostate Cancer Screening Recommendation

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MedlinePlus, U.S. National Library of Medicine: Prostate-Specific Antigen (PSA) Test

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Medical note: This article is for education only and does not replace an individualized medical evaluation. Screening and monitoring decisions should be made with a qualified medical provider who knows your history and risk factors.

Recharge Clinic  •  Men's Sexual Health & Performance  •