The Other Markers in My Package
Table of contents
The rest of this series covers the markers that moved between my April and October 2026 screenings. This last article sweeps up everything else. Some were only tested in April as part of a general screening package (tumour markers, PSA, an EBV test and hormones). Others were tested both times and just sat there being normal.
Everything here was normal. But for some of these tests, “normal” means less than you might think, so this article is as much about the caveats as the results.
Tumour markers, PSA and EBV (April only)
| Test | What it’s linked to | My result (April 2026) | Reference | Status |
|---|---|---|---|---|
| AFP | Liver and some testicular cancers | 1.8 µg/L | <7.1 | ✅ |
| CEA | Bowel and other cancers | 1.5 µg/L | <5.0 | ✅ |
| CA 19-9 | Pancreatic and bile duct cancers | 4 U/mL | <39 | ✅ |
| PSA (total) | Prostate | 0.694 µg/L | <4.0 | ✅ |
| EBV EA + EBNA-1 IgA | Nasopharyngeal cancer | Negative (1.5 EU/mL) | <7.2 | ✅ |
What they are
These are substances in the blood that can rise when certain cancers are present:
- AFP, CEA and CA 19-9 are proteins that some tumours release. They were developed mainly to monitor people who already have a cancer diagnosis, for example to see whether treatment is working or the cancer has come back.
- PSA (prostate-specific antigen) is made by the prostate. It goes up with prostate cancer, but also with an enlarged prostate, infection, recent exercise like cycling, or ejaculation.
- EBV IgA tests for antibodies to the Epstein-Barr virus (the glandular fever virus). Raised levels are associated with nasopharyngeal cancer (cancer at the back of the nose), which is more common in Southern Chinese populations. That’s why it often turns up in Singapore screening packages.
The big caveat: these aren’t good screening tests at my age
I’m glad they’re all normal. But I want to be honest that none of these is a recommended screening test for a healthy 34-year-old man, and I wouldn’t go out of my way to get them. That’s because:
- False alarms. These markers can be raised for lots of harmless reasons. A high result can lead to scans, more tests, sometimes biopsies, and a lot of worry, usually for nothing.
- False reassurance. A normal result doesn’t rule cancer out. Many early cancers don’t raise these markers at all. So “my tumour markers are normal” doesn’t mean “I don’t have cancer”.
- PSA has its own guidelines. PSA screening is a shared decision with a doctor, usually discussed from around age 50, or 45 if you have a family history of prostate cancer. At 34, without symptoms, it’s not something that’s routinely done.
- EBV testing is a bit different. It’s sometimes recommended for people at higher risk of nasopharyngeal cancer, such as those with a family history. It’s still a conversation to have with a doctor rather than something to tick off.
If you want cancer screening, the ones with good evidence behind them are age-based, like bowel cancer screening from age 50 in Singapore. Ask your doctor which apply to you.
Testosterone and related hormones (April only)
| Test | My result (April 2026) | Reference | Status |
|---|---|---|---|
| Testosterone | 15.70 nmol/L | 8.64–29.00 | ✅ mid-range |
| LH | 3.8 IU/L | 1.7–8.6 | ✅ |
| FSH | 7.7 IU/L | 1.5–12.4 | ✅ |
Testosterone is the main male sex hormone. It affects muscle, energy, mood, libido and bone strength. LH and FSH are the signals from the brain’s pituitary gland that tell the testes to make testosterone and sperm. Looking at all three together shows whether the whole system is working. In April, all three were comfortably in range.
Why I’d want this retested
Testosterone wasn’t part of my October tests, so I don’t have a before and after. That’s a shame, because a lot happened in between: I cut from 70.5 kg to 63.6 kg for a BJJ competition, my body fat dropped to 9.55%, and I was training up to 6 times a week.
That combination is exactly what can push testosterone down. When you’re eating less energy than your training uses for a long time (called “low energy availability”), the body cuts back on things it sees as non-essential, and reproductive hormones are high on that list. In men this can show up as lower testosterone, low energy, poor recovery and a dip in libido. It usually recovers once you eat enough again.
My fasting insulin also came back below the lab range in October, which is another sign of how lean I was at the time (see Fasting Insulin & HOMA-IR). If I feel flat once I’m back to training, testosterone is one I’d ask to have checked. More on why I’m not chasing an even lower body fat in Body Fat.
The steady markers
These were tested in both April and October and didn’t need their own article: normal both times, and barely moved.
| Marker | April 2026 | October 2026 | Reference | Status |
|---|---|---|---|---|
| TSH (thyroid) | 1.310 mIU/L | 1.160 mIU/L | 0.27–4.20 | ✅ |
| Free T4 (thyroid) | 19.6 pmol/L | 17.9 pmol/L | 12.0–22.0 | ✅ |
| Sodium | 138 mmol/L | 136 mmol/L | 136–145 | ✅ |
| Potassium | 4.2 mmol/L | 4.4 mmol/L | 3.5–5.3 | ✅ |
| Calcium (adjusted) | 2.31 mmol/L | 2.31 mmol/L | 2.10–2.60 | ✅ |
| Magnesium | 0.78 mmol/L | 0.79 mmol/L | 0.66–1.07 | ✅ |
| Phosphate | 1.29 mmol/L | 1.18 mmol/L | 0.81–1.45 | ✅ |
| Albumin | 44 g/L | 47 g/L | 35–50 | ✅ |
| Platelets | 190 ×10⁹/L | 242 ×10⁹/L | 140–440 | ✅ |
| White cell count | 4.1 ×10⁹/L | 4.1 ×10⁹/L | 4.0–11.0 | ⚠️ bottom edge |
A few quick notes:
- Thyroid. TSH and free T4 together show how well the thyroid is running, and it controls metabolism. Both were normal and steady, which is reassuring through a big cut.
- Electrolytes and minerals (sodium, potassium, calcium, magnesium, phosphate) are kept in a tight range by the kidneys. Sodium was right at the bottom edge in October, which can happen with a lot of fluid intake or sweating. It was still in range.
- White cells were 4.1 both times, just above the bottom of the range (4.0). A lower-normal white count is fairly common in fit, lean people and isn’t a concern on its own. Since it hasn’t moved, I’ll just keep an eye on it at the next full blood count.
What’s next
- Nothing to act on for the tumour markers, PSA or EBV. They were a one-off as part of the April package.
- If I retest, I’d add testosterone to see whether the cut affected it.
- Keep an eye on the white cell count at the next full blood count.
This is my own personal data, shared for interest only. It’s not medical advice.
Until next time, peace and love!