Prostate-Specific Antigen (PSA), Free and Total
Adds the free-to-total ratio that helps tell benign prostate enlargement from cancer when total PSA is borderline.
Consider this test if:
- A previous total PSA came back in the 4 to 10 ng/mL range and you want to clarify biopsy risk
- Weighing whether to proceed with a prostate biopsy versus continue monitoring
- Family history of prostate cancer and you want a more detailed baseline
- Tracking PSA over time alongside symptoms of prostate enlargement
- HSA/FSA eligible
- Typical results in 1-2 days · Reviewed by a real clinician
- Drawn at a CLIA/CAP-accredited lab near you ·
Pre-test considerations
No fasting required. Avoid ejaculation for 24 to 48 hours before the draw, and schedule the blood test before any digital rectal exam, prostate biopsy, or vigorous cycling, since all of these can transiently raise PSA. If you take finasteride or dutasteride, note it, since these drugs lower PSA and the result is interpreted differently.
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What this test is for
PSA is a protein made by the prostate that circulates in two forms: bound to other proteins and free. This test reports total PSA, free PSA, and the percent free (free divided by total), which together refine prostate cancer risk better than total PSA alone. It is most useful in the borderline zone, total PSA between 4 and 10 ng/mL, where a higher percent free points toward benign enlargement and a lower percent free raises the probability of cancer, information that helps decide whether a biopsy is warranted. Elevated PSA is not specific to cancer: benign prostatic hyperplasia, prostatitis, recent ejaculation, and even a digital rectal exam can raise it. After treatment for prostate cancer, PSA falling to undetectable and staying there is a key sign the disease has not returned.
For first-pass screening, total PSA alone is usually enough. This free and total version earns its place when a total result lands in the gray zone and you want a clearer read before next steps. The separate ultrasensitive PSA is built for monitoring after prostate removal, where very low concentrations matter.
Biomarkers tested
Includes 3 biomarkers
Free PSA measures the fraction of prostate specific antigen that circulates unbound to blood proteins, as opposed to total PSA, which counts both bound and free forms. The ratio of free to total PSA helps distinguish benign prostate enlargement from prostate cancer when total PSA falls in a borderline range, since cancerous tissue tends to release more of the protein-bound form while benign tissue releases more free PSA. A low free PSA percentage raises suspicion for cancer and often prompts further evaluation, while a higher percentage supports a benign cause like BPH and can help men avoid an unnecessary biopsy.
- Specimen
- Serum or plasma
- Measures
- Mass concentration
This ratio compares free-floating PSA to total PSA in your blood, refining what a borderline total PSA result actually means. Prostate cancer cells tend to bind more PSA to carrier proteins, so a lower free-to-total ratio raises suspicion of cancer, while a higher ratio is more consistent with benign prostate enlargement. It's most useful after a total PSA lands in the gray zone (roughly 4 to 10 ng/mL), helping decide whether a biopsy is warranted or whether monitoring is reasonable.
- Specimen
- Serum or plasma
- Measures
- Mass fraction (%)
PSA is a protein made by prostate cells, and this test measures its total concentration in blood without separating the free and bound fractions. Levels rise with prostate enlargement, inflammation (prostatitis), and prostate cancer, which is why it's the standard tool for prostate cancer screening in men over 50 (or earlier with family history) and for tracking known prostate conditions over time. Rising trends matter as much as single values, so testing PSA on a routine schedule lets you catch upward movement early rather than reacting to a single high number.
- Specimen
- Serum or plasma
- Measures
- Mass concentration
What you'll learn
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Insights that connect the dots. A clinician reads your whole picture, not one result in isolation, connecting family history, past results, and lifestyle into clear next steps.
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Your personalized action plan. Nutrition, supplements, and training in one clinician-reviewed protocol, updated as your results change.
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Track your trends. Upload results from any lab and see each biomarker trend over time, so you know what is working.
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Never miss a recheck. Mito tells you what is worth retesting and when, then reminds you so nothing slips.
What to expect
- 1 Book instantly
Click, book, done. Choose a convenient lab location near you. Transparent, up-front pricing.
- 2 Quick lab visit
Testing to fit your busy schedule, usually 15 minutes or less. Walk-in and appointments available.
- 3 Typical results in 1-2 days
Your results post straight to your dashboard as soon as the lab completes them.
- 4 Expert guidance
Included with Mito membership. A clinician reviews your results and your personalized action plan follows, with clear next steps.
Everything your health needs,
in one membership
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Every test at our cost
Members pay our cost on every test, with lab fees passed straight through. The full receipt is itemized, never padded.
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Continuous tracking, all in one place
Upload past labs and watch your trends over time. Every marker and visit lives in one longitudinal record, so all your care stays together.
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Year-round clinician support
Text anytime and get clinician-reviewed answers. When you want to go deeper, 1:1 consultations are available at affordable rates.
All for $9/month
Order any test or consult without joining. For $9/month, members unlock member prices, trend tracking, and year-round clinician guidance.
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Frequently asked questions
View all FAQsHow does pricing work?
Every test shows the member price next to the standard non-member price, so you can see what membership saves you. The member price is our cost, covering the lab and what it takes to run the service. It is never a profit on the test itself. Mito makes its money on the $9 membership, not on marking up your tests. Membership is $9 per month, and any applicable lab order or draw fee is itemized before you pay.
Where do I get tested?
Choose an available partner lab at checkout. If your cart contains multiple blood tests, Mito helps consolidate the eligible tests at one lab when possible. At-home kits and scans follow the collection or appointment process shown on their product page.
Is this eligible for HSA/FSA?
Yes. Eligible tests can be paid for with an HSA or FSA card at checkout.
When will I get my results?
Your results appear in your Mito dashboard after the laboratory completes processing. A clinician then reviews them before your analysis and personalized action plan are finalized. Timing varies by test, and specialty assays and at-home kits may take longer.
Do I need a physician's order?
No. Mito provides the laboratory order when one is required, so you do not need to arrange a separate physician visit before purchasing.
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