T Nation

22 Y/O with Pituitary Tumor


#1

hey,
i’m going to make it short.
i was diagnosed with a pituitary gland tumor 3 years ago after feeling depressed for no reason and a disappeared sex drive. the tumor was creating too much prolactin and therefore my testosterone and dopamine were low.

so i was put on cabergoline which decreased my prolactin almost to zero and boosted my total testosterone from 250 ng/ml to 650 ng/ml at some point. at that point I started to feel better more energy and a better sexdrive.

after my last bloodcheck i found out my results were the following:

total testosterone: 3.66 ng/ml
shbg: 18 nmol/L
index free testosterone: 72.10
androstanediol gluc. : 13.2 ng/ml
FSH: 1.6 U/L
LH: 5.8 U/L

I still take cabergoline twice a week (no side effects) but I could feel much better ( mood, sex drive, erections, sperm volume, etc ). I told my endocrinologist my free test is way too low but she said I was in the average ( low end ) so it’s ok. I have to disagree with her.

what do you guys think about those numbers?


#2

Recon you can post the ranges to those labs? It’s hard to tell without them with different measurements.


#4

total testosterone: 3.66 ng/ml ( 2.80 - 11.00 )
shbg: 18 nmol/L ( 10 - 57 )
index free testosterone: 72.10 ( 20.00 - 96.00 )
androstanediol gluc. : 13.2 ng/ml ( 3.4 - 22.00 )
FSH: 1.6 U/L ( 1.4 - 18.1 )
LH: 5.8 U/L ( 1.5 - 9.3 )


#5

Average for a health virile young male? - not

FT index 72.10 means nothing as it is free amount of low TT

FSH and LH are usually broadly similar. May be lingering effect of adinoma. Also, FSH has a decent half life, but LH is short, so a snap shot of LH is not very informative, but does seem low.

I am calling this collateral damage to the pituitary.

At 22YO, TRT needs hCG or infertility is probable. You might do OK on hCG injections alone, with some SERM in place of hCG from time to time.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

You need to check FT directly in the future, not calculated.

Doctors are the problem. Please study the stickies, you need to know more than the docs and that is not hard.


#6

First of all thanks for the reply. I’ve been reading the stickies and it cleared my mind up a little.
here are some other results from the same previous labs. one important thing to note is that I only had 1h of sleep before the blood check because I have a delayed sleep phase syndrome which I know obviously affected my labs.

sodium: 140 nmol/L ( 136 - 145 )
potassium: 3.9 nmol/L ( 100 - 109 )
chloride: 100 nmol/L ( 100 - 109 )
alkaline reserve: 30 nmol/L ( 22 - 31 )

total cholesterol: 136 mg/dL ( < 190 )
triglycerides: 103 mg/dL ( < 150 )
HDL cholesterol: 38 mg/dL ( > 40 )
calculated LDL cholesterol: 77 mg/dL ( < 115 )
no HDL cholesterol ( total cholesterol - HDL cholesterol): 98 mg/dl
total cholesterol/HDL: 3.6 ( < 5.0 )

TSH: 4.795 mU/L ( 0.300 - 4.000 )
free T4: 15.4 pmol/L ( 9.0 - 26.0 )
free T3: 6.3 pmol/L ( 3.5 - 6.5 )

morning cortisol: 36 ng/mL ( 50 - 250 )
DHEA-sulfate: 3270 ng/mL ( 800 - 5600 )
androstenedione: 0.87 ng/mL ( 0.60 - 3.10 )

prolactin: 0.8 μg/L. ( 2.1 - 17.7 )

I’m also from Belgium so sorry if the labs measurements are different or if some terms are not correct. I’ll ask my my endo to measure my free T directly and also my E2 levels for my next blood check.

low FSH is caused by my prolactinoma tumor which explains why my sperm count is low and my erections are not so great.

It also seems like i have a subclinical hypothyroidism and maybe an adrenal fatigue looking at those numbers. I think my iodine intake is ok as eat pure sea salt daily with every meal. My diet lately has been consisting of mostly organic foods: eggs, lean chicken meat, olive oil and a lot of veggies and fruits especially bananas. my carb intakes are mainly bananas, white rice and bread.

throughout my 2 years of cabergoline treatment my prolactin has been under the average around 0. I’ve read today that that to low prolactin levels can cause problems as well.


#7

Please check that above is correct number.

Cholesterol=136 is too low. Diet? Cholesterol<160 is associated with increased all-cause mortality. Think about what that means. Cholesterol is the foundation for all of your steroid hormones, including cortisol and Vit-D3. Eat more animal fats and eggs.

In your climate, you are probably Vit-D3 deficient. Take 5,000iu per day. Take 25,000 for first 5 days.

TSH should be near to 1.0
fT4 and fT3 should be near mid range or a bit higher.
Your high TSH and high fT3 with low cortisol suggests adrenal fatigue.
Read the thyroid basics sticky and post your oral body temperatures.
Past and current stresses and major stress events are factors.

You should be taking 0,5mg/week Dostinex/cabergoline in divided doses to reduce prolactin and shrink the adinoma. Your labs suggest that you are medicating.

I am not aware of any problems in males from low prolactin.

There is no iodine in sea salt unless the packaging states that it is iodized!
Are your outer eyebrows sparse?
Do you feel cold easily? - always that way?

https://www.google.com/search?q=iodine+deficienty+belgium&ie=utf-8&oe=utf-8


#8

No, my outer eyebrows aren’t sparse and I don’t particularly feel cold. However sometimes my hand palms and fingers do.
Thanks! I started to buy ionized salt. I’ll post my oral body temperature soon with my new labs.
As far as stress events goes, I was extremely nervous and lacked of self confidence in my teenager years and I was constantly sleep deprived so yes I suffered from a lot of stress. But things got way better when I graduated from college and got a job. You stated i may need hCG along with some SERM. but why not use an AI if it helps to pass more free T to the androgen receptors? Especially if hCG might boost my T and E2 levels.


#9

hCG to importantly to preserve fertility, SERM replacing hCG occasionally to generate some FSH. You should do labs on SERM at some point to see LH/FSH levels.

Yes, you need anastrozole as required to get near E2=22pg/ml, that is an ever constant.

See the thyroid basics sticky re iodine etc.
Good to have multi-vitamins that have iodine+selenium and males should avoid vitamins that have iron.