T Nation

25 Considering TRT Blood Panel


#1

Hello,

My name is Daniel. This is my first time posting on the forums.

I have (Last time I checked 6 months ago) a pituitary microadenoma (prolactinoma). I have taken Bromocriptine for several years (since I was 18) with no change in the size of the adenoma or blood serum prolactin. So, (being young and stupid) I stopped taking my medication, drank alcohol and sat around eating junk food for a long time. Naturally I gained a little weight around the mid section (42-1/2" waist and I'm 6'5") and lost almost all gains. So, I became disappointed in the person I had become. So, I started weight training, working on my 40yd dash, vertical jump, etc... to get into shape. I also started on a Targeted Ketosis Diet ( A variation of the keto diet except with carb ups with glucose rich food pre-workout) I went into get a blood panel done back in (7/29/14) (around the time I started to work out and eat better).

This is what my results were...

Name Value Reference Range
TSH 2.600 0.450-4.500 uIU/mL

Testosterone, Total, LC/MS 355.2 348.0-1197.0 ng/dL

Free Testosterone(Direct) 5.9 9.3-26.5 pg/mL

T4,Free(Direct) 1.60 0.82-1.77 ng/dL

Cortisol 26.4 2.3-19.4 ug/dL

LH 5.4 1.7-8.6 mIU/mL

FSH 3.4 1.5-12.4 mIU/mL

Prolactin 25.9 4.0-15.2 ng/mL

Insulin-Like Growth Factor I 177 115-355 ng/mL

I was shocked about the results to say the least. My prolactin was higher than ever and to my surprise my cortisol was high as well not only that but my total testosterone was in the range of an 80 year old man with my free test being below normal at all. However, my endocrinologist left me a voice mail after reviewing the results only mentioning that he wanted me to do a 24 hour urine test for my cortisol. With alot of research (reading through published and peer-reviewed medical studies, contacting cancer specialists across the country, etc...) I found out that taking curcumin (the flavonoid in the root turmeric) inhibits cell proliferation, induces apoptosis (programmed cell death of the tumor) as well as regulate cortisol and increase testosterone in hypogonadal men ( this is all because of its ability to bind to the CB1 receptor in the pituitary and it's antioxidant properties). So, I got around to doing the test on 9/24/14 (nearly 2 months later... 2 months more dieting... 2 months on curcumin). I did the urine test and I was in the normal rage! Here are the results for that...

TOTAL VOLUME 3000 mL
CORTISOL, FREE, URINE 42.5 4.0-50.0 mcg/24 h
CORTISOL, FREE, URINE 17.8 mcg/g creat
CREATININE, URINE 2.39 0.63-2.50 g/24 h

Ever since this test I have pretty much been doing the same thing. I have consistently gotten stronger and my waist is down to 38" flat ( down 4 1/2" ) as of today (1/11/15). I am trying to cut as much as possible (to 36" waist or 10-12% bf) while keeping my strength gains (so far I have been able to some how) until about march when I will go get my new blood work done. Im hoping and praying that all of my hormone levels will be in the normal range and if they are I will go into get an MRI to see how much the pituitary adenoma has shrunk (hopefully 100% gone). If they are not in normal range however I will definitely go on TRT and continue taking the antioxidant curcumin because I have seen it alter my hormones for the better (cortisol).

  • Any thoughts on my original blood panel?
  • Why didn't my endocrinologist talk about my low test?
  • Is it even safe to have my Free Test below normal range like that?
  • I feel like he should have tested my estrogen as well due to the weight gain on my chest and mid section/ hips... thoughts?

#2

We have a lot in common, It’s actually a bit scary lol (Even the same name, similar height)

Your TSH is not optimal, you should look deeper in to that. Read KSman’s thyroid sticky an test for TSH, Free T3, Free T4, and, antibodies.
Also a full set of labs CBC, Metabolic panel, retest Test, LH, FSH,and, add E2.

While your prolactin has a negative feed back on testosterone your FSH and LH don’t seem too suppressed, so there could be a mix of secondary and a bit of primary. Try cabergoline over bromo and get prolactin under control before the next set of labs.

When prolactin, thyroid, and, any other issues are treated, see how testosterone responds, if still low. Attempt SERM restart, this could work and reboot you HPTA if this fails, and the problem weren’t the testes you could try HCG monotherapy. If all fails HCG, TRT, and AI.

  • Most docs are useless with TRT.
  • Hypothyroid also leads to weight gain.
  • I wouldn’t say immediately unsafe, but it will affect your quality of life and your health in the long run.

#3

And note that if you don’t have a long term history of using iodized salt, you are probably iodine deficient and that can easily lead to low thyroid function which is best evaluated by checking body temps as per that sticky.

Why not take bromocriptine? Cabergoline 0.5mg/week might be better.


Typically, BEC is administered at an initial dose of 1.25 mg nightly with food and is gradually increased to 2.5 mg bid in 1-2 weeks, as tolerated. Doses larger than 7.5 mg/d are seldom needed except in the treatment of macroadenomas.
*** note dose is way more than 0.5mg/week
*** you really don’t want to take any drug with bromine in it if avoidable

  • basically side effect free for doses of interest - not dose levels for parkinson’s

Read the advice for new guys sticky.

Be worried about starvation diets!