T Nation

Anyone Feeling Better on Lower Doses?

Recently discussed options with a neuroendo to treat prolactin aside from surgery and some experimental drugs and the most favorable choice was to lower my dose of T in hopes E2 will stop driving prolactin up.

Success stories from those who have gone down in dose? Need a little inspiration here!

I did 60 e3.5d for Most of the 3 years on injections (120mg a week). It landed total T trough 900-925 and Free T in around 32-35ng/dL. My SHBG runs around 28-32. I now inject EOD 26mg which is equivalent to 91mg a week and feel really good. Been on this about 8 weeks now…Total T trough 818 and Free T 28ng/dL on last labs. I think I have found the lowest dose that relieves my low T symptoms. Time will tell!

My prolactin was high prior to TRT. The more I raise my dose, the lower prolactin gets.

There are other things you can be doing here. Not to mention, how high is your prolactin?

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You are injecting ED, right?
I dont think e2 is driving your prolactin up. I think its only your prolactinoma causing that.
I’ve discussed the prolactin issue with a lot of progressive doctors. I really believe you should remove your prolactinoma - surgery, gama knife or whatever you think is safest. I personally would choose the gama knife, I was ready to do it when they told me last year fals diagnosis I have adenoma, but then I did second NMR and it turned out to be empty sella which is not treatable in any way

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I don’t see how you can just recommend surgery on a forum board. He stated he was looking for options other than surgery or experimental drugs. I haven’t looked thoroughly but did the OP even confirm he has prolactinoma? Stress reduction, thyroid, exercise and meds are all options that can be tried first before undergoing surgery and the risks that come with it.
@OP I can’t answer your actual question as I have no experience with this, however have you confirmed the reason for your high prolactin levels is related to E2? If not try lowering your dose as noted and do bloods to establish if it had any effect. I’d really suggest following an endo’s advice and direction.

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I have followed his case for a long time and I have similar issues. Also he was recommended surgery from at least one doctor, he tried to control the prolactin with caber with no success so yes I recommend to follow his doctors recommendation for surgery

Mine was a little high prior to TRT, but now it’s the highest it’s been. It’s tricky because some of mine is bound to IgG (macroprolactin).

Before TRT it was in the 20-40 range, now it’s more like 60-80.

I was hoping TRT would drive it down some too, Dr Saya was thinking the same.

I’m still considering removal, but it’s definitely gone up since start TRT. Check this out:

https://www.endocrine-abstracts.org/ea/0049/ea0049ep836

How did you face the issue eventually?
E2 fueling pituitary gland to produce more prolactin is a well known issue in medical literature, as you pointed out.
And that means treatments would target E2 and not prolactin.

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Still facing it. Shortly after my last post, I started having really bad issues with libido, and after countering those with Cialis, it seems to have lowered my E2 to the point where the issue worsened. However, my prolactin stayed elevated during this period. So I don’t think that’s the entire issue.

I’ve also found enough research showing that macroprolactin causes sexual issues despite how it’s not supposed to:

Most of the men with macro-prolactinemia (78%) had erectile dysfunction as the presenting complaint

https://www.ncbi.nlm.nih.gov/pubmed/20558354

Another that’s female oriented:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4901097/#!po=50.0000

Taking a break from the Cialis, letting things level out again, and keeping up on blood tests to see where things stand. Actually going Monday.

Once this eases up, I’m planning to try quinagolide (an alternative to caber/bromo) to bring prolactin down. Regardless of TRT and E2 I have had elevated total prolactin for years now so I think giving treatment of that a shot is worthwhile.

I have another thread setup to document that trial - maybe the mods can merge if they feel it’s best: Quinagolide for Elevated Prolactin