Oh, where to begin. First of all, thank you to everyone that has shared and contributed their stories and advice on this forum. Now I need your help in understanding what to do next.
With low-normal Total Test, I’m hoping that getting Prolactin and SHBG in check will improve my Free Test.
ME: 31 year old, non-drinker/smoker, physically active (crossfit/mountaineer), healthy eating, male with typical “low t” symptoms, including a massively depleted libido, low energy, sadness/negative moodiness, lack of muscle development, poor sleep, etc.
…went to Men’s Clinic…
Had my levels run, most things look in range except for SHBG and Prolactin, which are both high and can negatively affect Free T.
Hemoglobin A1c - 5.3 (4.8-5.6)
Testosterone, Serum - 536 (348-1197)
SHBG - 54.5 (16.5-55.9)
Prolactin - 17.2 (4-15.2)
Tsh - 2.33 (.45-4.50)
LH - 6.5 (1.7-8.6)
E2 - 18 (7.6-42.6)
Prostate - .4 (0.0-4.0)
Free Test (calculated) ~ 9 ng/dl
HIGH SHBG: As many of you know, the more SHBG you have, the more of your total test is bound up, leaving less of it free to do the good stuff. And since two thirds of circulating testosterone is bound to SHBG, having high SHBG means you have less Free T to use.
HIGH PROLACTIN: Makes sense with the tenderness I experience in my nipples.
Prolactin is produced in pituitary gland. One of the reasons for high prolactin is prolactin-producing adenomas (also called “prolactinomas”), which are benign (non-cancerous) tumors.
Low thyroid function is another cause of raised prolactin levels. However, my thyroid levels are normal, so it must be something else.
For high Prolactin, the most commonly used medicines are cabergoline and bromocriptine. OTA/Herbal remedies include Ashwagandha, Mucuna Pruriens, B6, Zinc and Vitamin E.
For high SHBG, it is not typically treated directly through prescription means. OTA/Herbal remedies include Boron, Magnesium and Vitamin D.
Doc recommended getting a pituitary MRI to determine if cause of high prolactin is a tumor. Scheduled an appointment for next week with an Endo to discuss.
Consider the possibility and side effects of taking Cabergoline vs Herbal Remedies like Mucuna Pruriens.
Am I missing anything here?
Feeling a lot of helplessness and self-pity over not being able to fix this. If Cabergoline is prescribed, should that help lower SHBG as well or should I also try some of the herbal remedies to lower SHBG more directly? In other words, is high Prolactin linked to high SHBG? Saw this somewhere, but don’t quite understand if it is correlation or causation: > “Testosterone is dopaminergic. High SHBG = Low Free Testosterone . Low Free Testosterone = Lower Dopamine. Lower Dopamine = Higher Prolactin.”
For anyone that has used Dostinex/Cabergoline, should correcting Prolactin levels be enough alone to send Free Test levels in a positive direction or does that have more to do with SHBG?