T Nation

High E2 Levels Causing Prolactin to Rise?

hey guys,

I just came off a ph cycle and took nolva for my pct. to make a long story short ive been off of nolva for 2 months now. I got bloodwork done while i was on tamoxifen, 17 days post tamox, and 2months post tamox.

while on tamox
prolactin- 9.9
estrodial- 48.6

17 days after
prolactin- 10.9
estrodial- 46.3

2 months after
prolactin 12.6
estrodial- 30.3

as you can see the estrodial levels dropped a ton but they are definitely still elevated. can elevated e2 levels cause prolactin levels to rise? If so would taking an AI be smart instead of taking a prolactin antagonist like caber or prami? because if i take the AI it will lower the estrodial levels and will ultimately lower the prolactin. I just started taking vit b6 as well to help with the prolactin.

thanks,
-eric

Yes, increased estradiol acts towards increasing prolactin.

On the other hand, assuming your figures are pg/mL, 30 is not really an elevated E2 value. It could be desirable to tweak the value a little below this, but you wouldn’t want more than a 33% reduction. So that probably is not going to be a major factor with regard to your prolactin level.

Assuming the prolactin level is in ng/mL, those values are really not unusually high either.

Is there some actual symptom, such as lactation, that has you concerned about prolactin?

well my libido still isnt back. its definitely improving. my nipples are still puffy and i can squeeze them and make stuff come out. also my nipples are weird. the actual nipple part where stuff can come out of they are like bubbles almost. thats the besti can describe them. so im guessing my prolactin/ estrodial levels are still elevated from baseline levels. i ordered some letro that im going to take on a low dose to see if my symptoms improve and get bloodwork done in about 10 days.

I just started liquid letro today. I started with .5 mgs for a preload affect if you will and will continue on .25 mgs ED. Hopefully this will reduce my estrodial and my prolactin will come with it. Will .25 mgs of letro cause my e2 to go down so low that it will make my libido worse? should i take that dosage every other day? I am going to get bloodwork done in 10 days or so to see where im at and taper off the letro so i do not get a rebound affect. I am also taking vit B6 everyday. 200 mgs 3 times a day. what do you think about this protocol Mr. Roberts?

It’s hard to estimate: if your estradiol level was in pg/mL which I suppose it was, then all that was called for was a tweaking. It’s possible that 0.25 mg/day might overcompensate. It also quite well might not. It’s not an unreasonable guess though as to what might be right in your case.

Especially if not frontloading, a value taken only 10 days in won’t be too reflective of long term results.

The frontload would be to take 3 days’ worth on the first day, then go to the daily dosing. I would still rather do the E2 test 14 days into it rather than at 10 days.

yea i thought about doing a lot higher dosage on the first day but I wanted to see how my body reacted to it. I did feel really light headed and out of it after I took it but it could have just been a coincidence. Im going to start .25 mgs tomorrow. Ok so youre saying if I took it for 10 days and then stopped, basically my e2 would just go back up to where it was? Do you figure this is why my prolactin was on the rise because of the elevated estrodial? I know nolva upregulates the progestin receptor and the elevated estrodial isnt helping that at all. I’m not sure if its all in my head but my libido was higher today than it has been since ive been having these issues.

thanks a lot Mr. Roberts, I really appreciate your input
-eric

Well, any individual reading from a blood test is only a snapshot, so it is possible that while your E2 value was midrange at that particular time, it might be higher at other times. But that is speculation: I’m saying only that we don’t know that it may not be higher at other times.

But if the 30 pg/mL is a typical value for you, then it really doesn’t explain high prolactin.

On the letrozole dosing, I wasn’t clear: I wasn’t referring to using for some number of days and then suddenly stopping. But rather, because letrozole stays in the system for some time (the half life is 2 days or longer) the amount in the system on any one day, if one has been using the drug for say at least a couple of weeks, is not only the amount taken that day, but most of what was taken the previous day, about half of what was taken 2 days ago, perhaps roughly a third of that which was taken three days ago, about a quarter of what was taken 4 days ago, etc.

But if all a user does is just take the regular daily dose from the beginning, then obviously that’s not the case, and it takes quite some time for levels to build up to where they should be for the dose in question.

The frontloading method bypasses that buildup time and gets levels approximately correct fairly promptly.

ok well I dont have pre cycle bloodwork to compare to unfortunately. But im guessing since my libido isnt back to normal yet that the prolactin has to be it. and since I can still squeeze stuff of out my nipples that my prolactin is high even though it is in normal range, it is not normal for me.

And the fact that my nipples are puffy that my estrodial is still elevated and maybe that is causing the prolactin to rise. Also here is my last full blood work. could the high estrodial be suppressing me hpta and maybe causing my total and free test levels to be lower than normal?

Im only 19 and these numbers look a little low. especially free T. Did I just screw my self up from pro hormone use and im screwed for life?

bloodwork #3 ( approximately 2 months post tamox probably a little less)
Total test- 535 ng/dl(280-800)
free test- 9.9 pg/ml (no range given)
LH- 5.2 miu/ml
FSH- 3.1 miu/ml
total estrogens-80 ( <
estrodial-30.4
prolactin 12.1 ng/ml

like I said before I have no pre cycle bloodwork so maybe my test levels were just on the lower end to begin with. I dont really have hardly any facial hair, my voice isnt very deep, and its hard for me to put on muscle naturally and I have a very strict diet and workout plan so I know its not that.

ok well my nipples are still puffy so im guessing that means my estrodial is still elevated. and I can still squeeze stuff out of my nipples so that would mean my prolactin is still elevated as well. Those two together explains the low libido right?

So taking an AI should fix those two things. also I read that high estrodial suppresses the hpta so maybe that would explain my test being kind of on the lower end? Or maybe I just never had high test to begin with.

i dont have a lot of facial hair and am not a really hairy person in general, I dont really have a deep voice, and Ive always had trouble making any substantial gains naturally. I have a very strict diet and training program and work my ass off in the gym so I know for a fact thats not it.

Is it possible to make my natural test levels lower just from taking one month pro hormone cycles? I took a few earlier and never had libido problems but then again I never took a compound like the last one (which consisted of tren and bold) here are my last bloodwork values if you want to take a look at them.

bloodwork #1 ( on tamoxifen )
testosterone, serum- 1029 ng/dl (280-800)
free testosterone- 24.9 pg/ml (9.3-26.5 pg/ml)
LH- 18.0 (1.7-8.6)
FSH- 11.6 (1.5-12.4)
TSH- 1.630 (0.450-4.500)
Estrodial- 48.3 pg/ml (7.6-42.6)
prolactin- 9.3 ng/ml (4.0-15.2)
estrogens, total- 110 (40-115)

bloodwork #2 ( 17 days post tamox)
testosterone, serum- 730 ng/dl (280-800)
free testosterone- 18.3 pg/ml (9.3-26.5 pg/ml)
LH- 7.8 (1.7-8.6)
FSH- 5.5 (1.5-12.4)
Estrodial- 46.6 pg/ml (7.6-42.6)
prolactin- 10.9 ng/ml (4.0-15.2)

bloodwork #3 ( approximately 2 months post tamox probably a little less)
Total test- 535 ng/dl
free test- 9.9 pg/ml
LH- 5.2 miu/ml
FSH- 3.1 miu/ml
total estrogens-80
estrodial-30.4
prolactin 12.1 ng/ml

Do my free test levels look pretty low to you? could the elevated estrodial be causing hpta suppression?

thanks so much for the replies,
-Eric

also am I going to get estro rebound from taking .25 mgs a day and then tapering by taking eod and e3d? ive seen a lot about peoplegetting estro rebound from letro but at such a low dose I couldnt see this happening as long as I taper off. What do you think?

any input on that Mr. Roberts?

Eric if you can squeeze stuff out of your nipples I’d definitely say you need to be adding ancillaries you aren’t taking now. I’d look to cabergoline, especially if you are lactating

yea I think I need to as well but isnt there something that has to be causing the high prolactin levels? If I take a dopamine agonist like prami or caber it will bring my levels down but once im off of it wont it just start rising again if I dont find out the problem

Your earlier posts didn’t give the reference normal levels for the particular tests you took, which provided a problem for interpretation. For some reason, the particular lab you used gets different values than what is more typical. At your lab, we now see that 30 pg/mL is rather than being only 50% above the bottom of the range, and about half of the top of the range, is nearly 4 times the bottom of their range and about 3/4 the top of the range.

Now still, 3/4 of the top of the range is a common value and ordinarily would not cause (indirectly) lactation. I don’t know why that is happening for you.

Ditto on the prolactin level.

However, I would use pramipexole to reduce prolactin anyway, and also preferably adjust estradiol down to a lower value. I really don’t know what to suggest on the odd scale that they are using, but aiming for 20 pg/mL on their scale wouldn’t be overshooting. (However their 20 may be anyone else’s 30.)

Not to thread jack but Bill do you recommend pramipexole over cabergoline for prolactin control based on effectiveness or it is more of a price and availability issue?

Pramipexole has no adverse cardiac effects whereas cabergoline can cause cardiac fibrosis.

Either can be completely effective in reducing prolactin.

Just a quick add - fair play to the posts as always by Bill Roberts always the fountain of knowledge.

:slight_smile:

As my posts take an age to appear, apologies for the double post.

But anyone see anything strange re his Test/LH levels ?

Whatever PH he took probably didn’t do much if anyting at all it for all the world looks like like he was never even fully suppressed, and by taking the nolva/tamo he just boosted his natural test levels.

If he controlled the estrogen, then he reduced progesterone sides as well, as progesterone is synthesised in response to estrogen… so i wonder when did you 1st notice these side effects ?

I mean wtf kinda PH did you take ?

300- what do you find strange about my test and LH levels? And I doubt I was fully suppressed. It was a 4 week cycle of finaflex ripped(tren and bold). I first noticed that I had NO sex drive whatsoever while on the otc pct product called revolution pct. So I freaked out and did some research and saw that a serm was recomended so I got one and I think things only got worse from there because I didnt really know what I was doing.

[quote]atlninja82 wrote:
300- what do you find strange about my test and LH levels? And I doubt I was fully suppressed. It was a 4 week cycle of finaflex ripped(tren and bold). I first noticed that I had NO sex drive whatsoever while on the otc pct product called revolution pct. So I freaked out and did some research and saw that a serm was recomended so I got one and I think things only got worse from there because I didnt really know what I was doing.[/quote]

Ye Rule 1 - Dont use Pro Hormones bunch of shit at best, fuck knows what was actually in it.

Get yourself some Cabar a.s.a.p. to be honest, your doctor can get it for you, if you run into issues, he has to write a special script here in the UK … dunno where your from.

Your LH levels show you weren’t fully supressed, what amazed me lol though i readily admit i know sweet fuck all about Pro Hormones.