Came across the forum whilst researching my symptoms of low libido, lethargy, lack of motivation, and depression. I initially put it down to just getting older but then read about declining testosterone levels and decided to investigate. I have seen that there is a wealth of knowledge on this forum and was hoping I might get some assistance and direction.
Waist: 33cm Hips: 39cm
Activity: resistance training 3-4 times peer week, daily 20m walks
Alcohol: 2-3 units a days whilst on holiday but nothing otherwise
General health/medication: not on any medication and general health is fine
I have had a blood test and whilst my testosterone levels look ok I do have elevated SHBG and prolactin. From my limited knowledge, I don’t think my liver or thyroid levels are so bad to be causing the SHBG or prolactin to increase but I could be wrong.
Kidneys - was dehydrated and had done a heavy leg session night before test
Urea 6.4 nmol/L (2.5-7.8)
*Creatinine 104 umol/L (59-104)
EFGR 66 (>60)
ALP 68 IU/L (<130)
ALT 27.2 IU/L (<50)
CGT 31 IU/L (10-71)
Thyroid - I have started to consume diary on a regular basis to increase my iodine
TSH 2.15 mIU/L (0.27 -4.2)
Free T3 4.51 pmol/L (3.1-6.8)
Free Thyroxine 18.4 pmol/L (12-22)
Proteins - have started boron 12mg to tackle elevated SHBG
Albumin 42.3 g/L (35-50)
*SHBG 59.7 nmol/L (18.3-54.1)
FSH 5.76 IU/L (1.5-12.4)
*LH 8.74 IU/L (1.7-8.6)
Oestradiol 98.3 pmol/L (41-159) - 98.3 pmol/L = 26.7 pg/mL
Test 18.4 nmol/L (8.64-29) - 18.4 nmol/L = 531 ng/dl
Free test 0.263 nmol/L (0.2-0.62)
*Prolactin 715 mU/L (86-324) 715 mU/L = 33.6 ng/mL
I have spoken to my GP (I’m U.K. based) and he was completely unconcerned about the prolactin. He did question me about my low libido and depression and proceeded to prescribe 37.5mg of Venlafaxine (Effexor).
My questions for you gentlemen:
- Are my prolactin levels elevated enough to cause the above symptoms? Also, what levels would be regarded as ‘optimal’?
- Have any of you gentlemen been prescribed 37.5mg of Venlafaxine/Effexor and if so how was your libido?
- Am I right to be worried about my Doctor? From my limited internet research, I fail to see how a SNRI would help with my low libido and, whilst rare, could even further elevate my prolactin.
- I’ve read that prolactin and dopamine have an inverse relationship and so was wondering could that potentially mean my feelings of depression and lack of direction are stemming from low dopamine levels? If that’s reasonable then I’m curious why the doctor would prescribe a SNRI and not a dopamine agonist (Cabergoline) or a NDRI (Wellbutrin) - if this assumption is correct then I will be asking my GP this on my next visit. But I’m all ears to any opinions/guesses.
- Whilst my total testosterone levels look ok I am concerned about my free levels. I’ve put this down to my SHBG and will re-test after I’ve been on the boron for a month or so. If my free levels don’t increase what else can I try and what kind of ‘optimal’ free testosterone levels should i be aiming for?
- Should I be concerned about my LH level?
Thank you for taking the time to read all of the above. I hope I provided enough information. But please do let me know if you need more.