T Nation

Just Started TRT, Elevate Prolactin and Estradiol

I started TRT about 8 wks ago I am a 56 yr old male . I was expierencing depression ,lack of libido and erectile dysfunction. My doctor checked my levels 3 times and they all came back low with elevated prolactin levels and shbg levels . My estradiol levels where fine the elevated Prolactin Levels and shbg where due to Hep c which I required from a blood transfusion in 1985 due to a car acciedent. My levels where Total T 228 ng/dl, Free T 2.8 ng/dl, SHBG 134 nmol/L, Prolactin 36.1 ng/ml, Estradiol 24 pg/ml. LH 4.9 ul .

After eight weeks of TRT my levels where Total T 1272 ng/dl, Free T 21 ng/dl. SHBG 111 nmol/L, Prolactin 72.3 pg/ml. Estradiol 62 pg/ml ,LH 3.2 ul . The TRT has made a profound change in my life in the 8 weeks I have been on it. My depression has gone I have great energy levels and I have my drive back to do things in life. But my Libido has not come back and I still suffer from Erectile Dysfunction. I have been researching this and from what I have read the elevated prolactin levels,along with the elevated Estradiol and lowered LH levels can have a profound effect on libido and ED .I presented this to my Endocrine doctor and he said my levels where fine.

I asked him for some Medication to lower some of the levels but he refused.The Prolactin level is way out of range the range is 0.0-15.0, The range for the Estradiol is <50, and the SHBG range is 13-71. The Total T range is 270-1070 and the Free T range is 9-30. My doctor is a Neuroendocrine specialist and said he does not do much TRT. I do not know what to do. I do not know if what I read when I researched this stuff was correct but It seems to me that some of these levels are way out of wack.

Any help would be appreciated I am recieving 100 mg of Test E injections once weekly. I am going to try and drop these levels naturally but if it does not work I was thinking of Prami and Forestene but I do not know if this is a good idea.

0.5 to 1.0 mg/week of cabergoline/Dostex will lower prolactin. You need a MRI to see what is going on with your pituitary; adenoma suspected.

Take 1.0mg/week anastrozole in divided doses.

Suggest that you inject 50mg T twice a week and take 1/2mg anastrozole at that time.

You need to self inject. You can inject SC with a #29 0.5mg [50iu] 1/2" insulin syringe.

There is a lot of reading that you need to do and to pick up on terminology.

This is standard advice maintained here:

There is a huge amount of knowledge in the stickies. Please study these. Start with the advice for new guys sticky.

There is a lot to read there, so read carefully. There are suggestions for things that are root causes of low testosterone [T]. Low T is a symptom, not a root cause itself. But low T itself is a root cause of many of the symptoms one experiences. Note that other things cause the same spectrum of symptoms, so do not have T tunnel vision. Many docs are guilty of that and they only treat the symptom [low T] and do not attempt to find the real problem. If you go to a clinic that specializes in low T, you will get T tunnel vision for sure.

Post info about yourself as suggested in the above sticky. We need labs, almost all of your labs, not just hormones. We also need the lab ranges.

We see a very high number of thyroid issues in the population of guys that show up here. So there is a strong focus on that. Most people are iodine deficient to some degree. Your history of iodine intake from iodized salt and vitamins that list iodine is important. If you become iodine deficient, the RDA [recommended daily allowance] is inadequate for recovery of iodine stores. Please see the thyroid basics sticky for more information.

You do not want to suffer from subclinical hypothyroidism or get Rx thyroid meds to treat iodine deficiency.

If you are injecting T or contemplating that, read the protocol for injections sticky.

There are stickies for finding a TRT doc, estradiol [E2] and lab work.

Do not place your history or treatment details in the stickies! That belongs in your thread. Keep all of your posts in your thread so we can have a clear picture of your situation and needs.

Why is the high prolactin and shbg being blamed on hep c? I can see maybe you body has a hard time to clear estrogens and so maybe shbg is high but what does hep c have to do with prolactin ?

Prolactin should not just be blamed on anything and the underlying cause should be found especially when other hormones are out of wack.

Prolactinoma should at least be considered and I would get an MRI of the pituitary gland

You need a new doctor, nothing about your labs is fine. Lh and fsh will be shut down on trt unless you have testicular cancer so really no need to worry about lh anymore.

Had someone helped you with the other levels somehow maybe you wouldn’t of even needed trt.

Seriously man get away from this doctor, read the finding a trt doctor sticky

I am inclined to agree, but I did some looking around and found:
In this work we analysed the dynamics of prolactin serum concentration in male patients with chronic hepatitis C. A group of 52 men were included in the study, 26 of them constituted the control group. The diagnosis of the disease was confirmed by the presence of HCV-RNA in the serum and by the histological examination of the liver. None of the examined men was diagnosed with any co-existing disease nor any infection markers of HAV and HBV were found. The prolactin concentration was determined in the serum of patients twice: on the 2nd day of hospitalisation and after 4 weeks of hospitalisation by the use of radioimmunological method (RIA) applying a prepared set of reagents RIA-PROL-CTK-4 (Sorin Biomedica, Italy). The results were statistically analysed. An analysis of the dynamics of prolactin serum concentration in male patients with chronic hepatitis C shows a statistically important increase in this hormone serum concentration.

Learning something new everyday. But what is the mechanism?

Doc is an idiot.

High prolactin and low T is a red flag for prolactinoma.

Do you have LH and FSH data?

As KSMAN said get caber and pill cutter take half of 0.5 twice a week.

Anastrazole 1 mg cut it into four parts and take EOD.

With high SBGH you need a more T to bring up free T levels. You might have liver issues as well.

You’ve been given good advice by the cats here. Take care and keep updating.

Study is interesting… But ya what is causing it… And it’s only one study and I have a hard time to believe that the doctor read that study or has any idea that there is any study and isn’t just coming up with some bullshit to say… One study by how knows who found on the Internet doesn’t mean a thing if u ask me.