T Nation

Just Started TRT - High Prolactin

Hi, wondering if you guys can help. I have recently (8 weeks ago) started TRT (test levels are on the low side and I have the symptoms - I am 32) and am on the following:

  • 100mg Test E per week (split the dose EOD)
  • 100ui HCG daily

My prolactin levels have always been on the high side of the range and since starting TRT they have increased quite a lot and gone outside of the range. I have read the levels of prolactin are genetic and there is not much you can do to change them (besides caber).

do i need to get an MRI? worth going on caber anyway?

Before and after bloods



Bloods from 2014 & 2015 show prolactin at 249mIU/L. so it has always been on the high side.

I have a meeting with my doc in the next few weeks but just wanted to get some comments on here before.


Next step is MRI.

Cabergoline is normally used to treat high prolactin, definitely need an MRI.

Ok, thanks guys. I will get the MRI done to be on the safe side and will see what my doc says when I speak with him.

Reading online ‘A blood serum prolactin level of 1000–5000 mIU/L could be from either mechanism, >5000 mIU/L (>200 µg/L) is likely due to the activity of an adenoma; macroadenomas (large tumours over 10 mm diameter) have levels of prolactin up to 100,000 mIU/L.’

So my level (500 mIU/L) doesn’t seem to be too close that those levels.

Apparently prolactin is downregulated by dopamine and upregulated by oestrogen… which might explain why TRT has increase the level (oestrogen has gone up since starting).

Microadenomas are found when prolactin levels are only slightly elevated.

Doc said is likely related to the increase in the E2 and isnt worried about it for now.

Have changed the test injections to Sub Q to try and reduce the E2 level and therefore prolactin and will retest bloods in 6 weeks.

If the prolactin is still high then, then I will follow up with a separate specialist - not sure how easy it will be to get an MRI if i have to mention to a endo that i am on TRT.


E2 is increased because you are taking exogenous testosterone and testosterone has increased, therefore E2 increased.

Agree but I think there is a relationship with prolactin as well.


But I agree, think I will get it checked out by and endo anyway. Don’t really want to run prolactin high.

Right, it is just more profound in women. Regardless, you and your doctor are aware and watching. I suspect if it persists you’ll end up running down any cause.

@muaythai123 26.9 Nmol Testosterone is a little bit lower than what is expected for Test ENANTHATE it’s very potent stuff, properly dosed enanthate. i would expected you closer to 32nmols or 900 ng/DL i don’t know when you took the test too? how long after shot & what time in Morning?

That was the trough value. So dosing is EOD and that was before I did my HCG/test for that day (so around 2days since last injection).

That was 4 weeks after starting treatment. Does it still sound low?

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Not to low, really 4 weeks your starting to dial in, after 8 weeks (2 Months) will be properly dialed in your TRT Program. SO what day after your SHOT was this taken 2,3 or 4 days after injection? also was it done before 9 AM or before 10 AM?

B6 at 400-600 mg a day can bring prolactin down. An mri is an option but unless you’re developing vision symptoms or lactating like one of thoSe wet willy sprinklers, they’ll likely only treat with medicine.

I do a shot every other day. So in this case I did the shot Thursday morning and did bloods sat morning. Then did my shot after bloods.

@pmatt yes I guess the doc would give me some caber. My only issue is libido is not as good as I would want it, guessing it’s related to high prolactin.

Did you say 600MG of Vitamin B6 can bring prolactin down? wow didnt; know Vitamin can do that. is VALUABLE information if i have High Prolactin, can some guys on TRT have a big PROLACTIN increase then?

It absolutely can. If I wasn’t in traffic I’d link the study. Used it on me and on a few people I know for same.

I’ve not seen prolactin go up from trt itself. Usually a lab we draw baseline or if they’re having symptoms.

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So basically it’s a genetic predisposition right? where ever a man Gets High Prolactin or not right??? I never had it in my life before, so i doubt i will have on it TRT, and no i haven’t tested for it while on TRT.

Maybe. More likely a prolactinoma. Or external stimulus (sole right drugs. Some steroids)

That’s “some RX drugs” FYI