Hello, This is from the last lab that I have had. I am 29, It has been harder to keep muscle mass. I have no drive to do things, sex drive is low as well. It feels harder to think or remember things. These labs are from a new doctor. My previous doctor(before I moved states), the total T was in the low 400s, but the free T was below range, Prolactin was at the high end or even above. All I got from this doctor so far is that I am good. Even though my prolactin is high, I have slight gyno(confirmed by old doctor, They did an MRI to check my pituitary gland, they said they thought it was sunken, but it was inconclusive and to do another one).
My thoughts are too get the prolactin into an optimal range which might help my testosterone. Also, should I take vitamin D as well? Is there anything to boost T and lower prolactin or will I have to go with caber to lower it? Thank you for your help.
TESTOSTERONE, TOTAL 483
Reference range: 240 to 950 Unit: ng/dL
Testing performed by Liquid Chromatography-Tandem Mass
Spectrometry (LC-MS/MS).
TESTOSTERONE, FREE 9.66 5.05-19.8 ng/dl
PROLACTIN 14.0 4.0-15.2 NG/ML
TSH 2.52 0.27-4.20 MIU/L
VITAMIN D 25 HYDROXY 38 31-100 ng/mL
Can’t answer on your prolactin what you should do, but yes you should try to get the vitamin D up. Vit D is too important in the body not to supplement with your lower levels.
D3 is more effective at raising vit d levels The recommended is 400-800 IU is the recommended that I read, but some need higher. I would personally start at 800IU and get tested again after 2-3 months and see where your at. That is when it should peak with your dosage. If your levels are still low, up your dosage. From what I just read you take up to 4000 IU daily safely. Its also recommended to take magnesium and vitamin k2 with vit d as they help with vit d efficiency. It is believed they have a synergistic effect together.
Doctors in the sick care system aren’t overly concerned with low numbers, they mostly care about in range, the problem is most men need FT above midrange to feel good. You’re dealing with someone who is likely very ignorant in hormonal knowledgeable.
Young men generally have high testosterone, old men low testosterone, you have the testosterone levels of a 75+ year old and percentage wise you are lower than most in your age group.
Your TT is barely acceptable, but your FT is lower and the only explanation is your SHBG is probably above midrange. If your SHBG gets into the 40’s, it starts deactivating testosterone and you will see FT decrease. TT is the junk hormone, it is not bioavailable, FT is the only stuff that matters.
Prolactin is fine now, how high as prolactin previously?
25-34 years of age 45 subjects 617 ng/dL You should be here.
35-44 years 22 subjects of age 669 ng/dL
45-54 years of age 23 subjects 606 ng/dL
55-64 years of age 43 subjects 562 ng/dL
65- 74 years of age 47 subjects 524 ng/dL 75-84 years of age 48 subjects 471 ng/dL You’re here.
85-100 years of age 21 subjects 376 ng/dL
I really appreciate your help systemlord. I will tell him to give me a referral to an endocrinologist. I do not see him wanting to go any farther on this matter except for wanting to give me an ssri.
No this is not a good idea, you can’t just go to any endocrinologist because most are clueless and have no real understand about normal T status. You need someone that isn’t corrupted by the sick care system. Doctors in the sick care systems have one hand tied behind their backs, the insurance companies are the ones hogtying the doctors preventing them from taking action so the greedy insurance companies can keep the profits.
Insurance companies have been doing this since insurance company first launched in the 70’s, many industry experts said this was the death of healthcare in this country. You have to score at a testosterone levels of and elderly man with type 1 diabetes, this is what the establishments are comparing you to when you come in for treatment.
You have to have TT levels below <300 on two separate occasions to be considered for TRT, you are wasting time going to a doctor that takes insurance. I know exactly how this will go, Both your TT and FT levels are “in range” your doctor will tell you that your levels are normal.
As I’ve said time and time again, you need to stop waving this super-biased flag against doctors.
Not only is it incorrect, because there are plenty of qualified doctors treating low T patients, but it’s utterly hypocritical for you to be so deadset against doctors in the “sick care system” while not paying any attention to your own personal healthcare.
This is a 100% appropriate course of action. Or consider a urologist, who can also address TRT. Like you’d do with any specialized physician (pulmonologist, opthalmologist, whatever), check references and do your footwork to find a qualified doc and then go see them.
He can check for pituitary tumors and other causes for low testosterone, but getting TRT with his numbers, it’s not going to happen because TRT is prescribe <300. The endocrine society recommends TRT to those <300, the AUA recommends the same. So if we go by the guidelines, no way is the OP getting TRT.
Like I said, he can check for pituitary tumors and other causes for low testosterone, but TRT will not be prescribed because there is no way to bill the insurance company if 300>, if TRT is prescribed the insurance company will deny coverage and the provider will be left with no reimbursement for services.
Work with your physician to get clarity on the pituitary. If you have an empty sella or a partially empty sella than hypopituitarism needs to be evaluated - thats more than just giving TRT. Keep trying to find the root cause for your borderline/elevated prolactin.
That’s an issue the doctor’s office would sort out. A good medical office’s billing department can get things done with little to no hassle for the patient. A paperwork issue isn’t going to prevent a good doc from prescribing proper treatment.
Pretty much everyone should be taking D. When you’re on the lower end, you’d be fine with 1,000-2,000 for a couple of months before retesting your levels. Some people with very low levels take 10,000+ per day, but there’s no need for you to go that far. B6 may be beneficial for reducing prolactin at 500mg or so per day.
Yep, this should also be on the to-do list.
For context, what’s your height, weight, and general fat level?
Thank you Chris. I will look into the endocrinologist because my insurance covers anything in the hormone field. If worst comes to worst, I will seek outside my network help. I will request more information on why my prolactin is staying elevated and about the MRI. I hope fixing my prolactin will help with my testosterone levels as well. I will start supplementing vitamin D and contact my doctor immediately. From all my research, it seems as though prolactin decreases testosterone. I wanna to try other options before going into TRT. Should I also try to get shbg, e2, lh,fsh, or anything else. I do have my cbc with diff and comp.
Also, I am 6’1" about 180 when previously I stayed around mid 190s. Bodyfat has always been low. Normally in the 7-8% at peak training, but now about 10-12. The 7-8% was based off a 3 site electric micrometer system. The 10-12 is a guestimate at the moment. Huge decrease in strength, it is harder to get back to the level I was at. I forgot to add irritableness to the list before, but it is getting better now that I am back in the gym. I will see what I can get done along with any new labs to keep this posted.
