T Nation

Low Free Test. High Prolactin. Help?

Hey there I’ve been browsing the site for a while trying to gather as much info as possible. Had my bloods done after symptoms of low t. Sex drive next to zero, partial ed etc. Don’t feel depressed or stressed or anyhthing. I’m 37 years old always worked out about 6ft 80kg and 15% body fat. I’d consider myself fit although my diets been off last few weeks because of knee surgery hence why I think my cholesterol was out of range. The problem with sex drive has been getting progressively worse over the last few years just getting through it with viagra.
Was just looking for some advice on my bloods. I was considering trt, but after seeing my prolactin out of range maybe it’s that. Any advice on how to bring this down and higher my free test.
I also have a low sperm count and I’m about to go through ivf with the Mrs.
Any help much appreciated.

Your results look similar to mine, my ft3 and ft4 are also at a good level but with elevated tsh. Your tsh is a bit higher than mine though . Ksman says the high tsh could be because of high rt3. You should take your body temps as indicated in the thyroid sticky.

I have elevated prolactin aswell although mine is much higher than yours. Could be a pituitary adenoma which needs an MRI to check it. Although it can also be elevated due to recent orgasm, hugging babies or puppies.

Your fsh is also high which means your testes aren’t working properly/making enough testosterone. High fsh can also indicate testicular cancer but I’m not sure how high it would need to be to indicate that, but it is definitely elevated .

Thanks for he reply mate… when you say tsh I’m guessing that’s thyroid stimulating hormone. It says it’s in normal range looking at the results… after googling high prolactin symptoms it fits in with my symptoms. I’ve heard cabergoline can bring it down as well as B6. I’m not sure how high prolactin needs to be to be accepted for prescription on nhs. Went to see my gp last week and have a follow up I’m a couple of weeks so see how that goes .

Tsh= thyroid stimulating hormone yes. The general consensus on here is that it should be closer to 1. I highly doubt an NHS gp will want to help you with it as it’s in range. Would be a good idea to check body temps as referred to in the thyroid basics sticky…

As for prolactin I doubt they will want to help you with that either mine is 610 and im struggling to even get an MRI so good luck getting cabergoline. I’ve tried p5p which I think is the active form of b6? Generally considered better than b6 and that didn’t work for me.

The ranges for thyroid and testosterone are bogus and doctors wait until your reach diseases status before offering treatment, this saves on healthcare costs. There are some doctors who are proactive and take action when TSH reaches 2.5, but will be tough to find in your country, basically not the NHS but private.

You need to test rT3 but also is important to test fT3 together because these need to be a proper ratio, antibodies should also be tested. Most doctors in your country won’t understand thyroid very well and if they see high rT3, they have no idea what to do and will tell you your fine just to get rid of you.

Your SHBG seems to be grabbing onto most of your testosterone and not creating enough FT, most doctors won’t even understand the relationship SHBG plays in sex hormones. Be prepared for a fight with doctors.

Go private or go home.

1 Like

Even if you go private though you still need to take a proactive approach and Do as much research as you can . Ive gone private and the guy I see still doesn’t have the best of understandings of male hormones imo.

If you can’t get cabergoline for the prolactin bromocriptine/parlodel will bring it down. It’s easier to get from online pharmacies.

Have you done all the “normal” hacks for free testosterone yet?

Lose body fat
Eat saturated fats
Eat cholesterol
Eat mono unsaturated fats
Eat more omega 3 fats
Reduce stress
Sleep more
Weight train 4x/week
Get enough vitamin D
Magnesium
Zinc
Cruciferous vegetables

2 Likes

Yeah my diet is usually on point apart from the last few weeks it’s been off due to an injury. I train 4/5 times a week do squats, lift heavy and cardio… I’ll try bromocriptine if I don’t get any luck with the doctors. Thanks for the info. I’ve been in contact with mike from balance my hormones as well in the uk just in case my gp doesn’t come through.

You have a degree of primary hypogonadism with low T and high LH/FSH. Docs may want to put you on clomid but that may be a bad idea as too much LH could desensitize the LH receptors.

Docs examined your testes and found ?

If you go on TRT without hCG to support your testes your fertility at major risk. With TRT, the standard hCG 250iu subq EOD may not work as your testes are not working very well with high LH.

High prolactin should be treated with 1/4mg Dostinex/cabergoline twice a week. MRI often used to judge size of adinoma. If allowed to grow it can press on optic nerves and that outcome must be avoided.

Injuries and other stress can lead to elevated rT3, reverse T3 that interferes with fT3 at T3 receptors. There is no receptor for T4.

Your fT3 should be able to support good oral body temps. You will find how to check that below. When fT3 is adequate and temperatures are low, we are quite certain that rT3 is the problem.

In the thyroid basics sticky find references to: stress, surgery/injury, over training, fT3, rT3 adrenal fatigue and Wilson’s book <-- read it!

Prolactin lowers dopamine and that is depressing. That is another stress factor. Could show up as apathy or lack of joy.

Training with low T and low thyroid function is a very high contributor to adrenal fatigue as natural energy is eroded and replaced by adrenalin to get the work done.

Prolactin has no direct effect on FT. SHBG does.
SHBG is made in the liver to scavenge sex hormones. That is increased by low T and elevated E2.

AM cortisol appears OK. In later stages of adrenal fatigue cortisol can go low then that would be a major problem.

How to reduce rT3?
Address stress issues and life style. Workouts need to be tamer.
Need T3 only thyroid med to depress TSH so T4 drops. Then there will be less fT4 for fT4–>rT3. T3 time release is available in USA as a compounded med only. Do not know options there.


Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.

2 Likes

@ksman thanks for the reply. I will look into what you’ve said… I’ve had an ultrasound on my testes and I have a vericosele on the left side apart from that the doc said there ok… problem is finding a doctor in this country who knows what there doing. Thanks again.

One last thing. You mention hCG 250iu subq EOD may not be enough to preserve my testes. Would a higher dose work and how much. Also do you have to do hcg EOD indefinitely, whilst you wants children or can you take time off it?

When you say online pharmacies, do I need a condition to get it? Like online doctor kinda thing? I have high prolactin and looking for Bromocriptine.

Thanks

Not sure about Bromocriptine. I used Cabergoline, which the doctor prescribed 0.5MG every 2 weeks keeps my prolactin from elevating