T Nation

Low T, FSH, SHBG, High Prolactin

Thanks to this forum an all the great information I choose to get a blood test online prior to going to the doctors so they wouldn’t just give me anti depressants. I need some advice on my results and anything I should bring up or ask my Doctor.

• 26y
• 6’4
• 210lbs
• Sparse chest hair and patchy facial hair unable to grow beard
• Had many minor head injuries during my youth, never concussed or knocked out but some stitches.
• Low libido, Fatigue, Depressed, anxious, no motivation for anything, Forgetful, Weak, i just feel terrible.

Testosterone 7.08 (8.7-29)
Oestradial 89.6 (41-159)
F Testosterone (calc) 0.196 (0.2-0.62)
LH 5.42 (1.7-8.6)
FSH 0.76 (1.5-12.4)
Prolactin 391 (86-324)
Albumin 43 (35-50)
F Androgen index 47 (24-104)
DHEA sulphate 8.5 (4.3-12)

Any and all information would be helpful. Thanks

Have you had an MRI on your pituitary? Or has your doctor mentioned it? Also have you had your thyroid levels checked?

Something is lowering your testosterone, LH is midrange so testosterone should also be midrange. The problem you face is most doctors are operating on little knowledge as this area of medicine.

Antidepressants are often scripted and used to treat or mask undiagnosed medical conditions which worsen on ADs, then wasting time when you could be treating the cause of your condition. Managed healthcare needs to you keep coming back for more drugs, more medical problems to feed the engine that is sick care so all these companies can do well financially.

I haven’t been to the doctors yet I’m about to book an appointment now since I wanted to have some results to show them. When I did search my lab results pituitary tumor did pop up is that what it looks like? Is an MRI the usual way to detect a problem with it? I haven’t had my thyroid levels checked yet I’ll make sure I mention it to my doctor, I assume they will want to take bloods before anything happens.

I wouldn’t say that is def what it looks like but its a possibility. Get to the docs and get the work up. Move from there.

They will need an MRI to determine pituitary tumour.

Your prolactin level isn’t that high.

Everyone on here says to get an MRI if slightly elevated.

Mine is always high as the stress from the blood tests raise it (I.e. they can’t always get bloods and have to try multiple veins).

Keeping in mind that his is close to 400 and his range tops out at 324.

From https://pituitary.org/knowledge-base/disorders/prolactinomas

Hormonal Diagnosis

The diagnosis of a prolactinoma is confirmed by demonstrating persistently elevated blood levels of prolactin. A prolactin level of over 150-200 ng/ml is almost always due to a prolactin secreting pituitary adenoma. In all patients with suspected pituitary tumors, a complete pituitary hormone evaluation should be performed. This testing is especially important in patients with potentially large tumors who are likely to have some degree of pituitary failure (hypopituitarism). It is important to note that moderate elevations of prolactin (30 - 200 ng/ml) can occur as a result of several other causes, which must be excluded prior to invoking a pituitary tumor. The most common causes are listed below:

  • pregnancy or in the post-partum period
  • stress (discomfort, exercise, low blood sugar)
  • low thyroid function (hypothyroidism)
  • kidney failure
  • liver failure
  • medications (such as anti-ulcer and antidepressants)
  • “stalk effect”
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The original poster didn’t give unit of measurement but I assume it’s mIU/l.

391mIU/l to ng/ml that you reference above is around 18.4. So not even a moderate elevation.

Maybe I am wrong and the OP is a different unit of measurement.

But in my experience people on this forum all overreact with prolactin and tell everyone to get an MRI, when the elevations are quite mild. It’s also a very reactive hormone which can be elevated by many things (stress, estrogen etc).

In response to OP your test is very low. I would do a few more blood tests and then go and see a doc you should be able to do TRT.

Don’t believe the forums too much, they are useful but not always the best. Podcasts and books have been the most helpful in my experience, an obviously a good doc but they are rare

The units are different. The TS measurement would have been in mU/L. Converted to ng/ml it will be 18. This is almost certainly not the result of prolactin secreting pituitary adenoma.

People need to stop blindly advising people to get an MRI.

He gave no units…all he gave was a range which he was way over. Secondly I told him to go to the doctors. Thirdly, MRIs don’t hurt you.

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He isn’t way over range, he is very slightly over range. If you cant see that the units you were quoting did not correlate with the lab ranges then you shouldn’t be giving out advice.

MRIs don’t hurt you but needlessly pursuing one uses up precious resources and facilities which may pose unnecessary burden on the health care system, certainly in the UK.

I told him to go see his doctor. I stand by that. You offered no advice. @silentsam please include units of measure for clarification.

That is not really a valid reason to not pursue an MRI. Personally I didn’t pay any attention to his prolactin number. If he is nervous that he has a pituitary tumour than he should see a doctor. The only way to rule out a tumour definitively is an MRI. Is this an over-reaction to the prolactin number? Probably, if that is the only motivation, but I didn’t get the impression that the sole symptom was prolactin.

By all means see a doctor regarding the results, but the doctor should be the one to determine if an MRI is needed.