T Nation

Recent Blood Sample High Prolactin

I just got back my blood sample result.

About me: mid 30’s old, non-drinker/smoker, have sedentary job but 3-4 times heavy lifting at gym, healthy eating, male with typical “low t” symptoms, including low libido, low energy, absolutely no motivation, sadness/negative moodiness, lack of muscle development, poor sleep, hair thinning & loss of hairline etc.

I don’t do TRT or any medicine. Only consuming Multivitamin, Ashwagandha, Vitamin C (1gram), Vitamin E.

Result

Creatine kinase = 1.2
Hemoglobin = 135 (134-170)
D-Vitamin = 134 nmol/L (50-178)
Cortisol = 189 nmol/L (145-620)
Total Testosterone = 17 nmol/L (5.7-26)
SHBG = 28 nmol/L (15-95)
LH = 4.9 IE/L (1.5-9.3)
Estrogen = 86 pmol/L (<150)
Testosterone, bioactive (unbound) = 9.2 nmol/L (2.8-21)
Prolactin = 264 mIE/L (HIGH) (60-260)
TSH = 2.6 (0.4-4.0)
T3 = 4.8 (3.3-6.0)
T4 = 17 (10-27)

How do you interpret the result?
Why are my Prolactin so high? Do you think that my symptoms are due to high prolactin?

I also wonder if my Estrogen and Free Testosterone are low or could be better?

You will get more responses if you put in the ranges.

Done

Do not know. Height, weight, waist circumference, muscular? Best lifts? Body hair?

Maybe.

Could be better.

164cm, 60kg. stayed at the same weight in bench press for over 1 year. One muscle group per day 4-6 reps and 3 sets. 80% RM.

Body hair medium, not grows fast as 3 years ago.

Do you mean my E2 are low or high?

Your options, as I see them, in no particular order:

  1. pituitary MRI
  2. repeat labs
  3. start TRT

If you took this lab within 1 hour of waking up your cortisol is low.

Do more labs to get baselines.

Take fasting:

Iron panel
Dhea s
Lipid panel
Metabolic panel that includes glucose
A1c
Insulin
Retake total and free t
DHT
Am cortisol

You should take pituitary mri.

I did the lab after 2:30 after waking up.

I also did some of those test but didn’t write down all but here are they:

Iron - 15 (9-34)
Triglycerides - 2.5 (0.45 - 2.6)
HDL Cholesterol - 1.22 (0.80 - 2.1)
LDL Cholesterol - 4.26 (1.4 - 4.7)
LDL / HDL Quota - 3.5 (<5)
Cholesterol - 6.5 (3.3 - 6.9)
Glucose - 5.1 (4.0 - 6.0)
ASAT - 0.26 ( 0.25 - 0.75)
ALAT - 0.43 ( 0.15 - 1.1)

But do you guys mean I gonna retake the hormonal test again to see if it’s accurate?

Because last time I took Testosterone test was 2017 and I had much less around 12 nmol I was actually surprised I got 17 nmol even when I’m older and also I have those symptoms.

Are my estrogen low or high?

Should I consider HCG or Clomid monotherapy before jump on TRT? Which one should I go for first? Because I will not jump on TRT if my Total T are within normal range. Maybe I will consider for when I’m in 40s since it’s lifetime thing with TRT.

Like you, I have high prolactin. After blood work and and a MRI, my Endocrinologist told me I have two Tumor’s in the front and back of my Pituitary. The worst problem of many is my Adrenal System is 99% crashed. My Dr. put me on Cabergoline. The drug after 3 months has stopped all the prolactin from being pumped out to feed the tumor’s. Caber starves the tumors and they shrink down to tiny or nothing. For many people surgery won’t be necessary. Any one with high prolactin should consult an Endocrinologist. If my Adrenal System cannot recover I’m stuck with no protection from cortisol. So far my result is an accelerated aging of my body. For example my skin is beginning to wrinkle and stretch like an old person. I do not want to go on corticosteroids for life. TRT is saving me, muscle loss and being reversed every month. High prolactin must be looked into. I only found out about this when I walked into LowT of West Houston. All the specialists I went to for over 10 years came up with a lumps of manure.

Are you on Cabergoline whole life or it is a “quick fix” things to get rid of the tumor?
How easy is it to get Cabergoline on prescription? Is that enough to show the blood test or do the DR need to take another test and from there prescribe it?

how high was your prolactin? Mine was slightly higher like op, and i had no tumor.

Effect

Cause

Get a better training split. As far as prolactin, it’s slightly above range. If that’s a concern then get yourself some P5P and use it (start low) for perhaps two or three weeks. See if you feel better. If you do then prolactin was an issue. If you don’t then it’s not the issue. Simple, cost-effective way to test out if it’s prolactin.

I have order a P5P. It’s 100mg per capsule. But some says 250 mg is more effective.
How low do you mean?

If all goes well, I will be on cabergoline from ~12-24 months. What will decide is my next MRI in a few months. If your blood test shows over the threshold (mine was 38) you get a second blood test, after showing still high, you have to have the MRI. If you are over and you feel exhausted much of the time you should definitely see an Endocrinologist. These Dr.'s are the one to treat your situation. My Dr. put me on the Caber. Half pill Mondays and Thursdays. I know lots of body builders take Caber to allow them to orgasm, abuse of this drug can result in heart valve prolapse. Then heart valve replacement is the only option. I respect the drug and I wish I didn’t have to take it. This med has some crazy side affects. Like sex addiction, I have experienced my brain thinking about sexual stuff and its in a loop playing for hours while trying to sleep at night. It can be scary. I started to take Amitriptyline 75mg around 5pm. By 10-11pm I put my head on the pillow and OUT, until morning. Its a drug for depression (I’m not) there are other great off label uses for it too. Its important to know that prolactinomas untreated will cause blindness over time. Our pituitary gland hangs and almost touches our optic nerves. If the tumor gets close to the nerve you start with tunnel vision and from there it worsens. This was always my biggest fear. With two tumors almost the friggen size of my pituitary gland it gets frightening.

I believe it was 38, not hugely over, but bingo…two tumors growing.

I will first try P5P, Mucuna and Vitamin E for a month to see if I can lower that shit. And then get a blood test.

I will also try 1-4 gram Ginger per day, one study link it has same effect as Clomid for more free T.

Mine is 18.8 range 4-15.2

Had mri 3 years ago. Nothing found.

Well, that’s not SO high, but it’s elevated. Try taking B6 (P5P) to lower it a bit

Edit: take just 100mg of P5P a day to start. You likely won’t need more than that

I may pick up some myself today. When’s the best time to take it?
I’ll see how I feel by lowering my prolactin a bit.
Also would I be masking a possible Tumor?

No, I don’t think so. Your PRL would be super out of range if it was a tumor (not a doctor, this isn’t medical advice, etc). You could get an MRI just to be sure tho.

300mg of P5P felt like .5mg of Caber for me. And that was waaaay too much. So I’d start with 100mg once a day