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Talk to Me About Prolactin (Latest Labs)

I’ve seen prolactin brought up here as something you don’t want too much of, but I don’t know much about it other than that. And lately I’ve been struggling with inconsistent libido. And so I’ve been adjusting this and that trying to dial it in, but nothing seems to help.

But today I got labs back and this time it has prolactin (I hadn’t been tested for prolactin in the past). And here’s what it shows:

Prolactin 21.9 (ref 4.1 - 15.2)

Monomeric Prolactin 14.2 (ref 3.0 - 11.6)

I hadn’t even heard of monomeric prolactin before. But judging by what I’ve read here, these levels are responsible for my inconsistent libido? What else does it affect, and what can cause it to go high like that? And what is the treatment?

Thank you…

Possible symptoms:
Hormone imbalances
Decreased libido
Erectile dysfunction
Decreased body and facial hair
Visual disturbances
Infertility
Gynecomastia
Headaches
Low bone density

Caused by prolactinoma or microadenoma (malignancy is rare).

MRI diagnosis, dependent on size and symptoms, monitor, correct any hormone deficiencies, treat medically, or surgically.

At least you produce prolactin. My body barely makes any. I’m low out of range.

And what symptoms do you have being low out of range? Orgasms and nipple stimulation heavily increase prolactin.

Zero sex drive.

The scariest thing about overrange prolactin is why is it happening.
When organs go a bit crazy(cancer) they start dumping hormones into our system. 95% of the time this is how doctors figure out you have a cancer.

A T mono protocol can also raise prolactin over range. Usually E2 is also high at the same time.
Once your doctor determines you don’t have cancer cabergoline is the most prescribed drug to reduce prolactin.

When I started TRT almost 3 years ago, one of the things I noticed was that orgasm changed…not for the better, but still good. It was worth all the other benefits. Plus libido went up. So a little lack of sensitivity and a change in orgasm (and a little harder to get there) was well worth it.

So I’m thinking that TRT raised my prolactin right from the start. And over time it has gotten progressively higher to the point where I am now, which is all of the above symptoms but now with low libido and even ED.

Is that a thing? Is this a possible scenario?

So I had my appointment yesterday and was prescribed Carbergoline to lower the prolactin.

0.5mg once a week. However, the pills are oval with a nice indented line across the middle. Easy to break in half. Is there any advantage to breaking it in half and taking it twice a week?

Also, I have since read that an overactive thyroid can raise prolactin. And my latest labs showed my free T3 was high (5.6 pg/ml out of 2.2 - 4.4), so my thyroid meds have been reduced (T3 and T4). Might that have caused the problem or contributed? Because I’m unclear whether the actual mechanism of the thyroid being overactive causes it, or just the amount of thyroid hormones it puts out while being overactive…

It is typically prescribed twice a week. The half life is around 2.5 days.

Do you know your TSH level?

Unfortunately, this time the doc did not test for TSH…just for T3 and T4. Once I heard about the thyroid angle I looked for my TSH too.

So now I’m wondering that when I bring my T3 down, if the prolactin will go back to normal (if it was the sole cause)…

It might go down with your thyroid tweaks.
I would still take the cabergoline until you get a blood test that has your prolactin back into single digits.

Thank for the advice.

I was originally taking 50mcg of T4 and 15mcg of T3.

Given my numbers, do you think I should lower the T3 to 10mcg or 5mcg?

Because during the appointment, when the doc brought up the high T3 results, I told him that as soon as I saw the labs (I get them online as soon as they’re complete), I lowered my dose to 10mcg. He said that was good and that he was going to tell me to lower it to 5mcg, but to go ahead and keep it at 10.

So I’m confused as to which is really best for the situation.

Sorry gtron I am not the guy to ask about thyroid meds.

Interesting comment…In general, Is it optimal to have prolactin in single digits? My most recent prolactin levels were:

11.1 ng/ml - (2.0 - 21)

Since it’s mid range, I thought it was fine… But I have been having erection issues… And do have thyroid issues that point to hypothyroidism too that I just found out in latest blood work.

From what I read, both hypo and hyper thyroid will cause high prolactin. But that was a single blurb I read on it. You may wanna double check on that.

11 is probably fine.
I’ve had some gyno issues in the past and my prolactin was 18 top of my range was 16.
Now a days I just pefer single digits.

@hrdlvn - Thanks for the reply, I appreciate it.

Hea we are all on this dam journey together there is no reason we can’t help each other out.