I started by visiting a doc because i had fatigue and sloppiness symptoms that i could not
find an explanation to. At first i thought it was hypogonadism of some form so the doc took some simple bloodworks just to get the basics checked out.
Later i went to an endo to seek confirmation for my low T levels and just to get a real
full bloodwork, he checked for other stuff aswell. At this time i had cut down on fat intake
brutally and fasted the day before the test because the doc wanted to check for diabetes.
This is the most recent one from a different lab:
[Hormonal]
S-Testosterone 19 (10-35) nmol/L
S-SHBG 14 (13-71) nmol/L
S-FSH <1 (1.4-19) E/L
S-LH 2.6 (1.5-9.3) E/L
S-Prolactin 33 (3-19)** ug/L
S-Androstendione 5.2 (3.2-9.9) nmol/L
S-P4 1.3 (<2.0) nmol/L
S-DHEAS 5.2 (3.3-13.9) umol/L
S-Cortisol 665 (200-650) nmol/L
E2 was not checked, i asked why and he said it wasnt relevant. But it will be included in the next test which is in a week.
[Thyriod]
S-TSH 2.71 (0.20-4.00) mE/L
S-T4 free 15 (9-22) pmol/L
S-T3 free 5.4 (2.5-5.6) pmol/L
S-TPOab 0.5 (<5.6) kE/L
S-TGab 1.9 (<4.1) kE/L
S-TRab 0.9 (<1.0) E/L
Total T4 and T3 was not checked.
And plenty of other that i dont know whether they are relevant or not, but all were in normal range.
Next step is an MRT to check for pituitary gland tumour specifically for prolactinoma.
Now i have two questions. First off, how is it possible that my FSH/LH levels stayed the
same but testosterone increased by 72%. Both my first and latest test were taken under the
same circumstances, both at 9am in the morning, at both times i felt like shit.
Lastly, i read that a prolactin level <100 is most likely not due to a pituitary tumor.
The doc said that this is most likely a miscalculation and that i shouldnt worry. But incase
it indeed is prolactinoma of any kind, in which way will it benefit me to reduce prolactin to normal levels by taking DAs. The reason i ask this is because the endo said it wouldnt make a difference unless its a tumor thats pressing against other parts of the pituitary gland and reducing their function.
what are your symptoms? libido, body temp, drive, etc.
what medications/supplements are you currently taking (along with dosage amounts)?
high TSH, but good Free T3 and good Free T4. I would normally expect high Reverse T3, but your Cortisol is high which makes that slightly less likely. low ferritin can contribute to high RT3. What is your hemoglobin/hemacrit levels?
Prolactin is terrible and probably messing up a lot of your systems.
FSH/LH were low both times - MRI of the pituitary to rule out a tumor is good.
Vit D is low (but better then most people). Taking 6,000iu Vitamin D3 is advisable for almost anyone.
DHEA-S is low.
Would be nice to see Reverse T3, Pregnenolone, Progesterone, Ferritin, B12, and Magnesium - plus possibly others per the blood test sticky.
Hey, cant say ive had any libido or sex drive “problems” afaik although i feel the could be better, it was mostly tierdness, hot flashes, no initiative and so on.
I dont take any medication whatsoever that could cause raised prolactin levels, i only supplement with vitamins, minerals and fish oil.
Hemoglobin is at 154 (134-170)
Hematocrit 0.46 (0.39-0.50)
Progesterone was taken i thought i wrote it, P4 at 1.4 (<2.0)
S-Ferritin 189 (30-200)
DA i meant dopamine agonist, to lower the prolactin levels.
your cortisol is high, your ferritin is high, your free T3 is high… so why is your TSH > 2??
The only possibility that I can see is the possibility of high Reverse T3 which is causing too much interference with your free T3 which in turn causes your TSH to rise because your system is not able to use the Free T3 that is already present.
or since high RT3 can interfere with the conversion of T4 to Free T3… but you have plenty of free T3.
maybe if your cortisol is too low OR too high - it interferes with the Thyroid. Or maybe prolactin is causing the high TSH value.
I think the cortisol was high due to fasting the day before because my endo wanted to check for diabetes. Otherwise the endo basically said the same as you. He pointed out possibilities of abnormality and there was always another hormone that disproved it. What was mostly interesting to me was the low FSH and LH levels.
Anyways i double checked the numbers incase i wrote something wrong and they were all correct. Unfortunately the lab im taking the tests at dont measure total T4 and T3 so ill never know.
MRI scan is next week wedensday and the bloodwork im doing next friday only includes thyroids and the basic hormones including E2 this time. Guess ill see then.
Suspect cellular thyroid resistance due to elevated TSH and high ft3 in relationship to ft4.
Check ferriting levels. Goal (100-200) in order for body to optimize thyroid
Cortisol saliva would also be good to check as well because cortisol is needed to drive thyroid into the cell
You have enough thyroid in the blood but your not getting it to the tissue resulting in higher TSH
Any thing >2 in TSH even 1.5 could red flag potential issue
Vitamin D is very low which goal should be 70-90 for healthy levels.
Hypothyroid can cause prolactin levels high as well as too much sex before the blood draw.
Low dopamine can also cause elevated prolactin levels as well.
There is a slight chance i might be getting cabergoline or some other dopamine agonist. Do these have any noticeable dopaminergic properties? Stuff like elevated mood etc
I recently tried phenylethylamine by itself and god damn i have not felt so good since i was like 12 even though it was brief lasting, all my symptoms i was complaining to the endo about were basically perished and the mood stayed elevated for a little while longer.
Im starting to think high prolactin is not a symptom but the cause, atleast i sure as hell hope so.
Caber [0.5mg/week] will increase dopamine and may improve your mood. You could add low dose Rx seleginine/deprenyl, 2.5mg EOD to extend the half life of dopamine before it is destroyed by MOA enzymes. This does not entail the usual risks of non selective MAO inhibitors. So you would increase dopamine production rates and also reduce dopamine metabolization rates… working both sides of the equation.
Caber does not have a long serum half life, however, the MAO inhibitor action persists for 7-10 days.
PEA does what you describe, but can be exhausting and might make [any] adrenal fatigue worse. Deprenyl extends the effects of PEA, as would any MAO inhibitor. You would need to reduce PEA dose and then find a proper dose. You could easily get PEA overload with PEA+deprenyl.
LH levels change a lot a are peaking in the AM. FSH has longer half life and is a better indicator of gonadotrophin output from the pituitary.
Wow thanks for clearing that up. I was just wondering about mixing deprenyl with cabergoline, seems perfect for me. Elevates dopamine AND opens the possibility for an extra PEA kick in the ass with small dosages, saves me money aswell
[quote]KSman wrote:
Keep in mind that when you combine caber and deprenyl, that you need less of each.
[/quote]
I have been wondering, is prolactin surpressed due to the increased concentration of dopamine or is it because of the increased production of dopamine? Or some other property found in caber/benzo? Found out caber is very expensive here, 30 bucks for 2 tabs of 0.5mg while i can get 60 tabs of deprenyl for the same price.
Doc said prolactin went down but strangely enough its a different reference from the first test, taken maximum normal value into context then it hasnt changed.
He said androstendione was also way too high but could not find an explaination.
LH/FSH increased slightly but Testo shrunk. DHEA-S and SHBG increased.
MRT showed a 2.0mm cyst in the center of the pituitary gland, he did not explain 3dimensionally so im not sure if its inside our outside the gland, either way they didnt know exactly what it was but they said it wasnt a tumor. Correct me if im wrong but arent cysts tumors? what the hell are they talking about? He also didnt give me caber, he said it wouldnt matter much.
Nevertheless, they said to wait 6 months and redo the MRT to see if stuff has changed. Should i be worried?
Also, refering to my previous post, will deprenyl decrease prolactin?
Caber will lower prolactin. Ask doc what he is thinking?
An adinoma does not need to be cancer to create problems. These can be slow growing. But good to confirm that implication. Given this new info… how long ago do you think these problems started to occur?
Deprenyl will help, but caber plus low dose deprenyl would be better. Again; most docs are gun shy about MAO inhibitors and do not understand the safety of MAO-B inhibitors. Your prolactin is around three times what we see with most guys posting lab work here. Prolactin is a strong HPTA inhibitor. So is E2. Your E2 is too high as well. Lower prolactin and E2 and your T levels may improve nicely.
FSH is a better measure of gonadotrophin output as LH levels jump around by the minute. Your low FSH is consistent with a strong HPTA repression. The lack of gonadotrophins may be increasing Androstenedione by not using it to produce testosterone and E2 in the testes.
Excessive amounts can contribute to higher amounts of E2 generation in peripheral tissues, leading to more E2 and deepening HPTA repression. Yes, this is a self amplifying problem, the HPTA is vulnerable to such problems and from an engineering point of view would be regarded as a flawed design.
Suggest 0.5mg caber per week in divided doses, 2.5mg deprenyl EOD [split the contents of the 5mg capsules], 0.5mg anastrozole per week in divided doses. Watch for increased T, LH/FSH and lower E2. Adjust anastrozole dose to get near E2=22pg/ml. You can take these drugs all at the same time is that makes life simpler.
Note mood and libido changes and report to your doc so he can see that there are benefits.
Prolactin levels change. Surges with orgasm for a while. Hold or interact with a baby and it will go up. In your case, these responses could be exaggerated.
I would estimate 4 years, give or take a year. Im not 100% sure but its been a while that seems like a lifetime.
I learned something about my doc today. Hes an old conservative geezer that would not listen to a word i said. I wont be seeing him anymore, way too expensive and has has not updated his knowledge about endocrinology since 1980 it seems. He said there was nothing more he could do and i should visit him in 6 months. When i asked about meds he said it wasnt neccesary.
Anyways regarding medication im on my own for now and i am a little tight on cash. I have read around about prolactin surpression and came across pramipexole. Seemed to have worked great for people so i placed an order on that instead seeing it was twice as cheap as caber. So right now i have pramipexole and deprenyl on the way, might switch to caber when stuff settle a little.
As for anastrozole i wont be able to get it until i order the next batch(1 month). But i might be able to get a hold of 6-oxo until then, should use that or skip it?
As for prami, do you know anything about dose schedule? I have read it is stronger than caber, tabs i ordered were 0.18mg. 20 tabs for same price as 2 tabs of 0.5 caber