T Nation

TRT for 6 Months, High Prolactin

Hi all any advice would be much appreciated.

I am 30 and I started trt sub q injections test cyp 70mg a week and 200 IU of HCG 3x a week along with 0.5 mg of adex divided up three times a week and I have had blood tests showing high prolactin but no side effects.

Blood results

Red Blood Cells
HAEMOGLOBIN (G/L) 162 g/L 130.00 - 170.00
HCT 0.477 L/L 0.37 - 0.50
RED CELL COUNT 5.21 x10^12/L 4.40 - 5.80
MCV 92 fl 80.00 - 99.00
MCH 31.1 pg 26.00 - 33.50
MCHC (G/L) 339 g/L 300.00 - 350.00
RDW 12.8 % 11.50 - 15.00
White Blood Cells
WHITE CELL COUNT 4.9 x10^9/L 3.00 - 10.00
NEUTROPHILS 2.52 x10^9/L 2.00 - 7.50
LYMPHOCYTES 1.83 x10^9/L 1.20 - 3.65
MONOCYTES 0.38 x10^9/L 0.20 - 1.00
EOSINOPHILS 0.09 x10^9/L 0.00 - 0.40
BASOPHILS 0.02 x10^9/L 0.00 - 0.10
Clotting Status
PLATELET COUNT 155 x10^9/L 150.00 - 400.00
MPV 10.5 fl 7.00 - 13.00
Kidney Function
CREATININE 107 umol/L 66.00 - 112.00
Liver Function
ALANINE TRANSFERASE 35.6 IU/L 10.00 - 50.00
CK *232 IU/L 38.00 - 204.00
GAMMA GT 17 IU/L 10.00 - 71.00
TOTAL PROTEIN 64.9 g/L 63.00 - 83.00
TOTAL PROTEIN 64.9 g/L 63.00 - 83.00
ALBUMIN 41.4 g/L 34.00 - 50.00
GLOBULIN 23.5 g/L 19.00 - 35.00
Iron Status
FERRITIN 169 ug/L 30.00 - 400.00
Cholesterol Status
TRIGLYCERIDES 0.96 mmol/L 0.00 - 2.30
CHOLESTEROL 4.28 mmol/L 0.00 - 4.99
HDL CHOLESTEROL 1.29 mmol/L 0.90 - 1.50
LDL CHOLESTEROL 2.55 mmol/L 0.00 - 3.00
NON-HDL CHOLESTEROL 2.99 mmol/L 0.00 - 3.89
Heart Disease Risk
HDL % OF TOTAL 30.14 % 20.00 - 100.00
Thyroid Function
FREE T3 4.56 pmol/L 3.10 - 6.80
FREE THYROXINE 17.5 pmol/L 12.00 - 22.00
TESTOSTERONE 18.7 nmol/L 7.60 - 31.40
FREE-TESTOSTERONE(CALCULATED) 0.382 nmol/L 0.30 - 1.00
17-BETA OESTRADIOL 58.1 pmol/L 0.00 - 191.99
SEX HORMONE BINDING GLOB 36.8 nmol/L 16.00 - 55.00
PROLACTIN *333 mIU/L 86.00 - 324.00
Prostate Screen
PROSTATE SPECIFIC AG(TOTAL) 0.876 ug/L 0.00 - 1.40

Increases in prolactin can happen for a number of reasons. First certain prescription medications will increase levels of prolactin such as some SSRI and SNRI drugs as well as nearly all anti-psychotics and other drugs as well. So that is a benign cause, on the more concerning sign it can also be caused by a pituitary adenoma. Even when small they can interfere with LH/FSH production causing secondary hypogonadism while simultaneously increasing prolactin. Not trying to concern you or anything. Are you taking any other prescription medications than test c, hcg and adex?


Thank you for your reply.

Yes I think you may have discovered the cause, I have recently started to take fluoxetine (Prozac). To compound the evidence that this is cause, my t level was higher a few months back but my prolactin was well in range.

Many thanks

T levels too low.

Your lab results are affected by injection frequency and lab timing. Recommendation it two injections per week and always to labs halfway between injections. Time of office visits can be wrong.

CK can be elevated by muscle injury/soreness.

70mg T cyp really never provides adequate numbers.
FT is way too low, but see above.
Average FT seems low as low E2 from FT–>E2.

fT3 is below mid-range.
Oral body temps expected low.
TSH reflects low fT3
fT4 is good, but is not the active hormone.
T4–>T3 conversion may be impaired even though ferritin is adequate

Prolactin can be elevated from recent hugging or cuddling {babies, kittens, puppies} and also from recent orgasms, avoid prior to lab work.

Hi KSman

Thank you for your advice.

Yes you are correct my oral body temperature never really gets up to 98 and I started to take iodine 12.5mg BD daily for around 4 months.

I reduced the t cyp to that low dose as a bit of a knee jerk reaction to high t level on 125mg a week which caused me some mood problems.

I inject sub q 3 X a week Monday, Wednesday and Friday.

I will gradually increase the dose of t and keep the adex the same dose. Is there anything else that I should tackle or anymore suggestions?

Many thanks

If adex the same, E2 can be expected to increase in proportion to T dose increase. There can be some interplay of E2-liver-SHBG as secondary effects.

That much iodine twice a day is excessive for a maintenance dose and can be a reason by itself for higher TSH levels.

Thank you for taking the time to answer these questions, it is much appreciated.

I will reduce the iodine and increase t. Do I need to take t3? And I’ll attempt to get the e2 nearer to 80.

Many thanks

It is unwise to take a lot of iodine without selenium.

Low body temps, when waking <97.7F and <98.6 in afternoon, can be from:

  • Low fT3
  • rT3 reducing effects of fT3
  • very low CoQ10 which can be a result of a statin drug
  • combos of the above

I needed T3 and get that as time release which is a compounding pharmacy only item in USA, pharma has fast acting.