Hyperprolactinemia and Hypogonadism Male w/ bloodwork

Bluecept

New Member
Hey everyone! I'm a 20yo male who has been lifting and boxing for about six years. I am looking to start doing my own trt protocol since my endocrinologist is really unhelpful and the legal route is just not cutting it.

For context, I had an unexpected 40lb weight gain over the span of two months last fall and currently still experience fatigue, memory loss, ED, loss of strength and muscle, a stubborn fat storage, low libido, and just generally feeling bad. First bloodwork set showed a prolatin level of 19.8 ng/mL and test of 442 ng/dL. I took a brain MRI with contrast revealing liver function was good and no pituitary tumor was present, so I looked to the thyroid. Thyroid antibodies seemed to be in a healthy range but my FSH and LH are currently in the gutter. Surprisingly, my prolactin seemed to self-right itself to some extent.

Current bloodwork:
% Free Testosterone105.1 pg/mL
Testosterone, Total, MS498 ng/dL
Prolactin7.5 ng/mL
Thyroid Stimulating Hormone1.770 uIU/mL
FSH1.28 mIU/mL
Luteinizing Hormone2.1 mIU/mL


Hope to hear some more educated thoughts on any next steps I should take. Since the main direct fix for hypogonadism is a test supplementation, I feel like having an AI on hand won't be needed. Can't wait to learn so much from this forum and get more involved in the community.
 
Your prolactin was elevated but seems like your testosterone level was within normal range, assuming LH and FSH was also initially normal. Since MRI already ruled out pituitary microadenoma, I would think about possible drug/medication uses, which should have been considered prior to MRI, and rule out macroprolactinemia; a benign condition which can easily be fix by polyethylene-glycol precipitation method but the physician will have to put it in the order when measuring prolactin. Repeat labs looks good. I would suggest getting an estrogen level also.
Honestly, consider traumatic brain injury and it's complications such as depression/Traumatic Encephalopathy Syndrome given your history of boxing, especially since you had more than 5 years of exposure.
 
Hey everyone! I'm a 20yo male who has been lifting and boxing for about six years. I am looking to start doing my own trt protocol since my endocrinologist is really unhelpful and the legal route is just not cutting it.

For context, I had an unexpected 40lb weight gain over the span of two months last fall and currently still experience fatigue, memory loss, ED, loss of strength and muscle, a stubborn fat storage, low libido, and just generally feeling bad. First bloodwork set showed a prolatin level of 19.8 ng/mL and test of 442 ng/dL. I took a brain MRI with contrast revealing liver function was good and no pituitary tumor was present, so I looked to the thyroid. Thyroid antibodies seemed to be in a healthy range but my FSH and LH are currently in the gutter. Surprisingly, my prolactin seemed to self-right itself to some extent.

Current bloodwork:
% Free Testosterone105.1 pg/mL
Testosterone, Total, MS498 ng/dL
Prolactin7.5 ng/mL
Thyroid Stimulating Hormone1.770 uIU/mL
FSH1.28 mIU/mL
Luteinizing Hormone2.1 mIU/mL


Hope to hear some more educated thoughts on any next steps I should take. Since the main direct fix for hypogonadism is a test supplementation, I feel like having an AI on hand won't be needed. Can't wait to learn so much from this forum and get more involved in the community.

Exactly what are you getting at with this? Your results are completely normal and withing healthy ranges. There is no next step here except if you want to start using steroids?

As for the slightly high prolactin levels, that happens, it's not like your hormone levels are static. Prolactin can also be raised due to stress of venipuncture, it's why it should be measured via 3 to 5 blood samples taken in succession of 15 minutes and the first blood draw should be disregarded. I'm surprised doctors ordered a brain MRI based on one? slightly elevated prolactin level?

I'd look elsewhere for your symptoms. 105 pg/ml is a fine testosterone level and should provide you with all the DHT a person needs to have normal libido. You can check your estrogen levels but I doubt they are low with normal free testosterone levels.
 
Your prolactin was elevated but seems like your testosterone level was within normal range, assuming LH and FSH was also initially normal. Since MRI already ruled out pituitary microadenoma, I would think about possible drug/medication uses, which should have been considered prior to MRI, and rule out macroprolactinemia; a benign condition which can easily be fix by polyethylene-glycol precipitation method but the physician will have to put it in the order when measuring prolactin. Repeat labs looks good. I would suggest getting an estrogen level also.
Honestly, consider traumatic brain injury and it's complications such as depression/Traumatic Encephalopathy Syndrome given your history of boxing, especially since you had more than 5 years of exposure.
Went to get a second opinion at another endocrinologist and repeated some labs. FSH and LH were low again, and the endo also suggest TBI as a likely cause of my symptoms as well.

New endo prescribed 100mg test/week with follow up bloodwork and sperm analysis in 14 weeks (so quarterly during the year). Just wanted to check if you think this will be a sufficient dose to correct the hypogonadism?

Thanks for the info and your insight bro. Can't wait to feel better on treatment!
 
Exactly what are you getting at with this? Your results are completely normal and withing healthy ranges. There is no next step here except if you want to start using steroids?

As for the slightly high prolactin levels, that happens, it's not like your hormone levels are static. Prolactin can also be raised due to stress of venipuncture, it's why it should be measured via 3 to 5 blood samples taken in succession of 15 minutes and the first blood draw should be disregarded. I'm surprised doctors ordered a brain MRI based on one? slightly elevated prolactin level?

I'd look elsewhere for your symptoms. 105 pg/ml is a fine testosterone level and should provide you with all the DHT a person needs to have normal libido. You can check your estrogen levels but I doubt they are low with normal free testosterone levels.
I can see how my levels seem healthy for the most part, but I still experience consistent symptoms of low T. The prolactin is not much of a concern anymore since the results of the new labs. And yeah my access to healthcare was limited from living in multiple states, so my doc went right to ordering the brain MRI to rule out any hidden abnormalities.

I regret not getting any estrogen labs drawn, but I will be starting TRT shortly so hopefully no aromatization happens. Considering it's a low dose of 100mg/week, I am banking on the fact everything will be good in that category. Thanks for your input bro!
 
I can see how my levels seem healthy for the most part, but I still experience consistent symptoms of low T. The prolactin is not much of a concern anymore since the results of the new labs. And yeah my access to healthcare was limited from living in multiple states, so my doc went right to ordering the brain MRI to rule out any hidden abnormalities.

I regret not getting any estrogen labs drawn, but I will be starting TRT shortly so hopefully no aromatization happens. Considering it's a low dose of 100mg/week, I am banking on the fact everything will be good in that category. Thanks for your input bro!

Man, why are you going on testosterone REPLACEMENT therapy if you've got normal testosterone levels? Being on trt is not as simple as just replacing your endogenous testosterone, there are a slew of other processes that get shutdown, dysregulated, etc. when you start administering trt. From internal clock systems, to neurosteroids, to the suppression of gonadotropins (LH for instance has other functions then just stimulating the production of testosterone in the testies like memory; LTP, and a slew of other neurological functions) and the need to use HCG which brings it own problems to the table, etc. People don't realize this but it's not as simple as just pinning test and that's it.

Taking testosterone for fixing energy and libido issues is like taking a xanax if you've got anxiety. 500 ng/dl total test and 105 pg/ml free test are population averages. I've got a lover free T number at the moment and am waking up with night boners.

What's your SHBG, what's your iron status, do you have any underlying inflammation, too much stress maybe, etc.? This are all factors that are contributing to how you feel and they effect your testosterone levels. For instance, high SHBG (which lowers free T) is often a protecting mechanism, in the example of iron, free T increases iron absorption, in the case of gut issues when there are problems in the small intestine, iron absorption (transferin saturation) will go up, and that will increase SHBG, which will then in turn lower free T. Now, if you bypass this and increase free T via exogenous T, as in TRT, you'll severely upregulate iron absorption which will just fry your brain, worsen your mental condition, and a slew of other issues like problems with blood glucose management, cardio vascular issues, etc.

What I'm getting at is that just hopping on TRT without a full set of blood work, and a systems check up is negligible practice and this TRT clinics should be held accountable.

But seeing as how you are on a drug abusing steroid forum and not on a TRT health forum, maybe you should be honest with yourself and admit that you just want to use drugs and have some fun? Idk. what's your whole story, so pardon me if I'm overreaching, but based on the little info you provided, what you are doing now is in a lot of ways just pure moronic. You are 20yo mate. You need to address the underlying issues of your problems, not just shoot up steroids in your ass. Damn social media bs.

*Not to mention that you can just lower your SHBG and have higher free T while still retaining natural T production and you'll feel like you're on TRT.
 
unexpected 40lb weight gain over the span of two months
/\ This seems like a big deal. Definitely not normal. Seems more like the underlying cause is related to that rather than current T levels.
 
@Millard has a point @Bluecept. 40 pounds in 2 mounts is actually hard to believe to be even possible. But it definitely isn't androgen related. How is your thyroid? And the mental problems you have sound like a side effect of the weight gain; it sounds like mitochondrial dysfunction coupled with insulin resistance. Going keto for a short while and do some fasting days shoul alleviate the brain fog. Have you been on ssri's?You can also try stuff like 5HT1a antagonists which help with PFC blood flow and stuff like BHB salts helps a lot with lowering inflammation and helping mitochondria. Again, all of this is not caused by normal T levels. Yes you are low for your age, but still no way your issues are caused by T.
 
How is your thyroid? And the mental problems you have sound like a side effect of the weight gain; it sounds like mitochondrial dysfunction coupled with insulin resistance
Hey again, sorry for my late response. I totally get what you're saying but it's sometimes just easier to just pin test instead of going on a wild goose chase to find an underlying condition that may not be there. The endo chopped it up to just be TBI from boxing that disrupted my hormones and knocked around my pituitary a bit too much.

I had that one thyroid antibody bloodwork done and everything seemed normal. I do regret not also testing my SHBG, iron, or estrogen levels before starting TRT; however, since I have been on it for two weeks, I have never felt better before. Morning erections again, good mental status, no easily onset fatigue, the works.

To be completely honest though, I have never heard of a lot of the other conditions/terms you used and I'm all ears to learn more. Definitely going to look into mitochondria dysfunction, but no idea where I would begin to diagnose that or fix it. For background conditions, I have chronic neck pain (no specialist ever came to a conclusion on the cause) and took amitriptyline for maybe like a year when I was 15-16 range. That medication got rid of the migraines but not the neck pain, so I kinda just live with it every day. It's probably some form of inflammation since it gets worse with stress -> cortisol release -> inflammation? Idk. I tend to live a low stress life and not let shit get to me tho. Hopefully that answers the ssri and inflammation questions. I have also taken bpc and a little mk-677 a year ago as a healing protocol after easily breaking my ankle for a second time.

Thanks so much for all of your input bro, def learning a lot from you. I am honest with myself and know doing TRT is a cop out from taking extensive time to find underlying issues bc I want to feel good at the chance of an easy option and stop chasing random diseases.
 
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