What causes low prolactin and IGF-1 when all else looks great?

[JmarkH]

I received my new labs after 8 weeks on my new protocol. I don't take T. I take HCG 250IU x4wk and 50mg enclomiphene x 4wk.
TT is 956 ng/dL r264-916, FT 17.3 pg/dL r6.6-18.1, E 38.4 pg/dL r7.6-42.6, but prolactin is 3.6 ng/dL r4.0-15.2, and IGF-1 65 ng/mL r64-240.
I'm concerned about the prolactin and IGF-1 being low.
Labs are attached.
I'm also concerned about the new enclomiphene availability situation. For the most part, I've found my sweet spot, and now medication restrictions. I would hate to have to go on T while my body is fully capable of producing its own.
How might I bring up the prolactin and IGF-1?

 

[BigTex]

I will take a stab at this one.....the most common cause of low IGF-1 in males is age, you are 63. I don't see your serum HGH levels but critically, HGH levels dictate how much IGF-1 that the liver releases. These both can also be tied to testosterone levels, how ever, your T levels are high. I would definitely talk to your doctor about what you can do. Another guess might be, according to a recent Journal of Sexual Medicine study, low prolactin is actually strongly associated with Metabolic Syndrome. You do have high LDL, low HDL and a slightly elevated fasting blood glucose reading. Might be some dietary changes you can make to get both of these in check.

The following strategies can help maximize a IGF-1 levels if they are found to be inadequate:

• Weight lifting. Among the many health benefits offered by regular resistance training with weights, the hormonal impact of elevated HGH levels, which in turn raise IGF-1 levels, is one of the most important.
• Adequate sleep. The pituitary gland, where HGH is synthesized, releases the majority of growth hormone gh during sleep. As the chart below indicates, the pulsatile secretions of HGH increase substantially (both in terms of quantity and frequency) throughout the night. Therefore, elevating HGH release through more sleep will also trigger a beneficial production of more Insulin-like growth factor-1.
• Intermittent Fasting. The practice of intermittent fasting, sometimes called IF, refers to the popular eating plan of abstaining from any caloric intake for 16, 18, or 20 hours each day (the fasting window), followed by a period of eating generally between 4-8 hours. The available clinical evidence shows that fasting practices such as IF can result in enormous gains in circulating HGH and, therefore, in greater resultant IGF-1 release by the liver.
• HGH Replacement Therapy. Hormone replacement therapy (HRT) may be necessary for patients who have a particularly significant clinical, diagnosed deficiency due to an underperforming pituitary gland.

 

[JmarkH]

Does anyone know if CJC 1295 / Ipamorelin increases IGF-1?
I use a cpap and get 7.5 hours of sleep per night.
I'm already doing resistance and weight training 3 to 5 times per week.
I guess this might just be my liver still recovering from FLD. I had elevated liver panels up to the first of this year. I stopped drinking alcohol in December of 2021 and started working out in February of 2022. After both, the liver panels dropped into range.
I've also lost 15lbs since February. I do have a follow-up appointment with the Doctor on the 21st.

 

[BigTex]

Absolutely CJC 1295 and IPA will increase your IGF-1. I would start with bed time injections and test after a few weeks. If it is not where you want it then increase to 2 - 3 doses per day.

 

[Systemlord]

I had tried peptides to increase my IGF-1 to no avail, but later found out I was iron deficient. The next time I checked IGF-1, it had gone up substantially.

 

[FunkOdyssey]

Enclomiphene drastically reduces IGF-1 level by blocking estrogen receptors in the liver.

 

[BigTex]

Enclomiphene drastically reduces IGF-1 level by blocking estrogen receptors in the liver.

Ronald D. Wiehle, Gregory K. Fontenot. Oral enclomiphene citrate lowers IGF-1 in men with secondary hypogonadism while raising testosterone: Implications for cancer prevention. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1326. doi:10.1158/1538-7445.AM2013-1326

Abstract 1326: Oral enclomiphene citrate lowers IGF-1 in men with secondary hypogonadism while raising testosterone: Implications for cancer prevention.

Abstract. Introduction: Lowered hGH and IGF-1 have been linked with protection from various cancers.Methods and Subjects: We determined levels of IGF-1 and pituitary hormones in men with secondary hypogonadism under treatment with enclomiphene (a.k.a. Androxal) in comparison to topical...

aacrjournals.org

 

[JmarkH]

Enclomiphene drastically reduces IGF-1 level by blocking estrogen receptors in the liver.

Now the reduced IGF-1 was an unknown on my part. Does it also reduce prolactin?

 

[FunkOdyssey]

Now that was an unknown on my part. Does it also reduce prolactin?

I haven't seen a study to that effect but I would say probably, because estradiol stimulates prolactin levels to increase and enclomiphene is interfering again by blocking the estrogen receptors. I think the fact that this is happening all over the body is potentially a cause for concern with long term use.

 

[nodoctor]

I noticed the above paper links IGF-1 with cancer risk. I'm vegan and Dr Greger and others I respect sometimes reference elevated IGF-1 in heavy meat eaters and strongly correlated with increased risk of various cancers. Does that cause any of you concern if running (as I do) various GHRP and GHRHs to increase IGF-1 for training, healing, skin, etc? Or am I missing something here?

 

[JmarkH]

The safe zone seems to be 80-175 with the sweet spot at 100-140 ng/mL. These are the numbers I'm aiming for.
Both Low and High Serum IGF-I Levels Associate with Cancer Mortality in Older Men

 

[RP McMurphy]

Enclomiphene drastically reduces IGF-1 level by blocking estrogen receptors in the liver.

Yup. This has been my experience as well. Clomiphene tanked my IGF-1. Curious if this correlates to lowered growth hormone production...