27 Yr Male on TRT, Zero Libido

You also say that you ‘run a lot.' Running, especially for distance, is a huge drain on testosterone levels and libido for anyone but a young guy. What you do for workouts can fry your central nervous system and deplete test as well as libido. Sound sleep is also a factor, as is stress levels. Any one or combination of these things can lower libido.

And, as usual, madman's post is spot on.

Admired said:

Haven't had DHT tested and prolactin before starting TRT was

L

[TD="class: red"]Prolactin[/TD] [TD="class: red"]1.9

[/TD] [TD="class: red"]4.0-15.2 (ng/mL)[/TD] [TD="class: red"]MB[/TD]

How does prolactin play a role in libido? I don't know where it sits now however.

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I'm not on TRT, but I've been having issues related to high E2 and prolactin. I can tell you from experience that if your prolactin goes off the bottom of the scale you'll feel bad. I inadvertently drove my prolactin down below 1.0 using cabergoline. Felt great while it was coming down, but once it went too low I was lethargic and had no libido similar to when my prolactin and E2 were too high. Mine is back up to 8.9 now and I feel normal again - even a little too horny at times. I'd recommend you aim for something close to, but not below the 4.0 ng/mL level.

keigwin said:

I'm not on TRT, but I've been having issues related to high E2 and prolactin. I can tell you from experience that if your prolactin goes off the bottom of the scale you'll feel bad. I inadvertently drove my prolactin down below 1.0 using cabergoline. Felt great while it was coming down, but once it went too low I was lethargic and had no libido similar to when my prolactin and E2 were too high. Mine is back up to 8.9 now and I feel normal again - even a little too horny at times. I'd recommend you aim for something close to, but not below the 4.0 ng/mL level.

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How did you bring back up your prolactin level?

Admired said:

How did you bring back up your prolactin level?

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I cut my dose of cabergoline. Trying to optimize my hormones has been a real balancing act. Frequent blood tests and adjustments are a must, and I haven't been doing blood tests often enough.

Ok just got back recent bloods, let me know what you guys think

E2 Sensitive: 18.6 pg/ml range: 8-35
Estradiol (regular test): 25.3 Range: 7.6-42.6 (pg/mL)
Prolactin: 1.1 ng/ml Range: 4.0-15.2
T4,Free(Direct):1.34 Range: 0.82-1.77 (ng/dL)
Testosterone, Serum: 838 Range:264-916 (ng/dL)
TSH: 2.090 Range: 0.450-4.500 (uIU/mL)
Triiodothyronine (T3), Free: 3.1 Range: 2.0-4.4 (pg/mL)

Can this low prolactin be the determining factor here? Also E2 does seem a bit low as well. My Endo called me today suggesting going on low does AI, I told him i wanted to wait for the E2 sensitive results and sure enough they look a bit on the low side even though it's in range. But still I would imagine I would have some libido unless that low prolactin just kills libido?

Admired said:

Ok just got back recent bloods, let me know what you guys think

E2 Sensitive: 18.6 pg/ml range: 8-35
Estradiol (regular test): 25.3 Range: 7.6-42.6 (pg/mL)
Prolactin: 1.1 ng/ml Range: 4.0-15.2
T4,Free(Direct):1.34 Range: 0.82-1.77 (ng/dL)
Testosterone, Serum: 838 Range:264-916 (ng/dL)
TSH: 2.090 Range: 0.450-4.500 (uIU/mL)
Triiodothyronine (T3), Free: 3.1 Range: 2.0-4.4 (pg/mL)

Can this low prolactin be the determining factor here? Also E2 does seem a bit low as well. My Endo called me today suggesting going on low does AI, I told him i wanted to wait for the E2 sensitive results and sure enough they look a bit on the low side even though it's in range. But still I would imagine I would have some libido unless that low prolactin just kills libido?

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Too much or too little prolactin can lower libido. I don't like your sensitive E2, it need to increase. Troubling that your doctor wanted to start you out on an AI before the labs came in! Your TSH may be indicating a problem, it's a shame no Reverse T3 or antibodies tested.

Low libido could be linked to both low prolactin and low E2.

What is wrong with TSH, seems right in the range. He is increasing my unithroid medication from 25mcg to 50mcg because of it. How do I increase E2 and Prolactin?

On another note I went through previous blood work and came across my TPO before TRT

Thyroid Peroxidase (TPO) Ab 279 H 0-34 (IU/mL)

What is TPO and is 279 too high? What does this signify?

Systemlord said:

Too much or too little prolactin can lower libido. I don't like your sensitive E2, it need to increase.

Low libido could be linked to both low prolactin and low E2.

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I agree with this based on my own experience. A bit less AI should move your E2 to the low to mid 20s, which could help your symptoms. I would still focus on the low prolactin as the #1 culprit, though. It's dropped again and these near-zero levels will make you feel crappy.

keigwin said:

I agree with this based on my own experience. A bit less AI should move your E2 to the low to mid 20s, which could help your symptoms. I would still focus on the low prolactin as the #1 culprit, though. It's dropped again and these near-zero levels will make you feel crappy.

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I'm not even on AI. How do I raise E2 and prolactin levels? I am sure this is my issue but I don't know how to raise them

Admired said:

I'm not even on AI. How do I raise E2 and prolactin levels? I am sure this is my issue but I don't know how to raise them

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You can raise estrogen by increasing testosterone, testosterone is converted into estrogen via Free T.

Are you sure you're not on any medications or supplements that could be lowering estrogen?

Systemlord said:

You can raise estrogen by increasing testosterone, testosterone is converted into estrogen via Free T.

Are you sure you're not on any medications or supplements that could be lowering estrogen?

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As stated previous I was taking around 100mg of zinc/day for about a month but I stopped after learning about how it acts as an AI
I am also taking

Multi-vitamin
25mcg Unithroid (levothyroxine sodium) daily
Horny Goat Weed
Ginseng
Garlic
Green Tea Extract
Ginger
L-Arganine
L-Citruilline
L-Tyrosine
Ashawaganda
Copper
D-3 if I don't go outside for sun
Ginkgo Biloba

All of these were taken to try to increase libido, however, after seeing no results I stopped all medications/supplements except Thyroid med and Copper. I am thinking because i took so much zinc it acted as a fairly strong AI so hopefully it will go back up, I will also midly increase my next test cyp to a bit over 100mg. Now as far as increasing prolactin I have no idea how it got so low or how to increase it.

Admired said:

I'm not even on AI. How do I raise E2 and prolactin levels? I am sure this is my issue but I don't know how to raise them

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Sorry, I assumed you must be on an AI. Men with high BMI and/or blood glucose can have low prolactin. If these are true for you, then lifestyle changes might help (and they'll help you feel better overall and possibly bring your other hormones in line).

The neurotransmitter dopamine influences how much prolactin your pituitary makes. More dopamine = less prolactin. Are you on any medications that increase dopamine (e.g. certain antidepressants)?

After that, my knowledge is tapped. If it were me, I'd be spending a lot of time googling. Or maybe someone else here has the answer.

keigwin said:

Sorry, I assumed you must be on an AI. Men with high BMI and/or blood glucose can have low prolactin. If these are true for you, then lifestyle changes might help (and they'll help you feel better overall and possibly bring your other hormones in line).

The neurotransmitter dopamine influences how much prolactin your pituitary makes. More dopamine = less prolactin. Are you on any medications that increase dopamine (e.g. certain antidepressants)?

After that, my knowledge is tapped. If it were me, I'd be spending a lot of time googling. Or maybe someone else here has the answer.

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I'm in great shape so BMI is not issue. I'm not taking antidepressants and the only other dopamine type supplements im taking are Ashawaganda, L-Tyrosine and mucuna pruriens from time to time.

Would you guys suggest supplementing with 50-100mg of DHEA to increase E2 levels? Also how should I try to increase prolactin levels to normalcy?