Extensive blood work results. Prolactin, DHT, Estradiol, Luteinizing way off?

[fiddystorms]

Just got my lab results. Paid for a little extra after reading a bunch on this forum (thank you all for that). I really don't know enough to decipher this stuff. I don't know what to be concerned about or what it all means... but I know how I feel & it's not great after my testosterone is back in line. Been on Androgel for 4 months.

 

[Vince Carter]

Prolactin I would test that one again just to eliminate any lab error, any chance you had any sexual activity or orgasm ~24hrs prior to your test? That could create a false high PRL test. Usually for a PRL, and PSA, too, you want to refrain from orgasm and sex 24-48hrs prior.

I think your DHT is fine were it is, your PSA is <1 and if there's no hairloss present I would just be happy that it's above range. If it stays up PSA would be something to include in all your routine testing, to keep an eye on it. DHT is not bad by any means.

Estradiol....meh if you're not having negative symptoms I would also leave that one where it is for now and let your protocol and therapy continue to mature at this point.

 

[fiddystorms]

Thanks Vince. I was well informed on the 48 hrs rule. Definitely refrained from all activities, didn't even look at the victoria secret catalog when it came in the mail! As for negative symptoms & Estradiol... I really don't know what negative symptoms to look for. I'll have to read up on that again. I forget what I read 3 weeks ago about it (Oh shit, is that one of the symptoms?).

 

[Dr Justin Saya MD]

Just got my lab results. Paid for a little extra after reading a bunch on this forum (thank you all for that). I really don't know enough to decipher this stuff. I don't know what to be concerned about or what it all means... but I know how I feel & it's not great after my testosterone is back in line. Been on Androgel for 4 months.
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Copying my response from your other thread:

With that sky high prolactin you will need a pituitary MRI before your initial consult. I would also encourage rechecking the prolactin one more time to rule out lab error, before we start a treatment for it. Make contact with your intake coordinator at my office and forward this thread including my response.

 

[johndoesmith]

Copying my response from your other thread:

With that sky high prolactin you will need a pituitary MRI before your initial consult. I would also encourage rechecking the prolactin one more time to rule out lab error, before we start a treatment for it. Make contact with your intake coordinator at my office and forward this thread including my response.

You'd think with a prolactin that high he'd be blind essentially. My money is on lab error. I've never seen a level THAT high.

 

[Dr Justin Saya MD]

You'd think with a prolactin that high he'd be blind essentially. My money is on lab error. I've never seen a level THAT high.

I have with a rather large prolactinoma...but lab error is always first to rule out with any suspicious result.

 

[johndoesmith]

I have with a rather large prolactinoma...but lab error is always first to rule out with any suspicious result.

Reading my previous post I apologize, as my tone may have been a little confrontational, and I didn't mean for it to.

I was just shocked by a 4 digit prolactin level, there's a first time for everything!

 

[Dr Justin Saya MD]

Reading my previous post I apologize, as my tone may have been a little confrontational, and I didn't mean for it to.

I was just shocked by a 4 digit prolactin level, there's a first time for everything!

No I didn't take it that way at all. In fact, I've certainly seen more lab errors (by several fold) than 4 digit prolactin levels.

 

[fiddystorms]

I have with a rather large prolactinoma...but lab error is always first to rule out with any suspicious result.

Thank you Dr. Saya. I did what you asked & sent the forum post below to the intake coordinator. I will wait to hear from him.

 

[Dr Justin Saya MD]

Thank you Dr. Saya. I did what you asked & sent the forum post below to the intake coordinator. I will wait to hear from him.

Great, call them if you don't hear back from them after Monday.

 

[fiddystorms]

I heard from Adam first thing this morning. Took my blood test this afternoon. Should have results in a couple days.

 

[Dr Justin Saya MD]

I heard from Adam first thing this morning. Took my blood test this afternoon. Should have results in a couple days.

Very good. Will await results. You can post here for continued discussion and community education.

 

[fiddystorms]

One slight problem. Your staff reacted Monday morning so quickly with the script for the blood work that I didn't prepare ahead of time and had something to eat roughly five hours before the test. Also had coffee. will this skew the results?

 

[Vince]

One slight problem. Your staff reacted Monday morning so quickly with the script for the blood work that I didn't prepare ahead of time and had something to eat roughly five hours before the test. Also had coffee. will this skew the results?

When you get your script for labs, there's no hurry in getting them. I only do labs when I'm prepared. I usually call Defy ahead of my 6 months lab appointment and order them.

 

[Dr Justin Saya MD]

One slight problem. Your staff reacted Monday morning so quickly with the script for the blood work that I didn't prepare ahead of time and had something to eat roughly five hours before the test. Also had coffee. will this skew the results?

Not for the purpose of what we're seeking....which is to confirm or invalidate the very high reading on your previous draw. Not fasting can have a smaller impact.

 

[fiddystorms]

Ughh... same result! Actually, this one has a "greater than sign". >4700

apparently I am unable to add a photo today... so here's the link: https://drive.google.com/open?id=0B23WcVO0cdYsY2ZTaWthLUNYVkU

 

[Vince Carter]

Well that's def unusual, let Dr Saya take care of you!!

 

[Dr Justin Saya MD]

Ughh... same result! Actually, this one has a "greater than sign". >4700

apparently I am unable to add a photo today... so here's the link: https://drive.google.com/open?id=0B23WcVO0cdYsY2ZTaWthLUNYVkU

Staff will be reaching out to you soon, if they haven't already, to arrange an order for a pituitary MRI.

Out of curiosity, have you experienced any visual field deficits, particularly bitemporal hemianopsia (you can look it up - visual deficit in OUTER portion of right and left visual field)?

 

[fiddystorms]

Thank you Dr. Saya, your staff has been excellent! MRI scheduled for next Thursday. I have not experienced any visual field deficit. I have good vision & have never worn glasses. I wouldn't say I have noticed any visual impairment that wasn't related to age & it's very minor if at all.

 

[fiddystorms]

Still at square one with this MRI.
6/14/17 - Insurance (really good insurance too) will not cover an MRI that is prescribed out of network. postponed MRI to see if family doctor would prescribe the MRI.

6/15/17 - Family doctor would not prescribe MRI, said it would cause trouble with insurance co. coming from him & that I need to see an endocrinologist to get that prescription. Made appointment with an endo for 7/26... one & a half months away but my first consultation with Dr. Saya is July 11. I had a feeling my family doc who prescribed Androgel to me was a bit miffed that I went outside his realm to Defy medical for help & that was the real reason, so I made an appointment with an ear nose & throat dr. who's medical intake person said he dealt with pituitary gland issues.

6/19/17 - Ear nose & throat doc said he couldn't help me, that the prescription would need to come from an endo or a neurosurgeon for there to be no problems with insurance covering it (At least he gave me my co-pay back as well). Postponed MRI again.

I've called a half dozen endo's for an appointment sooner than July 26... none available. Any recommendations on how to get into see one of these guys sooner? I do not want to delay the process with Dr. Saya any longer than necessary.