High prolactin

[arsenio7]

Hi all,

In the last few months, I started to experience issues getting strong wood, having a late ejaculation (or even not), and way less semen.

I did my blood test and voilà: (I'm not on TRT)

total T: 727ng/dL
shbg: 69nmol/L (lab normal range: from 18 to 54)
cbg: 55 mg/L (lab normal range: from 22 to 55)
albumin: 45.2 g/l
prolactin: 39 ng/ml (lab normal range: from 4.6 to 21.4)

shbg and cbg are slightly elevated, and prolactin is going to the sky...

shall I proceed with some other tests like E2 and E1?

Cheers

Arsenio

 

[Systemlord]

Anti-depressants (SSRI’s) will increase prolactin.

 

[Systemlord]

shall I proceed with some other tests like E2 and E1?

E2 is the most potent form of estrogen, E1 is a weak estrogen, don’t bother with it. Most guys need an E2 over 20 pg/mL for strong erections.

Usually when SHBG gets this high, unless you have adequate pituitary response, guys start having problems with low Free T.

Basically as SHBG rises, Total T increases and Free T can stay the same or it can decline.

That’s why it’s always a good idea to check Free T using the equilibrium dialysis method when checking Total T.

 

[arsenio7]

Anti-depressants (SSRI’s) will increase prolactin.

thanks, for the info.
I'm currently under no medication. Should go further on investigations with this skyscraping prolactin?

 

[Cataceous]

If you want to be aggressive about it then get an MRI of the pituitary to rule out abnormalities. You could measure estradiol—because estrogens tend to increase prolactin. Otherwise, small doses of cabergoline can be used to normalize prolactin and alleviate the symptoms you describe.

Note also that your Vermeulen calculated free testosterone of 9.6 ng/dL is somewhat borderline. My impression is that some men can experience symptoms of hypogonadism in this gray area of 7-10 ng/dL. I wouldn't consider traditional TRT even if subsequent testing is still borderline, but a trial with testosterone nasal gel could be informative.

 

[JmarkH]

HIgh prolactin will give you those symptoms. Did you have sex prior to the lab test or was it over 24 hours? Sex will raise prolactin. You can do a search for high prolactin and ways to reduce it. Supplements are the slow approach but do work for some. After that there are medications but go low and slow with those.

 

[arsenio7]

If you want to be aggressive about it then get an MRI of the pituitary to rule out abnormalities. You could measure estradiol—because estrogens tend to increase prolactin. Otherwise, small doses of cabergoline can be used to normalize prolactin and alleviate the symptoms you describe.

Note also that your Vermeulen calculated free testosterone of 9.6 ng/dL is somewhat borderline. My impression is that some men can experience symptoms of hypogonadism in this gray area of 7-10 ng/dL. I wouldn't consider traditional TRT even if subsequent testing is still borderline, but a trial with testosterone nasal gel could be informative.

then I'll do another blood work with total T, estradiol, shbg.

I'm curious to know if this high prolactin is somehow linked to the high shbg and cbg (cause or consequence).

Does it make sense to check thyroid hormones?

 

[arsenio7]

Maybe asking GPT is not a good idea. :-D