Lab thoughts? esp as regards prolactin and cab?

[masfield]

here's my old protocol:
Testosterone: .25ml twice weekly
Nandrolone: .30ml twice weekly (for muscle-wasting disease)
HCG: .30 twice weekly
Anastrozole: .25mg twice weekly

based on my labs below, a dr at defy (not dr saya but i can't remember the gentleman's name) changed things a bit, to wit:

added DHEA (which i haven't been taking, i don't know why, some kind of motivation bleh issue, i guess)
changed hcg to .50 twice weekly.

i also take cabergoline, which i told him about and he didn't have anything to say about it. as you can see, my prolactin comes in at .7, which is well below the low-end reference number.

so .. could ya'll have a look at my labs and give me your thoughts?

thanks!


Test Result Flag Reference
--------------------------------------------------------------------------------------------
PSA | 2.19 | | <4.0 ng/mL
--------------------------------------------------------------------------------------------

DHEA-SULFATE | 128.6 | | 48.9-344.2 ug/dL
IGF | | |
IGF-I | 216 | H | 49-188 ng/mL

PROLACTIN | 0.7 | L | 4.0-15.2 ng/mL
EST | | |
ESTRADIOL | 10.4 | | 7.6-42.6 pg/mL
| Roche ECLIA methodology
TESTF+T | | |
TEST TOTAL LCMS | 978.8 | H | 264.0-916.0 ng/dL

FREE TESTOS. | 37.7 | H | 6.6-18.1 pg/mL

SEX HORMONE BG | 34.4 | | 19.3-76.4 nmol/L


--------------------------------------------------------------------------------------------
CBC/NO DIFF | | |
WBC | 7.3 | | 4.0-10.8 K/mm3
RBC | 5.26 | | 4.7-5.9 M/mm3
HGB | 16.2 | | 13.5-17.5 g/dL
HCT | 48.6 | | 40.0-52.0 %
MCV | 92.4 | | 80.0-100.0 fL
MCH | 30.8 | | 27.0-34.0 pg
MCHC | 33.3 | | 31.0-36.5 g/dL
RDW-CV | 13.9 | | 11.5-14.5 %
RDW-SD | 47.7 | | 35.0-50.0 %
PLT | 288 | | 140-430 K/mm3
MPV | 10.8 | | 9.4-12.3 fl
NRBC % | 0 | | 0.0-0.2 /100 WBC
NRBC # | 0 | |
COMP | | |
GLUCOSE | 93 | | 74-106 mg/dL
BUN | 14 | | 8-26 mg/dL
CREA W eGFR | | |
CREATININE | 1.42 | H | 0.6-1.2 mg/dL
eGFR AFRIC AMER | > 60 | | > 60
| GFR value is reported as mL/min/1.73 square meters
eGFR NON-AFR AM | 50 | | > 60
| GFR value is reported as mL/min/1.73 square meters
LYTES | | |
SODIUM | 141 | | 136-144 mmol/L
POTASSIUM | 3.8 | | 3.6-5.1 mmol/L
CHLORIDE | 106 | | 101-111 mmol/L
CARBON DIOXIDE | 27 | | 22-32 mmol/L
CALCIUM | 9.1 | | 8.5-10.1 mg/dL
LPD | | |
CHOLESTEROL | 189 | | <200 mg/dL
TRIGLYCERIDES | 74 | | <150 mg/dL
HDL CHOLESTEROL | 45 | | >39 mg/dL
LDL CHOLESTEROL | 129 | | <130 mg/dL
AST/SGOT | 32 | | 15-41 U/L
ALT/SGPT | 25 | | 17-63 U/L
ALK PHOSPHATASE | 68 | | 32-105 U/L
TOTAL PROTEIN | 6.9 | | 6.5-8.1 gm/dL
ALBUMIN | 4.0 | | 3.5-5.0 gm/dL
A/G RATIO | 1.4 | | 1.1-2.2
BILIRUBIN,TOTAL | 0.7 | | 0.3-1.2 mg/dL
TSH | 1.44 | | 0.34-5.60 mcIU/mL

 

[CoastWatcher]

Your estradiol is certainly low, and measured with the proper test, the LC, MS/MS sensitive test, it might be even lower. You're continuing with an AI as part of your protocol? It would appear you've nearly extinguished your prolactin. Where did it stand prior to your use of cabergoline? Most importantly, how are you feeling?

 

[masfield]

thank you, coastwatcher, for weighing in.

1/ if my estradiol is indeed low, what's the effect of that and what do you take (or take more of) to get it to the right levels?

2/ what is AI?

3/ i don't know what my prolactin was before i started cab. i read that cab might help anorgasmia so i began taking it without having labs done. so far, it has not helped with my problem, but maybe i'll start a new thread about that vexation.

4/ well, i'm probably feeling as good as when i started trt but have become accustomed to it. i have a muscle wasting disease along with something new called an essential tremor and b/ the two of them my well-being feeling is always going up and down.

5/ what's the significance of my prolactin being so low?

thanks again for your help!

 

[Vince]

2/ what is AI?
5/ what's the significance of my prolactin being so low?

AI - Anastrozole: .25mg twice weekly

Low Prolactin Is Associated with Sexual Dysfunction & Psychological/Metabolic Issues
​

https://www.excelmale.com/showthread...tabolic-Issues

 

[masfield]

ah yes, i'm still taking the AI (where does the I come from?).

i have no ED problems at the moment but ejaculating while with my gf is but a vague dream. a case of anorgasmia? maybe. but could it have to do with my low prolactin level? i'll investigate. (i can come via masturbation but even then it's a stretch and takes almost forever). i'm sure the zoloft isn't helping but i've been on it for years and years and never had problems like this before. very frustrating.

 

[Vince]

ah yes, i'm still taking the AI (where does the I come from?).

i have no ED problems at the moment but ejaculating while with my gf is but a vague dream. a case of anorgasmia? maybe. but could it have to do with my low prolactin level? i'll investigate. (i can come via masturbation but even then it's a stretch and takes almost forever). i'm sure the zoloft isn't helping but i've been on it for years and years and never had problems like this before. very frustrating.

Because of you low estradiol levels, you should consider lowering or stopping your Anastrozole. Higher levels of estradiol makes more men feel better, I believe it's better to have higher levels of E2 then lower levels. One of the biggest issues with trt is too low of estradiol levels, many men feel better with higher levels.

 

[Dr Justin Saya MD]

Stop the cabergoline and would do trial of holding the anastrozole to see how you feel. Looks like you had labs done “outside” as the estradiol is the standard estradiol...try to get the sensitive estradiol (LC/MS/MS) for next run.

 

[masfield]

thanks, vince. dr saya: okay, i'll stop the cab and the ai. i just got a defy notice today telling me that my next lab tests should be done soon. how long should i wait to get em done, given i'm just now stopping cal and ai. thanks for weighing in.

 

[Dr Justin Saya MD]

thanks, vince. dr saya: okay, i'll stop the cab and the ai. i just got a defy notice today telling me that my next lab tests should be done soon. how long should i wait to get em done, given i'm just now stopping cal and ai. thanks for weighing in.

I’d wait about 6 weeks.