Need some assistance - Prolactin levels and Estradiol (not sensitive test I don't think)

[pyater]

47 year old male, overweight- High blood pressure and cholesterol.

I started TRT back in August 2018. My primary care Dr. suspected low T after suspected Gynecomastia (later confirmed with Ultrasound & monogram).

Low T was confirmed with blood work and symptoms. Initial baseline was 134 total T. Started with Test Cypionate IM injections. Started with 100Mg monthly and titrated to 400MG every three weeks. With a local Urologist who I am not convinced is current with TRT protocol. I have asked several times about HCG and AI to no avail. I also think frequency and high dosage may be an issue. Here is summary of blood test results.



Latest bloodwork shows elevated Prolactin levels at 33.4 ng/ml after previous levels of 11.6 on 6/19/18 (before I started TRT) and 12.1 on 9/26. Open to thoughts and ideas no current HCG or AI usage just Test Cypionate IM injections.

Concerned about rising Prolactin levels and Estradiol levels.

Also, not feeling as great as when I started TRT back in August. Erections less lengthy. Mood, Libido and energy good.

 

[CoastWatcher]

Your doctor/doctors have failed you. Your protocol is a disaster and you are lost in the valley of medical ignorance. It happens to far too many men and it is ridiculous. The research is conclusive - smaller, more frequent doses of testosterone bring success. Whopping, big bolts doses such as you've been prescribed bring failure and frustration.

An excellent starting dose is 100-120mg of testosterone injected every 3.5 days. The half-life of testosterone is such that your protocol does nothing but drive your levels upward, then they sink. By the time you are due for your next injection you have nothing left in your system and feel hypogonadal all over again. A merry-go-round of misery. Oh, and with that stinking, large dose of testosterone, e2 levels jump. It's no wonder that you feel lousy. And, you're right: your prolactin should be addressed.

Time to find another doctor. There may be doctors in your insurance network who know how to play this game. Maybe. But if you can pursue out of pocke care, so much the better. Where do you live?

 

[pyater]

I am in Pittsburgh, PA.

 

[CoastWatcher]

It seems to me you have two options. Is your doctor open to being told that you are unhappy and want changes? There is plenty of good, solid peer-reviewed material here on the site that an open-minded physician could use to begin sorting out your care. We can point you toward this material. You shouldn't have to do it, but it's an option.

A better choice would be a new doctor. If you are open to the tele-health model, which so many of our members rely on, works. It costs you something but not as much as you may fear. Defy Medical and Prime Body deliver the goods. Are you open to the idea?

 

[pyater]

In the Defy intake process now, looking forward to their help!

 

[CoastWatcher]

In the Defy intake process now, looking forward to their help!

You made a wise choice. Keep us posted as things unfold.