Prolactin climbing, TSH periodically elevated

Before starting TRT, my TSH was going something like 1>1.5>2.5 and then on TRT 3.25, and now back to 2.2. Waiting for my consult with Dr Saya next week to discuss in more detail.

Alongside it, my prolactin has been climbing. It normally sits around 20-30, but lately has gone into the 30s and now 50s. However, one smart endocrinologist suggested I test for macroprolactin (bound to IgG), and found my actual prolactin to be within range, usually <11. In her opinion, this is why cabergoline made me feel worse and lowered my sexual function. I have a pituitary tumor, but she believes it's not secreting prolactin.

I've seen posts in the past of prolactin going up on TRT. Is that the case? What's the cause?

Until my last thyroid test, I was dead set on that causing my prolactin to bounce around.
 
Thryoid...what else did you have pulled? TSH in and of itself is a rather poor indicator of Thyroid function. I wouldn't acccept treatment if reverse T3 was omitted from your labs.

TSH
FT4
FT3
Reverse T3
Antibodies

...are what you need for a complete picture.
 
Thryoid...what else did you have pulled? TSH in and of itself is a rather poor indicator of Thyroid function. I wouldn't acccept treatment if reverse T3 was omitted from your labs.

TSH
FT4
FT3
Reverse T3
Antibodies

...are what you need for a complete picture.

Got it right here Vince:
screen-shot-2019-09-11-at-4-55-52-pm-png.8251


Can't really pin a huge difference between the tests, except a 5 day difference.

As far as the prolactin, I've read over and over that stress can really jack it up. The stress level lately has been extreme to say the least.
 
T4 is normal to see it in that range, T3 is up more than close enough to be optimal and RT3 looks acceptable, should be <15 so you're ok there. I don't see a reason to treat anything just because the TSH is a lil up but it's not bad. T3 is the active hormone and there's little indication of pooling so I don't see a problem there.
 
T4 is normal to see it in that range, T3 is up more than close enough to be optimal and RT3 looks acceptable, should be <15 so you're ok there. I don't see a reason to treat anything just because the TSH is a lil up but it's not bad. T3 is the active hormone and there's little indication of pooling so I don't see a problem there.

Thanks Vince
 

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Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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