Testosterone recovering after a prolactinoma

About two years ago, when I was 37, I had a physical and asked for a testosterone test mainly because I knew my dad had problems when he was about my age (he died in 1994). It was 108 ng/dL (range 300-1000). I guess that should have set off alarm bells, but the doctor wasn't worried and just told me to lose some weight and it'd be fine.

Fast forward to May of this year. In for another physical and ask for the same test ahead of time. 61 ng/dL. This time it was with the PA and I guess this was low enough to concern him. He ordered a bunch of other tests, including Prolactin. That came back as 1932 ng/mL (range 2 - 15), Testosterone was 52 that time. Uh oh. Off for an MRI.

They found a 2.5cm tumor (macroadenoma) on my pituitary gland. Off to the neurosurgeon and I was scared shitless of needing to have surgery inside my head. My blood pressure before seeing him was like 200/140 or so! Thankfully, no surgery right now since the tumor secretes prolactin and is considered a prolactinoma.

To summarize the treatment & tests so far:

5/22 - Prolactin 1932 - Testosterone 52 - FSH .8 (range 1 - 12) - LH .6 (range 2 - 12) - Testosterone free 11 (range 47-244)
6/28 - Prolactin 1262 - I had taken 2 cabergoline pills at this point!
(continue with 2 per week)
7/28 - Prolactin 416 - after this appointment, raised to 3 pills per week
9/7 - Prolactin 129 - Testosterone 73 - Free T4 .6 (range .6 - 1.5) - been taking 4 pills per week since, the Free T4 (thyroid function) caught the endo's eye from a prior test since it's low end of normal, and it's also something my dad had problems with

The endo has said that my next appointment on 11/10 is about the time when we'll start looking at whether my testosterone is recovering on its own; I'll have more labs before the appointment. I'd really rather not get involved with having to take another medicine for the test of my life, but I'd also like to start feeling normal again.. whatever that may mean.

Anyone been in a similar spot with one of these dumb tumors? Anyone have opinions on the chances of my testosterone recovering on its own after being screwed up for years (I reckon it took several years for that tumor to get to 2.5cm)? Any other thoughts?
 

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TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

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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