1 year TRT bloodwork results are in! Prolactin????

[hugovsilva]

Hi guys,

So my bloodwork results are in after 1 year of trt.

Protocol:
50mg Sustenon 250 twice per week
25mg Proviron ed
250iu HCG twice per week the day before the Testosterone injection

Everything was pretty normal with blood composition, lipids, liver, kidneys and so on, until I got to the hormonal panel. That's when things started to get ugly (see attachment).

PSA - an expected increase but still well withing acceptable values.
Thyroid - A slight decrease in function. I think maybe I am going hypo-thyroidal.
Estrogen - Increased to double the amount. I think its time to throw in some Anastrazole.
Prolactin - This one I was not expecting. A 3x increase in prolactin was not in the plans. Will this value come down once Estrogen is under control?
LH & FSH - Close to 0 as expected. I am officially shut down.
Total Testosterone - Increased to acceptable values 24.55 nmol/l (710ng/dl)

My question is: What might have driven the Prolactin so high? I was not aware that it would increase so much. Can it be the excessive Estrogen? Is there a relation?

Any other comments will be welcome.

PS - My doctor did not prescribe Free Test or sensitive estrogen tests.

[kelkel]

Prolactin most definitely follows estrogen and will elevate at a very rapid rate when E is high.
You need the sensitive Estrogen assay if possible.
Get a full thyroid panel next time. TSH is higher but it's still a weak indicator. FT3, FT4, RT3, Antibodies....
Keep an eye on PSA. Be aware that ejaculation within app 48 hrs of your test can elevate results.
If your using Proviron as an anti-e know that it's weak in that aspect. There's value to dht's but that's really not it's forte.

[hugovsilva]

Thanks for the reply Kelkel.

For now what I will do is to include Anastrazole at 0.25mg twice a week.

I feel this dosage should put my Estrogen in the 20-30 range.

Since it is quite high maybe 0.25mg three times per week is a better option.

Any thoughts?

I am doing my entire protocol by myself as my doctor doesn't know a thing about trt. His protocol was 1 ampule of Sustenon every month and now to reduce Estrogen he told me to reduce to 1 amp every 3 months. Seriously? Anyway, I need him to prescribe the bloodwork so that is what I am doing at the moment.

[kelkel]

Ok. I take it you do not normally run adex and depended on Proviron as your AI control?

I'd go with option number one, twice per week, the day after each injection. It works fast and you don't need to have it swing totally in the other direction as you now have to determine what will keep in in a healthy range, which will take a few more blood pulls. The goal is to obviously use as little as possible. After a month I'd retest your E2 using a sensitive assay and titrate accordingly.

A 20-30 range is recommended but base it by how you feel, not the number. Some feel better a bit higher and that's ok too.

[hugovsilva]

I used Proviron just because the doctor prescribed it and I saw no harm on using it.

I know it has AI properties but I would not rely on it for Estrogen control.

[kelkel]

I used Proviron just because the doctor prescribed it and I saw no harm on using it.

I know it has AI properties but I would not rely on it for Estrogen control.

No harm at all. Curious if you ever compared dht levels on and off of it?

[hugovsilva]

I am on finasteride since 1998 so I am sure levels will be higher and Proviron is actually welcome.

I am waiting to level my hormones so I can try to stop the Finasteride and check if normal hormonal levels will help with hairloss. I have been reading about it and it seems that hairloss, on top of being caused by the attachment of DHT to the scalp AR can also be caused by hormone imbalances. I can't wait to drop the Finasteride if that has no impact on my hairline.

[kelkel]

Good luck hugo. Hope it works for you!

[booku]

my TSH was 6.24 last blood work, you have any symptoms of hypothyroid at 3.75?

[hugovsilva]

I don't.
I am saying saying it because mt TSH is at the top of the range but my T3 and T4 are on the lower part, meaning that the Pituitary is trying to push the Thyroid to increase output but that is not happening.

[hugovsilva]

Prolactin most definitely follows estrogen and will elevate at a very rapid rate when E is high.
You need the sensitive Estrogen assay if possible.
Get a full thyroid panel next time. TSH is higher but it's still a weak indicator. FT3, FT4, RT3, Antibodies....
Keep an eye on PSA. Be aware that ejaculation within app 48 hrs of your test can elevate results.
If your using Proviron as an anti-e know that it's weak in that aspect. There's value to dht's but that's really not it's forte.

Kelkel,

Here my Thyroid values before TRT:

Free T3 - 5.6 pmol/l [2.8 - 7.1]
T3 - 2 nmol/l [1.3 - 3.1]
Free T4 - 18.5 pmol/l [12 - 22]
T4 - 93.9 nmol/l [66 - 181]
TSH - 1.79 mU/l [0.2 - 4.2]

Before TRT the values are nothing spectacular but not bad. The doctor did not ask for most of these values after 1 year. I think I am still not hypothyroidal but I will try to keep an eye on it.

[hugovsilva]

Good luck hugo. Hope it works for you!

Don't get me wrong Kelkel,

I am feeling much better now than before I started. Still, there is a lot of room for improvements and that is what I will try to do with the knowledge I gathered from this forum.
Its hard when your doctor is not knowledgeable and acts like he is, but its like I said, from him I just need the prescription to do bloodwork, all the rest I can manage by myself. I hope within next year I will find a better doctor or get all values in tune by myself.

[booku]

I don't.
I am saying saying it because mt TSH is at the top of the range but my T3 and T4 are on the lower part, meaning that the Pituitary is trying to push the Thyroid to increase output but that is not happening.

Yes, looks like I might have the same problem, still waiting on my full bloodwork. Is this a common issue when going on TRT? Over the long term the thyroid is suppressed? I just have not seen it talked about on this forum a ton

[dreadnok89]

What does 50 sus 250 twice a week a mean? Did you mean 500? Your e def has to rise with all that stuff

[hugovsilva]

It means 50mg twice a week for a total of 100mg per week. The dosage is not the problem. It seems that aromatase enzyme has a very strong expression in my body and my bf is 12% so it is not for being exessively fat.