27, Low T, slightly high Prolactin. Help?

[MrManGuy84]

Hi guys. Hoping to get a little help here.

I'm 27. I'm tired all the time, depressed (really flat and grumpy), and libido is missing. This has been going on for about 5 years. My Testosterone is a little low. My Prolactin is a little high. Nothing else seems to be amiss. I have no history of steroid use. Here's some recent bloodwork.

Prolactin 15.6 (ref 4-15.2)
Serum Testosterone 297 (ref 348-1197)
Free Testosterone (direct) 9.0 (ref 9.3-26.5)

FSH 6.1 (1.5-12.4)
LH 4.2 (1.7-8.6)
TSH, Reflex to T4 2.32 (0.34-4.82)

When I did an MRI 4 years ago, they found no issues with the pituitary. I have a varicocele, but a recent sperm test came back looking good.

I don't know the cause of all this. In the past I've had a lot of issues with anxiety, but libido was always fine. It disappeared about 5 years ago after 18 months at a really stressful job and a switch to prozac. Getting away from the job and also prozac for about 6 months didn't change anything. Shortly after I had my first Testosterone test and it was near the bottom of the normal range. If it's plain old depression, therapy and anti-depressants haven't done anything in years. Even my current therapist thinks there is probably something physical going on here with my test results.

I do take Wellbutrin for depression. Not sure if it does anything. I take 1 mg/Ropinirole for Restless Leg. Seems to work. I've been treating sleep apnea for about the last 9 months or so. It's made it so I don't fall asleep everywhere but emotionally and sexually I don't feel any better at all.

Unfortunately all the doctors around here are asshats. I'm stuck with doctors that take the student health plan for now. None of them are willing to help me. Probably doing some treatment on my own soon. Don't feel I have a choice. I'm going to try talking to a doctor who is a friend of a friend soon. Fingers crossed.

Read a lot of studies about clomid being helpful. Am going to start that shortly.

My one other concern is Prolactin. Not sure why that would be high. In the past it was always around 14, so it's been hovering around this area consistently. I was thinking about getting some pramipexole for this. Cabergoline is too expensive for me.

Anybody have experience with prami? How soon would I feel the effect of it if high prolactin is my problem? I also read a study (attached) that cabergoline raised Testosterone as it lowered the Prolactin and also alleviated a lot of sexual symptoms. Would prami have the same effect?

Aside from that it looks like clomid might raise prolactin, so that's my other concern. Most studies don't mention it at all, but I did see one abstract that said it rose by about 22%. This might account for those clomid users who see their T go up but don't feel an increase in libido.

Another concern is that prami looks like it drives TSH down a little bit. Uncool, but I don't know if I have a choice. Also the good news is that prami is sometimes used for RLS anyway, so it wouldn't exactly be out of line for me to try it and I could just stop taking the ropinirole.

Another idea is whether a higher does of ropinirole might help? But from what I've read it's not very reliable for prolactin reduction? Little confused there.

I'm attatching that study about cabergoline. I wanted to put a couple more pdfs up but they don't fit.

So my plan is to use clomid and also a little bit of prami replacing the ropinirole. Thoughts? Suggestions? Experiences? Thanks guys.

[edmundo22]

I'm no expert but SSRI's like prosac destroy libido by reducing dopamine to raise seratonin levels, depression is such a vague term would be nice to know theres an actual physical cause, welbutrin is hit or miss. If your depression and no libido are induced by high prolactin carbergoline will sort that out, Its also used to treat restless leg syndrome, there are much cheaper sources for carber other then a pharmacy. My prolactin was much lower then yours but I started carber 4 days ago, nothing dramatic but it is working, being an effective dopamine agonists its the only anti depressant that's ever worked for me. If you were to raise your low test I think that would make a much more dramatic effect in feeling good as opposed to simply not being depressed, also get your estrogen checked elevated levels are something that can mess with libido. You will get a much more detailed response from the vets on here, best of luck.

Manguy surprised you haven't got a response already, know what its like to be freaking out over all this, as far as I know there's no pitfalls to taking clomid, its not going to interfere with your natural testosterone production, just hang in there for someone with better expertise to chime in.

[MrManGuy84]

Thanks ed.

Anybody else? I'm freaking out here. Please help me. Doctors won't help me and keep blowing me off. Endo just told me to exercise more. Waste of time and money. I have an appointment with yet another doctor that a friend gets TRT from, but it's not until the 11th and I don't even know for sure what they'll say or do. Meanwhile the clomid I ordered online came today... not sure what to do. I'm so tired of feeling like crap and all the waiting is driving me insane.

[edmundo22]

^^^^^^^Think you need a bump

[Joeyissue]

Hey mate,

I'm not very knowledgeable in this department, however, I understand what you are going through. It's worse when you can't control the problem. Keep an eye on my thread (23 and low T). I will be visiting my endo this week and I will be blasting him with a lot of questions - the answers of which may help your situation.

For now, hang in there and keep strong (hypocritical of me because I'm absolutely losing my shit am to pm).

[MrManGuy84]

Well, I talked to a friend who is a retired endo. He told me my levels were definitely low and that getting treatment should help. That was really nice to hear after all the BS other doctors have given me so far. He gave me the name of another fellow who still practices who treats this stuff often. Now I'm just playing the waiting game again for about 3 more weeks. Canceling the other appointment I mentioned. It's only 5 days longer. In the meantime I am holding off on trying the clomid I bought myself or anything else.

The other good news is that my school insurance is going to cover the visit! That really surprised me. Very helpful.

Anyway, I really hope we can get this figured out. This sucks. And waiting sucks.

Would still love more thoughts from anybody. Maybe my original post was too long. Pretty simple - Test and free Test low. Prolactin slightly high. I guess the title says it all...

[steroid.com 1]

MrManGuy - You are talking about a lot of drugs in a "hit or miss" fashion and I would strongly advise against that as you may end up harming yourself even more.

If you have your BW can you please post everything complete with ranges?

You:
Prolactin 15.6 (ref 4-15.2)
Serum Testosterone 297 (ref 348-1197)
Free Testosterone (direct) 9.0 (ref 9.3-26.5)

FSH 6.1 (1.5-12.4)
LH 4.2 (1.7-8.6)
TSH, Reflex to T4 2.32 (0.34-4.82)

For a 27 year old your Serum Test and Free should be through the roof and you are both clinically low and there is a medical reason for that and you need to discover that as soon as you can.

I think without question it is contributing to your depression and how you feel and look.

Your prolactin tied to the low Test serum levels leads me to think you have a Pituitary problem even if you had a MRI done 4 years ago and they couldn't find anything.

Sometimes these pituitary tumors can be very very small and not be seen with an MRI...but your blood points to it for sure.

LH is fine so you should be producing and you're not...

Post all of your BW if you can and the guy will jump in but you need a proper diagnosis for sure!

[MrManGuy84]

Thanks gdevine! Now that I know I am headed to a doctor who knows what he is doing, I am feeling more stable and the idea of trying something on my own can wait. I was feeling really desperate after being blown off by so many other doctors and wasn't sure I had a choice. Now I'm just waiting.

The only other recent bloodwork I have is a semen analysis. It looked good. I had about 2% more abnormal forms than usual (52%) and they said it was a little thick, but I think I was a bit dehydrated so no big deal. Count was great. So things look fine there.

This is the first bloodwork I have done in 4 years. In the past, testosterone was anywhere from 330-460 on a range of 400-1080. LH and FSH were similar to where they are now. Prolactin was always 14.something on a scale that went up to 19. Thyroid has always been within normal parameters, including some of the more in-depth tests. Once or twice the thyroid stuff looked a little near the edge but re-tests were always in the middle. Everything else we've ever looked at has been normal.

I could dig those up and post them if it would be helpful, but I don't know how useful those tests are at this point four years later, especially since they never fell out of normal ranges. What other tests, if any, do you think I should get?