Minor Hyperprolactima, HCG Monotherapy, Cutting HCG Cold Turkey :(

[peterrogers8888]

Brief Description: I'm a 25 years old, 6'2'' and weigh around 200 pounds. I work out frequently, eat healthy, and outwardly appear to be in good health. A few years ago I was diagnosed with secondary hypogonadism and began HCG monotherapy. I have had multiple pituitary MRIs and nothing was ever found. I also have been on sythroid for hypothyroidism for the last six months after repeated TSH results of around 5 (more details below).

On the below treatment, I feel 'ok.' My major concern is my complete lack of libido that has persisted for 3 years. My lack of libido really depresses me as I feel it ruins my ability to date like a normal 20 something guy. My Dr. wonders if I have adult on-set Kallman's syndrome. Questions follow my labs:

Current Treatment:
325 units of HCG injected SUB-Q EOD.
.5mg Anasterole daily.
Flonase 1 spray daily for dustmite allergy.
50mg synthroid 5x a week. (so around 37mg per day)

LABS:
Glucose, Serum 79 mg/dL (65-99)
BUN 13 mg/dL (6-20)
Creatinine, Serum 1.05 mg/dL (0.76-1/27)
eGFR if NonAfrican Am 98 mL/min/1.73 (>59)
BUN/Creatinine Ratio 12 (8-19)
Sodium, Serum 140 nmol/L (134-144)

WBC 4.9 (3.4-10.9)
RBC 6.11 HIGH (4.14-5.80)
HEMOGLOBIN 17.7 (12.6-17.7)
HEMATOCRIT 53.4 HIGH (37.5-51)
MCV 87 (79-97)
MCH 29 (26.6-33.0)
MCHC 33.1 (31.5-35.7)
RDW 13.3 (12.3-15.4)
PLATELETS 247 (155-379)
NEUTROPHILS 52 (40-74)
LYMPHS 33 (14-46)
MONOCYTES 12 (4-12)
EOS 3 (0-5)
BASOS 0 (0-3)
NEUTROPHILE (ABSOLUTE) 2.5 (1.4-7.0)
LYMPHS (ABSOLUTE) 1.6 (0.7-3.1)
MONOCYTES (ABSOLUTE) .6 (0.1-0.9)
EOS (ABSOLUTE) .1 (0-0.4)
BASO (ABSOLUTE) 0 (0-0.2)
IMMATURE GRANULOCYTES 0 (0-2)
IMMATURE GRANS (ABS) 0 (0-0.1)

Potassium, Serum 4.6 mmol/L (3.5-5.2)
Chloride, Serum 100 mmol/L (97-108)
CO2, Total 25 mmol/L (19-28)
Calcium, Serum 9.6 mg/dL (8.7-10.2)
Protein, Total, Serum 7.4 g/dL (6-8.5)
Albumin, Serum 4.7 g/dL (3.5-5.5)
Globulin 2.7 g/dL (1.5-4.5)
Bilirubin, Total 0.9 mg/dL (0-1.2)
AST 38 IU/L (0-40)
ALT 44 IU/L (0-44)

Vitamin D--Will follow

B12 1131 High pg/ml (211-946)

FSH and LH both low (due to HCG)

Testosterone, Serum 818 ng/dL (348-1197)
Free testosterone (Direct) 18.5 pg/ml (9.3-26.5)

Thyroxine (T4) Free Direct 1.56 ng/dl (0.82-1.77)

TSH 1.240 uIU/ml (0.450-4.500)

Prolactin 16.5 HIGH ng/ml (4.0-15.2)

Estradiol 31.3 pg/ml (7.6-42.6)

My adrenals have been tested in the past and I doubt they are the issue.

Now my doctor wants me to stop HCG and anasterole and try .5mg per week of Cabergoline for a month to see if my testosterone levels rebound. I have been on HCG for two years now so I am scared to death of going cold turkey. I left him an email begging for clomid. We will see what he says.

Before HCG my prolactin labs were always around 15-16. Is 15 or 16 enough to significantly suppress testosterone levels? Is this idea of trying caber and dropping HCG for a month completely nuts? I have been off HCG for four days now and I already feel weaker. Is a month without clomid even enough for a pituitary to wake back up?

Would highly appreciate any feedback.

[kelkel]

A few thoughts:

Could you have been misdiagnosed? Thinking hypothyroidism causing hypogonadism? Not really sure of the timing here...
You need to give blood asap.
E2 is fine but there is seriously a lot of adex. Far more than most guys on a cycle.
High prolactin can/will suppress testosterone levels.
Caber is great for suppressing prolactin. .25 x 2 per will will suffice. Good sexual benefits as well.
Talk to him more about clomid AND nolvadex to help you restart. You will find good medical articles on Pubmed. Present them to him as you need SERMS to help stimulate your pituitary.

Is a month enough without clomid. It's impossible to answer. But consider the average PCT last 4 weeks itself with nolva and clomid.

[peterrogers8888]

A few thoughts:

Could you have been misdiagnosed? Thinking hypothyroidism causing hypogonadism? Not really sure of the timing here...
You need to give blood asap.
E2 is fine but there is seriously a lot of adex. Far more than most guys on a cycle.
High prolactin can/will suppress testosterone levels.
Caber is great for suppressing prolactin. .25 x 2 per will will suffice. Good sexual benefits as well.
Talk to him more about clomid AND nolvadex to help you restart. You will find good medical articles on Pubmed. Present them to him as you need SERMS to help stimulate your pituitary.

Is a month enough without clomid. It's impossible to answer. But consider the average PCT last 4 weeks itself with nolva and clomid.

Thanks for the feedback. I will look into giving blood. I don't think I have hypothyroidism as my labs for my thyroid were never that terrible. I agree that my E2 is okay..but the amount of adex I am taking scares me a bit. I talked to my doctor today. He is starting me on a month of clomid 25mg/day. I will be taking that and caber only. Only I respond quickly as my nuts are still up and running from the HCG. Hopefully the clomid works. My doctor claimed that the chances of clomid causing my testosterone to stick are probably only 1 in 10.

[kelkel]

Don't just look into giving blood. You should really do it. Your hematocrit is high. Thick blood leads to all kinds of issues. Look up polycythemia.

[peterrogers8888]

Looking up blood banks right now... Problem is I will have to lie about foreign travel, as they won't take the blood of people that have been malaria even though my doctor has tested me and I'm clear.

[kelkel]

Everyone fibs on those things. They test your blood and won't use it if there's an issue....
Increase your fluids as well.