Very Low Prolactin Levels

[Indymuscleguy]

Ok group,

Due to lots of business travel and ongoing and now solved thyroid issues, I am now trying to pre-plan a cycle for the coming months but I am looking at my blood work before anything starts.

My libido has been pretty low for some time, but I haven't had time to address it and have some info that tells the story.

My Urologist drew some lab work and wants to start HRT. Depending on what he decides to do and what advice I get from here will determine what kind of a cycle I would like to do once the blood work improves.

Here is what I got over the phone today...

I had a CBC/CMP/%free test/Total Test/Free Test/Prolactin/LH/FSH completed. Here's what I know...

CBC and CMP were normal...

%Free test was 0.51 (0.95 to 5.3)
Total Test was 1.05 (told that was normal)
Free Test was 206 (241 - 800)
Prolactin was 0.6 (2.6 - 13)

The NP said my Prolactin was way too low and was most likely the reason why viagra and cialis isn't working. Also...it's probably why I don't have much of a sex drive.

Based on the Free test of 206 he's going to do Cyp or Ethanate.

How is a low prolactin treated?

Thanks in Advance....

Stats:
Age 43
# cycles 6 in 8 years

If you need more info...just ask.

[tboney]

What is the issue with your thyroid?? Do you have any other conditions??

[Indymuscleguy]

I had Graves disease of the Thyroid in 2007...my TSH/T-3/T-4 has been very hard to regulate...seems steady now. Taking 15mcg of Cytomel daily and 188mcg of Synthroid daily. *note this is pharm grade non-generic thyroid meds prescribed by an endocrinologist.

[tboney]

You still have graves.....I have graves as well.. How was your thyroid gland dealt with? RAI? thyroidectomy? antithyroid drugs?

[Indymuscleguy]

I-131. Developed a rare hypokalemic issue that put my K+ at 1.6 and was paralyzed for about 12 hours. Was on oral K+ for about 2 weeks until the thyroid was completely dead. Then had graves opthamia and had a bilateral orbital decompression surgeries and then two eyelid reduction surgeries...that was all in late 07-08. Now on Humaria for clinical RA which has cleared up and now I'm ready to get back on track until we've discovered the low prolactin...

How is a low prolactin treated?

[tboney]

Wow! You have been threw it!! I dont think they treat it conventiionally. They have to diagnos the condition causing the low prolactin. Did you have hypopituitarism?

[Indymuscleguy]

Was never tested for hypopituitarism. We stumbled across the low prolactin based upon my general complaint of low sex drive and ED issues.

All of my Auto Immune issues started with UC...which ended up having a total colectomy with a J-pouch construction in 2005. 2005-2008 were hell years for me. 2005 was when I was in tip-top shape at 5'10" 185lbs 30"w and 10.2%bf...

I am suspecting Caber or Bromo may be what my Urologist is considering...he didn't say...it's just what I have been reading on here as a treatment

[tboney]

Caber and bromo lower prolactin not raise it.

[Indymuscleguy]

Ah..so..what raises Prolactin levels?

[tboney]

The use of some medicines, like aas', etc. Also, tumors of the pituitary. A damaged pituitary, all can cause prolactin levels to increase and sometimes decrease. Your doc needs to run a battery of tests to determin the problem.

But your problem is low prolactin?

[Indymuscleguy]

I just read that HCG in combo with HRT will help with low prolactin levels...

Re: low testosterone with normal LH and FSH levels
Make sure you rule out the other possible causes that can be treated separately. These include high estradiol or total estrogen, vitamin D deficiency, hemochromatosis (iron overload) and hypothyroidism. Test for estradiol, total estrogen, vit D 25 OH, iron, ferritin, TIBC, saturation % (these last 4 are a basic anemia panel) , TSH, and prolactin.

Once you have exhausted trying to find all the known causes and find nothing you will fall into the majority of cases which is unknown cause. Your T level is very low so you have to treat it. There are too many other serious health issues that will result from ignoring it.

I think the best thing to try first is HCG in low doses. HCG is similar to LH so it will keep your testicles working so they don't atrophy (shrink and become soft). If you don't care about this and don't want any more children then T replacement is fine. You can also combine T replacement and HCG which is what I do because the HCG alone does not get my T high enough. Be aware there are no long term studies on the safety of long term HCG use, only anecdotal evidence.

While on any treatment whether T replacement, HCG, or a combination you should monitor total T and estradiol. Estradiol if too hight (over 35 pg/ml) can ruin libido and cause other health problems. It can be controlled with supplements and Rx's.

[Indymuscleguy]

My symptoms are low sex drive/libido and severe ED. That's what got the Urologist going...with the aid of suggested bloodwork I read in here...

[tboney]

Right.. I agree. Those are indicators for low test levels. But that still doesnt indicate why your levels of prolactin are so low.

[Indymuscleguy]

Hmm...just called my Endo and left a message for an appt. Better not wait too long on this one. I was hopeful that my low test would get fixed...finally...and I'd be on the road to a FULL recovery...now schyt!

[Indymuscleguy]

bump for agreement on HCG useage...

[JHeisman1]

CUT/PASTED FROM WebMD:

Dopamine has the dominant influence over prolactin secretion. Secretion of prolactin is under tonic inhibitory control by dopamine, which acts via D2-type receptors located on lactotrophs. Prolactin production can be stimulated by the hypothalamic peptides, thyrotropin-releasing hormone (TRH) and vasoactive intestinal peptide (VIP). Thus, primary hypothyroidism (a high TRH state) can cause hyperprolactinemia. VIP increases prolactin in response to suckling, probably because of its action on receptors that increase adenosine 3',5'-cyclic phosphate (cAMP).

See bolds above.
1. talk with your MD about using TRH instead of synthroid /levothyroxine [which is T4]. If that is even possible yet. May be too costly as it is probably only used in laboratories.
2. Dopamine is a prolactin antagonist. Therefore, antidopaminergic medications [aka neuroleptics or anti-psychotic meds] have been shown to increase prolactin at the expense of lowering dopamine. This is a tricky subject and should let your MD deal with using neuroleptics. Maybe go to pubmed and search for neuroleptics AND hypoprolactinemia for more info though.

Good Luck...

[flatscat]

There you have it - start suckling

[Indymuscleguy]

Thanks everyone!