My Test and Prolactin and Estrogen Bloods

[jakemw]

Hey everyone i just got back a few lab results on my free test and total estrogen and prolactin levels.
I'm 24 and currently been on TRT for nearly a year now. Little background information on me, my hormone replacement therapy started when i got tried of the lump under my right nipple I've had sense i was in high school. I went to get a mammogram and ultrasound on it to make sure i didn't have some kind of cancer and it was just Gyno. Guessing from when i went through puberty. Any ways i had a full blood panel done to make sure everything was in check and when they came back my doctor was curious pituitary failure or something messing with my hormone balancing. Turns out at the age of 24 i had test levels of about 251. Found a doctor who most people in my town go to for HRT. Turns out this guy just prescribes it and has very little knowledge about really balancing my hormones etc. He has me now doing about 160mg a week of test and 500 a week of hcg , he actually wanted me to do 1,500ui of hcg a week and i found that to be way to much from everything i"ve read so i just stick to 500 ui's a week.

These are my bloods I requested he do so i can see were i am at. Also i read issues about prolactin so i asked to be checked for that as well.

Testosterone, serum 776 ng/mll limits 348-1198
Testosterone , free 35.15H ng/DL Limits 5.00 - 21.00
% free Testosterone 4.53H % Limits 1.50 - 4.20

Prolactin 33.0H ng/ml Limit 4.0 - 15.2
Estrogen, Total 232 H Pg/nl Limit 40 - 115

As you can see Pretty much all my levels our way out of range or slightly out of range. He says that my total estrogen levels are normal on TRT but i think he needs to test for E2 not so much total? Either way its way to damn high. He is sending me in for a CT Scan of the brain tomorrow to see if i have a tumor causing the pituitary gland to misfire. My prolactin levels obviously are not under control. I need any advise and i don't care how harsh your words are, ill talk any tips you guys throw at me. I'm working on finding another doctor soon maybe a urologist. I am also curious about my test free and % being higher then the Limit, I'm not sure if that's so much of a bad thing or maybe I need to decrease my test dosing slightly and get on a AI. He did prescribe me raloxifene a few months ago and tried it but it seems to give me bp issues so i discontinued. He's been really difficult about prescribing me Aromasin i don't understand why with me being prone to Gyno and estrogen issues.

Thanks for any advice y'all give me and if i am missing anything please ask and ill answer promptly.

Btw my last full panel bloods where on 1/20/2015 and everything checked out great except for hemoglobin levels being like .2 over the limit and hemotocrit levels being 1 over the limit at 52 instead of the limit of 51. Doesn't seem much of a concern to me, number of factors could had made it slightly elevated.

[OingoBoingo]

You're right; you need to check your E2.

Good luck with the CT scan.

[kelkel]

Elevated prolactin is indicative of pituitary adenoma's. An MRI would have been appropriate upon seeing this and before initiating TRT. If it is an adenoma and only secreting prolactin then a dopamine agonist could have possibly been all you needed to reduce your prolactin and thus elevate your test back to normal on its own. Not all adenomas are prolactin secreting. They can have a variety of consequences.

Yes, your levels are elevated. Total test does not matter, keep your focus on Free T and estrogen. Obtain a sensitive estrogen assay if at all possible. Your percent free is high. Normal is usually between 2-3%. Odds are your shbg is very low. Reducing your dose would be prudent. There can be a domino effect of issues when doses get to high.

When it comes to your hematocrit level being high you need to be concerned with this. Research polycythemia and in a couple minutes you'll agree with me. Give blood when you can and I'd probably suggest a double red cell donation first to speed up the decrease. Reducing your dose will help here as well.

Good luck with things and update us here please.

[jakemw]

Well KelKel if would had been nice if my doctor knew what to even test me for. They seem to think its just something you prescribe and bam your fixed. There issue like you mentioned was if i just had a prolactin problem which i was never tested for in past tests i could have raised my test levels back up on there own with a little medication.

I plan to lower my dosage and retest in a month or so. After i get this ct scan this week i should know if there's other issues, which my damn doctor sure has been taking him sweet ass time with getting my referral taken care of. Now he did underline my hematocrit levels on my test but never mentioned anything to me about it. Ill go ahead and bring it up sense its just out of range.
I will also go hopefully this week or the next and do a double blood donation, and continue to do that to keep my levels in check.

My main concern is, ya I was excited about starting trt honestly i gained some size off it i feel great but sometimes i still feel hormone balancing issues. Would you say I'm screwed and stuck on trt for life now that i have started, which i am fine with but i want to make sure I'm treating my body with respect and not misleading my health for my future, i mean i"m only 24 years old with all these damn issues.

So KelKel would should be my main focus right now to getting this situation taken are of. Lower dose a bit maybe to 70-80mg every 5 days get, get my ct scan, donate blood, get another full panel including e2, prolactin, free test, hematocrit i mean any other advise? I'll be sure to post future progress that way we can all see how im doing and maybe my steps can help someone else in the future. Also need to get my shgb test as well?

[kelkel]

I'd stay the course until you get your MRI of your pituitary, then decide.
No, not screwed and you don't have to stay on TRT. If the problem is located and correctable then you should come off and restart. Be much better to have naturally good T levels at your age.
Lowering dose is a good idea but main thing is your MRI. When you do change your dose you need to wait about a month to retest. All this can change depending on your MRI.

In the Finding A Doc sticky thread is a list of BW to get.

[jakemw]

Thanks sir i will bring back a update hopefully by the end of the week after my scan and we can see what kind of options i have. I will worry about the rest after the scan.

Thanks allot!

[kelkel]

You are welcome. Best of luck Jake.