Hormonal imbalances 19 y/o

[dnp200]

Hello to this wonderful community..
This is my first post here but i am following the forum for a long time, so i decided to post my own story.
From the age of 16 i had all the symptoms of low T and high prolactin but being embarassed kept me from going to a doctor.. So about 6 months ago i decided that i should get BW to figure out what is happening..
Testosterone 256ng/dl (range 249-836)
prolactin ~100ng/ml(4-15.2)
I also measured cortisol,Tsh,t3,t4,LH,FSH but i dont have access to this BW at the moment i can post everything at friday if anyone is interested (tsh was elevated)..
So i did mri scan (brain) and found a small tumor (prolactinoma).
I was prescribed 0.5mg dostinex(caber)/week..
After 3 months i did a second BW ..
Prl 2.8ng/ml
Testosterone 849ng/dl
TSH 2.95μiu/ml (0.27-4.7)
FT4 1.12ng/dl (0.7-2.0)
Anti TPO 8.6IU/ml (<34)
Anti-TG 19.2IU/ml(<115)

At this point i was feeling normal(or well i have forgoten how normal feels tbh) but i didnt had any symptom of low t or high prolactin and energy was at a good level..
So the problem comes here
6 months after 1st Bw i do a trird one and results are:
FSH 3.1 IU/L (1.5-15.4)
LH 5.9 IU/L (1.7-8.6)
PRL 3.2ng/ml
TSH 8.62μIU/ml (0.27-4.7)
testosterone 612ng/dl
So i was diagnosed with hypothyroidism and was prescribed 0.75 T4 every morning with an empty stomach..
The problem is from the 1st week of this treatment i had symptoms of low testosterone (low energy, low libido, no morning wood,difficult waking up in the morning etc). I spoke with the doc and i stopped the therapy (T4) and he told me we will do BW in 2 months from now and reevaluate..
Guys i have read the whole site stopthethyroidmadness that kel posts often, i saw that t4 only doesnt work but really i believe i should feel better treating hypothyroidism (even with only t4) not worse..
And also somehow i have many symptoms of struggling adrenal function given by the site i posted before (at 1st bw estogen was low and cortisol within range).. Any suggestions??? Can anyone tell me what is happening?? I trust my doc but i would like your opinions , i know there are many knowledgeable members here..
I really want to feel like a normal person again, this is really exhausting me physically but mostly mentally.. Sorry for the long post.

[kelkel]

My initial thought is that your adenoma (and I'm going out on a limb here) may be TSH secreting. Unusual but it happens.
I'll come back to this later when time allows.

[Simon1972]

Hi Dnp , What is your background medication, illicit or recreational substance use?

[dnp200]

Hello guys, first of all thank you for your answers..
Simon, i checked my whole medical history, no druugs or steroids used.And absolutely no rec substances..Never touched anything in my life..
Kel i didnt expect that.. I didnt even know those adenomas exist, and tbh i checked every symptom they cause and surpisingly many of these match my case,.. I mean could this kind of adenoma elevate prolactin to that level?that could explain a lot.
I am really confused now..

[kelkel]

Well, adenoma's can be strange creatures. I have one.
What's the range on your prolactin?
What's your FT level and range?

[dnp200]

Hello kel.
If by FT you mean free testosterone i havent tested it even thought i asked my doc..
My prolactin before starting treatment with cabergoline was 98ng/ml (normal range 4-15.2)
Now after 6 months of treatment it is 3.2ng/ml..
I will have access to the first BW before i started treatment in exactly a week and also to the mri results, i can post the size of the adenoma if this can help..

[kelkel]

I was referring to free T.
Caber did it's job for you. Nice. A little goes a long way with it.
Yes, extreme hypothyroidism can cause the high TSH level, just the timing is curious to me.

[dnp200]

Hello guys.
I have an update here. So after 1 year of the 1st mri i did a second a few days ago.. It seems that my adenoma has shrinked but it is still visible.. Last year it was 3mm now it is barely visible so cabergoline treatment is doing its job (i think)..
Anyway i did a new bloodwork too and the results were
FSH 3.4 IU/L (1.5-12.4)
LH 7.9IU/L (1.7-8.6)
PRL 5.6 ng/ml (4-15.2)
Testosterone 815 ng/dl (249-836)
TSH 6.31 μIU/ml (0.27-4.7)
Anti-TPO 6.3 IU/ml (<34)
Anti-TG 13.2IU/ml (<115)
So my problem is that even though testosterone and prolactin are back to normal, i am still feeling like crap, i have low energy and NO libido.. And i mean almost zero libido.. I also noticed that the past few months my memory was (is) really bad..
On this year that i was on cabergoline treatment i did 6 total bloodworks. At three bloodworks TSH was normal and on the other 3 it was high and it went like 1st bw (high) second (low) etc.... It was never stable.. So can anyone help me figure out what is going on??
I talked with my endo, he said we wont start a new treatment, we are continuing with just cabergoline, and i am doing a new bw in 6 months but guys this has been going on for a year and i cant really keep going like this..

[hammerheart]

You appear to have mild hypothyroidism, and need to get if fixed.

What's your daily intake of Iodine? Dietary deficiency will lead to goiter and hypothyroidism.

All of the symptoms you experienced on T4 are NORMAL, and transitory - it happens to me every I up the dose.

Did you straight jump to 75mcg? That's too much, you need to start lower, then increase.

You also need to test for FT3. Always have a full thyroid panel (TSH, FT4, FT3). No need to check antibodies every time.

Ever tested for SHBG or free t?

[IncreaseMyT]

Not bad on getting the T up. Your PRL was really high though so it had a high chance of working.

Caber has some of the least side effects but it still doesn't make you feel particularly well. Its kind of like taking Clomid and getting your T up but symptoms do not go away.

With that being said seems like you need to get the thyroid straightened out, and then go get more thorough labs like Bizzaro suggested.

Free T is all that really matters, in terms of androgenic effect. Need also your E2 and DHT could be valuable.

Your TSH is really high which indicates a slow thyroid. So I think Bizzaro is spot on.

If you were able to stabilize the thyroid and still do not feel better, knowing those other labs may point to the problem.

Hope this helps.