High prolactin with Androgel

[skaver]

Currently on 10g Androgel a day. I've been prescribed it for almost 10 years now and been under the care of an endo until recently. I know most people hate Androgel, but it's usually because they can't get decent levels of test. I don't have that problem ('m almost double upper limit). However, my endo sent me back to my GP because I'm too simple of a case for an endo to deal with. However, after I left my endo I went through some heavy duty fertility treatment (Clomid, Arimidex, HCG + HMG for 6+ months straight). They ran lots of bloodwork, but it was the first time I'd ever had prolactin levels tested. Turns out I'm way over the limit for my levels. Thought it was just because of all the hormones they were pumping full of for fertility treatments. The specialists at the clinic weren't worried about it. But it's been a year since I stopped fertility treatment and I've been back Androgel since. I got my latest bloodwork and my prolactin levels are still over range.

Any thoughts on what's causing prolactin levels to be elevated, or how to treat? I'm ordering some P5P to start.


Test: 52nmol/L ( range 7.6-31.4)
SHBG: 19nmol/L (range 16-55)
Albumin: 2.7g/dL
Free (TruT, calculated) = 2.56 nmol/L = 4.92 %
Bioavail (TruT, calculated) = 38.7 nmol/L = 74.3 %
Prolactin: 363mIU/L (86-324) (HIGH)
17b-Oestradiol: 76pmol/L (range < 192)

 

[skaver]

I wouldn't say my doc is great or that I'm lucky. He's in his 70's and admits he knows shit about TRT. My T levels aren't normally that high and my doc wouldn't approve. I'd been doing some experiments with DMSO trying to see the effect on absorption of Androgel so I wanted to get some testing done to see how well it worked. All of my levels have been stable for years, so he doesn't fuck around with me for the occasional blip.

He says he isn't concerned with the Prolactin levels, but my libido hasn't been the same since fertility treatment (which is also the first time prolactin levels were tested and found to be high). His theory is that I'm old and shouldn't have a high libido. But, my libido has been stable with Androgel for almost a decade, so the sudden change is unexplained. He's happy to handout viagra samples, but says I shouldn't worry about prolactin, which is why he's never tested for it before. He's not a big fan of WebMD-types who think they self-diagnosis a pituitary tumour. He's very old school.


From what I understand my prolactin levels are too low to be considered hyperprolacteremia, which is the primary diagnosis of a prolactinoma. I've been great at keeping my bloodwork markers balanced, despite the occasional blast. But my prolactin seems to be the only one I can't get a handle on.

 

[resilient1]

Currently on 10g Androgel a day. I've been prescribed it for almost 10 years now and been under the care of an endo until recently. I know most people hate Androgel, but it's usually because they can't get decent levels of test. I don't have that problem ('m almost double upper limit). However, my endo sent me back to my GP because I'm too simple of a case for an endo to deal with. However, after I left my endo I went through some heavy duty fertility treatment (Clomid, Arimidex, HCG + HMG for 6+ months straight). They ran lots of bloodwork, but it was the first time I'd ever had prolactin levels tested. Turns out I'm way over the limit for my levels. Thought it was just because of all the hormones they were pumping full of for fertility treatments. The specialists at the clinic weren't worried about it. But it's been a year since I stopped fertility treatment and I've been back Androgel since. I got my latest bloodwork and my prolactin levels are still over range.

Any thoughts on what's causing prolactin levels to be elevated, or how to treat? I'm ordering some P5P to start.


Test: 52nmol/L ( range 7.6-31.4)
SHBG: 19nmol/L (range 16-55)
Albumin: 2.7g/dL
Free (TruT, calculated) = 2.56 nmol/L = 4.92 %
Bioavail (TruT, calculated) = 38.7 nmol/L = 74.3 %
Prolactin: 363mIU/L (86-324) (HIGH)
17b-Oestradiol: 76pmol/L (range < 192)

You weren't kidding on the high levels of test. Considering your E2 is perfect that's impressive. Have you been using Arimidex along with the Androgel? SHBG is also great.

Clomiphene and HMG are known to result in hyperprolactinemia. There's plenty of research studies online that confirm. Also, HCG has a tendency to increase prolactin due to elevated E2. This is most likely the cause of your elevated prolactin issues.

Wrt to testosterone, the correlation is inverse, that is, low testosterone levels are (generally) associated with higher prolactin. If you're doing research read the abstract b/c instances in which prolactin rises due to testosterone appear to be associated with specific underlying issues, such as those with macroprolactinomas, a type of tumor that results in the excessive production of prolactin, which is affected by levels of testosterone.

How did you feel prior to fertility treatment compared to how you feel now? Energy, libido, mood.

 

[skaver]

You weren't kidding on the high levels of test. Considering your E2 is perfect that's impressive. Have you been using Arimidex along with the Androgel? SHBG is also great.

Clomiphene and HMG are known to result in hyperprolactinemia. There's plenty of research studies online that confirm. Also, HCG has a tendency to increase prolactin due to elevated E2. This is most likely the cause of your elevated prolactin issues.

Wrt to testosterone, the correlation is inverse, that is, low testosterone levels are (generally) associated with higher prolactin. If you're doing research read the abstract b/c instances in which prolactin rises due to testosterone appear to be associated with specific underlying issues, such as those with macroprolactinomas, a type of tumor that results in the excessive production of prolactin, which is affected by levels of testosterone.

How did you feel prior to fertility treatment compared to how you feel now? Energy, libido, mood.

I haven't had to use Arimidex with Androgel. I've been lucky that I can get away with DIM (EOD) and it seems to control my E2. Luckily, I've never been that sensitive to E2 sides though. I've ran a lot of high test cycles in the past with no AI and I've never had any gyro symptoms or bad edema.

From the research that I've done on HMG, HCG, and Clomiphene it seems like they can contribute to hyperprolactinemia, but I couldn't find much about for how long the effects should remain on the prolactin levels. I've been completely off HCG, HMG, Arimidex, and Clomid for a year now, but Prolactin levels aren't going down.

Prior to fertility treatment my energy, mood, libido were great. When fertility treatment started, I had to stop androgel and pump myself full of the wonderful fertility drugs. The effect on mood, energy, and libido were VERY bad. Probably the toughest time so far on my marriage. Once I stopped fertility treatment and resumed androgel my mood and energy significantly improved (but not back quite 100%), but libido hasn't recovered.

 

[resilient1]

I haven't had to use Arimidex with Androgel. I've been lucky that I can get away with DIM (EOD) and it seems to control my E2. Luckily, I've never been that sensitive to E2 sides though. I've ran a lot of high test cycles in the past with no AI and I've never had any gyro symptoms or bad edema.

From the research that I've done on HMG, HCG, and Clomiphene it seems like they can contribute to hyperprolactinemia, but I couldn't find much about for how long the effects should remain on the prolactin levels. I've been completely off HCG, HMG, Arimidex, and Clomid for a year now, but Prolactin levels aren't going down.

Prior to fertility treatment my energy, mood, libido were great. When fertility treatment started, I had to stop androgel and pump myself full of the wonderful fertility drugs. The effect on mood, energy, and libido were VERY bad. Probably the toughest time so far on my marriage. Once I stopped fertility treatment and resumed androgel my mood and energy significantly improved (but not back quite 100%), but libido hasn't recovered.

Likely due to the persistent levels of prolactin. I've heard great things from a bit of caber. I believe you can get it prescribed. Clomid is terrible, makes me cringe just thinking about my previous PCTs. Never again, thanks. But, HCG does not agree with me either, too of a rollercoaster, and to combine all three, god damn that sounds like torture.

I didn't think prolactin goes away. One would think it should, but after a year I don't think waiting any longer is going to change anything. Perhaps try some caber, that should take care of that lickity split. It shouldn't take much.

I agree that DIM works....mind you I use w trt level dosages.