Good to hear there is no adenoma.
The reason it has spiked is probably due to the fact that your free T and E2 do not reflect an appropriate TRT regime. The links provided by Charlie above show that elevated E2 can raise prolactin.
If it was me, I’d work with my doctor to get my dose/frequency to a point where everything it in normal range.
Other reasons for high prolactin :
Been on TRT for 5 Weeks and I'm Very Worried - #95 by charlie12
I don’t know what is so funny, this guy obviously has an adenoma, if you can rule out drug induced prolactinemia.
Remember these things are called micro for a reason.
I can also confirm adenomas cannot always be caught on NMR especially if the equipment and operator are not good.
Yea he either has drug induced prolactinemia or a tumor there is no other reason his prolactin would go up, unless he is pregnant.
@charlie12 keeps saying “other reasons”, yea, like what. What other reasons exactly?
If he did a cycle of deca and its up like that ok sure he doesn’t have a tumor. But thats not what he told us.
I also had elevated prolactine without adenoma, but have a little empty sella. And my prolactine is only little elevated and his is a lot. He must take caber for sure
I agree if he was barely above range that would be one thing. But it’s way up there.
Adenoma or not, the treatment is the same
He needs to correct his TRT regime before taking any other drugs.
For the millionth time, elevated E2 raises prolactin. His E2 is way way way over range.
@lenono the guys in our group with E2 over 100 do not have elevated prolactin. How is this possible?? 
Higher testosterone would be my guess.
I don’t necessarily agree with this but researched to help OP. Looks like old studies.
REFERENCES :
J Clin Invest, 1974 Feb; 53(2): 652 655, “Augmentation of prolactin secretion by estrogen in hypogonadal women”
PNAS, “Estrogen control of prolactin synthesis in vitro”, Dec 1 1978, 75(12):5946 5949
The Journal of Biological Chemistry, March 10, 1982, 257, 2133-2136, “Estradiol regulates the transcription of the prolactin gene.”
My prolactin happens to be above the range. Hasn’t changed a thing for me. I can still have sex at least twice a day if I want to.
I’m not sure what units are associated with the 100, but if they are the same as the OP, then his are 350% higher so no comparison can be concluded.
His prolactin was up before TRT. So unless he has a history of AAS use with a 19 nor, or some other medication that can convert to prolactin, it has to be a tumor.
It doesn’t just appear out of nowhere.
With all of that being said, whether your PRL is up because it is drug induced, or if it is from a tumor a dopamine agonist reduces those levels. Period.
Hence is why I suggested it. Cause is to doesn’t really matter why it is high, the fact is that it is high and he needs to get it down.
He’s had the MRI and no tumour so give that a rest. All evidence shows you were wrong.
Reduce the levels by fixing the TRT regime. Not patching it up with other drugs.
If you understood male physiology then you would understand that there is no other possible conclusion. The PRL does not just appear out of nowhere, thats not how it works.
@lenono standard units of pg/mL Again, you are using a lab range for the regular population of men not on TRT. It doesn’t apply. I understand you don’t get it. I assure you, it isn’t the same thing. You can’t drive up T to higher levels and not expect E2 to follow. Then when it does blame E2 for being high. It NEEDS to be there to follow T. It’s the whole point of TRT. That is where MOST of the benefits come from.
A Tesla 3.0 MRI with a very good operator that knows how to set it ip has a great chance to catch even smaller tumors. But I doubt he had any of these
Ive researched this extensively, I did 2 NMR to myself back then.
Hold on, what? I had high prolactin, 23 range 8-15, did MRI on my brain, nothing. Never did steroids or SSRIs or some shit.
