Surely the HPTA can bounce back more effectively if his current regime is fixed and his dose is lowered until free T and E2 are back in range.
I am not arguing (educating) you anymore man I am out. I have clearly substantiated my argument numerous times and numerous ways.
The literature speaks for itself.
Good day.
OK, Iāll be back after Iāve had my MRI if you are willing to listen to new information.
And to summarise your view:
Keep E2 double the range
Keep free T over range.
Just take some B6 in the meatime and have an MRI.
My view:
Fix E2
Fix Free T
Establish new prolactin levels and investigate pituitary adenoma if levels still exceed range.
No dude lol E2 double the range? ng/dl over 50 is a no no for us.
But none of that matters, the first order of business is to get the PRL down. If he is young, which I suspect he is, I would strongly consider discontinuing the TRT to see if reducing the size of his adenoma, allows his T to bounce back.
It only takes 3 months, the literature I posted shows that 75% of the time there is a 75% reduction in the size of the adenoma with dopamine agonist treatment. So small you might not even be able to find it anymore.
Iām not sure what you are saying about E2 in your first sentence.
So you finally agree he should fix his TRT regime and get E2 and Free T under control?
Not really, he should just discontinue it and do the dopamine agonist. But if he stays on T he needs a dopamine agonist anyway.
Any other advice for the poster to help restore and maintain his natural levels?
What do you mean? Yea there are lots os supps and stuff you can do to help. But nothing will work until he takes a dopamine agonist. Is that the 100th time I have written it? LOL
No you are now for the first time saying the poster should discontinue TRT. What advice do you offer him to help his HPTA recovery - just a dopamine agonist and some supplements?
Yea.
Background & objectives:
Hyperprolactinaemia affects testicular functions by influencing hypothalamo-pituitary-testicular (HPT) axis at various levels. Available literature on the level of defect, time course of improvement of gonadal functions and its relation with decline in prolactin levels is scanty. We carried out this study to evaluate the HPT axis in patients with macroprolactinomas, before and six months after cabergoline therapy.
In conclusion, impairment of HPT axis in majority of patients with hyperprolactinaemia is functional even in the presence of macroadenomas. Hyperprolactinaemia affects gonadal function possibly by acting at the level of hypothalamus resulting in subnormal basal secretion of gonadotropins required for optimal testicular functions. Recovery of gonadal functions begins soon after initiating treatment with cabergoline though duration of six months is not enough for its complete recovery.
Given that the poster has been taken exogenous testosterone, Iād seriously suggest a clomid protocol to help restart his HPTA. This plus the fact he has been taking HCG should prevent him ending up in an even worse situation.
Otherwise he is going to end up with very low free T and potentially high prolactin.
So you want to stimulate the adenoma? Where do you think PRL comes from? lol
I was under the impression HCG keeps me fertile? Should I stop thst? To add to this throughout all teens Iāve never had morning wood, no chest hair and since starting chest hair is coming. Facial hair hasnāt been a provlem.
It is your assumption based on a single blood test that there is adeonma, not a fact. Lets not go back through all of that again.
If the poster stops TRT, restarting the HPTA is critical for future health.
HCG will keep you fertile and will keep you naturally producing testosterone. But if you stop T and HCG, then this alone may not be sufficient for you to recover. If you are considering stopping, you really want to discuss this through with your doctor.
Just had the MRI, didnāt get told anything as he said my gp will contact me. I have the images if anyone can read them?
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No man. And also a pair of advice because Iāve been quacked:
Very few people can read properly pituitary NMR! Donāt trust a random doctor that has read it. Find a realy good NMR imagery specialist. I found the best in my country and he said there is no adenoma, but herniation and he showed it to me on the images and I understood it. He is one of the best in Europe by the wayā¦
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Did they explain you what is that cyst?
I would look for another independent reading of the images
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@lenono we were right.
@increasemyt you appear to be wrong.
Op just take the medication @increasemyt was telling you to buy without a Dr and never find out cause. Of course donāt do this
BTW my prolactin was slightly high when started on trt. Has come down to normal since.
@sky132 go back to the posts From @lenono and myself that give you other reasons for raised prolactin.
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