One issue of pituitary adinomas is that they can get big enough to damage the optic nerves. A MRI will at this stage probably not show any threat of that. If prolactin is up, the effect is on LH/FSH and lower testosterone is secondary to that.
Without LH/FSH labs, you doc has no idea what he is talking about. LH/FSH must be done before any TRT is started, too late afterwards. LH/FSH determines primary/secondary.
When T is low, you then do more diagnostic labs to try find out why. Low-T is the symptom, not the disease. LH/FSH is needed. I have no idea why prolactin would be tested and LH/FSH not. When LH/FSH is low, prolactin lab is done to try to find out why LH/FSH is low.
Note that prolactin should not be tested withing 48 hours of orgasm when prolactin is released. Also avoid cuddling puppies and babies.
Please read these links found here: About the T Replacement Category - #2 by KSman
- advice for new guys - provide more info about you!
- things that damage your hormones
- protocol for injections
- thyroid basics - check oral body temperatures as suggested
- finding a trt doc
You will learn more from that reading than from this thread.
Thyroid: You oral body temperatures are a very good guide to your thyroid status. See the note in the links. This will cost nothing.
If you have not been using iodized salt and/or vitamins that list iodine+selenium, you can expect thyroid problems.