High IGF-1 Blood Test: How Concerned Should I Be?

Pharma / TRT Testosterone Replacement
1

Am getting signed up with a real TRT clinic after six years of treatment by my GP. As part of that signup process, the new clinic drew a bunch of labs. My IGF-1 came back at 419 ng/mL on a range of 83-233, so it’s definitely elevated. I am concerned about pituitary adenomas/acromegaly.

What’s the right doctor to see about this? An endocrinologist? A neuroendocrine specialist? I’m not sure what kind of specialist to pursue and am anxious to get this moving with further diagnostics.

How concerned would you guys be if you saw a result like this? Anyone here ever have anomalous IGF-1 results?

Thanks!

2

What are other pituitary hormone levels? Prolactin? Did they look at your thyroid? What did the doctor say about the elevated IGF-1?

3

Haven’t had the consult with the doc yet. I just got these results on Friday afternoon. This was the initial onboarding panel from Defy Medical. I asked them to send me the results because I haven’t been able to schedule with Dr Saya yet (still waiting for E2).

He didn’t check other pituitary levels because there wasn’t any indication we needed to. I see my GP on Wednesday to discuss. I’m going to ask her to draw prolactin, IGF-1 again (at a different lab), and to schedule a pituitary MRI. I’m going to be calling endocrinologists tomorrow to get a consult ASAP as well, the docs I’ve located are all on the pituitary end of the endocrinology spectrum according to their listings. I’m in a bit of a panic about this and am working fast to try to get answers.

I had thyroid checked a few months ago and everything was fine. This was in February of 2018:
Free T3 3.44 pg/mL 2.18 - 3.98 pg/mL
Free T4 (EIA) 0.89 ng/dL 0.76 - 1.46 ng/dL
TSH 1.310 mcIU/mL 0.358 - 3.800 mcIU/mL
Thyroid Peroxidase Ab <28.0 U/mL <60.1 U/mL
Anti-Thyroglobulin <15 U/mL <61 U/mL

What were you thinking in terms of prolactin/other pituitary hormones? I’d be curious what was on your mind when you asked about those. Any other thoughts on this are welcome as well.

4

Rule out pituitary microadenoma.

5

Yeah. That’s what I’m concerned about and what I’ll be looking for my doc to do. What other bloodwork would you want to see to help evaluate? As I mentioned, I’m going to ask for a repeat IGF-1 and prolactin. Anything else you’d add?

6

LH and FSH. You already have TSH. I wouldn’t worry about it, it’s not crazy high, but you have to run it down. My guess is you will not find an explanation, but that’s just a guess. Good idea to run it again.

7

I have LH from last week
LH <0.2 mIU/mL 1.7-8.6

Seems like what I’d expect for being on TRT for 6+ years, no?

8

Yes, exactly.

9

I too have high IGF-1, and as a cancer survivor it definitely freaked me out. However, Ive had a pituitary MRI with perfect results, regular labs, and zero negative symptoms. As such, I’m monitoring levels during through labs. My first high test was coming off Clomid so maybe my HTPA was working too hard.

Not sure if theirs a correlation but over the past year I’ve slashed my cholesterol levels from dangerous to well within normal range. I’ve changed my diet and started lifting weights. Basically I’ve made a lot of lifestyle changes.

Have you made any lifestyle changes? What’s your diet and workout plan? I’ve read consuming high levels of protein and heavy lifting can raise IGF-1 in some guys. Don’t know if it’s true, but I do know when I tested high I was doing both simultaneously.

10

Thanks so much for this post. Very interesting to hear that your levels were elevated and that nothing showed up on further diagnostics. I’m glad for you! And also, hope your cancer stays in remission. I’m about to hit the 3-year anniversary of my surgeries and have the pre-MRI anxiety about those that I’m sure will stay with me for life.

How high was your IGF-1 at its highest? What diet changes did you make?

Lifestyle:

  • I eat a lot of protein, almost entirely from animal sources. No whey/casein powder, but lots of eggs, red meat, poultry, and fish. I use rice protein powder as well. I do have a sweet tooth and could cut back a bit on desserts.
  • I’ve been lifting consistently for 20 years. Even with cancer surgeries and a shoulder orthopedic procedure over the last few years I’ve kept up a lifting regimen.
  • I started getting my sleep apnea treated about six weeks ago and am using a CPAP machine for the first time.
  • One other factor that could be throwing my labs off is high-dose Vit D; I tested severely deficient in December and my doctor has had me on 50,000 IU of D2 every week since then. I’ve read that there are correlations between Vit D and IGF-1, so I’m discontinuing the D2 for the forseeable future to see if that helps bring my levels down at all.
11

just saw this comment on another forum from dr john crisler

"An IGF-1 over the average is only a problem is there is not a matching IGFBP-3.

And this is why injecting IGF-1 is insane.

BTW, “The average” are old and sick. NOT good enough for my patients."

12

Thanks. I’ll ask my doctor tomorrow if she can order that test as well.

13

I got some updated/repeat labs. Curious if anyone here has thoughts. Looks like prolactin is totally normal, IGF-1 still elevated, but IGF-1 Binding Protein is also above range, so it appears my body doesn’t have enormous free levels of IGF-1 circulating. Still feeling quite concerned.

Prolactin 5.9 ng/mL    Range: 2.1 - 17.7 ng/mL
IGF-1 397 ng/mL        Range: 83 - 240 ng/mL
IGFBP-3 6840 ng/mL     Range: 2474 - 5208 ng/mL