High Prolactin, MRI Shows No Pituitary Tumor

Pharma TRT
1

42 year old. I’ve been on TRT since May, felt great until mid July and have been getting blood test since then for anything I can think of. I got one for prolactin in late Nov through LetsGetChecked which showed it’s level was (or is) high at 472 (normal is 86-324). Showed my Dr who immediately ordered an MRI saying I probably had a benign pituitary tumor. Had the MRI this last Friday (took a while to get in) and just got the results back: there is no tumor in my pituitary gland.
My injections have fluctuated since May: I started by doing 60 mg every 3 days and felt great but my total T level was over 1100 so my Dr had me back off. So starting July 1 i did 100 mg every 7 days… then crashed hard in late July (see my previous post) probably from the change (still unsure).
Now I inject 50 mg every 4 days. My libido is a bit better but nothing like it was when I first started in May and June. My GF has an incredible body and we were having sex at least once if not two or three times a day then, not it’s about once every two weeks. She’s still hot, but I am blah and sort of uninterested.
I’m also pretty blah in every other aspect of my life… I am more interested in sitting on the couch and channel surfing and scrolling through crap on fb then going outside and skiing or hiking and going to the gym seems like a job now and my workouts have suffered.
I know there is an issue here, but whatever it is has made me to lazy to figure it out. Also, I’ve gained a bunch of fat (my holiday diet didn’t help, but still more fat than I should have while on trt)
I took one 6 week cycle of anavar (oral) in 2014 but nothing else other that my current use of trt in my life. Idk why my prolactin is high, but it’s obviously fucking me up?! I have had my dr check my estrogen this fall, it came in at 31 which he claims is in the normal range and didn’t want to put me on anything there. I did some looking around and while 31 is ‘normal’ some seemed to suggest it is still high. Not sure what to do…
Also, does anyone get ringing in their ears (tinnitus) from TRT? That started during my crash in july and now comes and goes. Also, my lower legs get pretty swollen a few days a week and veins stick out on them which I’ve never had there before. When I take my socks off there’s a big ring at the top of where they were and I had to get new liners for my ski boots and my lower legs are basically a different shape now.

Managing levels/keeping track of things while on TRT has been more work than I had ever imagined. Is that normal? I feel I did a lot of research before hand but will admit to some immaturity on the subject as a whole.

**side note on the MRI: While it didn’t show anything in my pituitary gland it did show that i have an “uncommon cluster of small cysts in the right perinatal posterior temporal/anterior occipital lobe”. So that’s great.

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We need all pre-TRT and most current lab work including total testosterone, free testosterone, SHBG. Some men will need very high total testosterone if SHBG was very high pre-TRT because free testosterone will be low even when total testosterone is sufficiently elevated.

The total testosterone is junk as in not bioavailable to your bodies tissues, the free testosterone is what matters. Your pituitary gland will increase TSH when the body doesn’t have enough thyroid hormones. Thyroid problems are linked to elevated prolactin, an increase in TSH can be why prolactin is high.

If TSH is elevated 2.5>, a thyroid panel is needed checking fT3, fT4, rT3 and antibodies.

Hyperprolactinemia in association with subclinical hypothyroidism

These normal ranges and the way most doctors interpret them is BS because western civilization is experiencing a decline in testosterone and sperm mobility so we have to match up with a population that is sick and slowly dying.

Your doctor only cares about the numbers, forget about how you feel at 1100, that’s not important, the numbers are everything to him because of a complete lack of knowledge.

Find another doctor ASAP!

Yep, I was on TRT for about two years before the tinnitus started, I’m having problems with the veins sticking out and throbbing sensation in legs and feet, but not edema, swelling in the thighs and midsection because I wasn’t urinating hardly at all.

These large infrequent injections can cause excess water retention that has nothing to do with estrogen and now your tissues have more fluid in them then causing ringing in the ears.

It sounds like you’re experiencing edema and may need a diuretic to purge excess fluid from the body if you find adjusting your injection frequency doesn’t do the trick.

You need to find out why you have edema, you need a full cardiovascular workup (echocardiogram). The blood return to the heart (inferior vena cava) can prevent deoxygenated blood from returning to the heart and if restricted can cause lower leg edema.

An echocardiogram can see if the heart is beating correctly. Iron deficiency can cause tinnitus as well, vitamin C deficiency can cause generalized edema. It sounds like you’re having the similar problems I am.

I wonder are you completely emptying your bladder?

How is your blood pressure?

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My prolactin is more elevated that yours. If there’s no tumor then nothing to worry about. Folks with tumors can have prolactin that is sky high (>1000).

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Oh I’ll check my prior levels and get back to you.
What’s TSH?
I live in western montana and can find a dr that has good experience with trt, but was thinking of trying an endocrinologist… would that be a better route?

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TSH is Thyroid Stimulating Hormone.

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Honestly it’s a total crap shoot and you’re unlikely to find someone that is all that good at it. The medical guidelines a lot of them go by say to prescribe a single 100-200mg shot every 2 weeks which obviously is pretty dumb with the half life being around a week… so by the end of 2 weeks you’re at or below where you started pre-TRT

Elevated TSH usually also means elevated TRH. Elevated TRH can slightly elevate prolactin, which is what you may be seeing. So yeah, thyroid problems can be linked to increased prolactin. The levels seen in people with actual tumors are like 10x higher than yours is.

HOWEVER, there are lots of people with prolactin similar to yours that are fine, so I wouldn’t be 100% convinced that is your issue honesty. I honestly don’t think it is your issue.

My opinion is you just need more T.

You need to know what your free T is and you need to know what your SHBG is.

You went from effectively 140mg a week to 100mg a week to 87.5mg a week… no wonder you feel worse. You were fine at 140mg a week symptom wise and feel like crap now that you’re lower.

This isn’t rocket science… I believe you just need more T. Judging by your history of symptoms vs. dosages, it seems pretty clear this is likely the issue. At the very least I’d be bumping that dose up to at least SEE if you get better… I bet you will.

If your doc won’t increase then you could use one of many telemedicine clinics that would treat you more on symptoms and less on numbers.

7

TSH stands for thyroid stimulating hormone which stimulates the thyroid gland to produce hormones and doctors rely on it sometimes exclusively to determine thyroid status even though it’s a poor marker for thyroid status.

This is not the route I would go, in my opinion endocrinologists are the worst. My bet is on the GP or urologist.