I Dont Know What to Do, Please Help

I have received my latest lab results from my doctor. I am a 20 year old with a prolactin secreting pituatary adenoma. It seems that I have stopped responding to cabergoline at a dose of 0.5 mg three times a week. I am also on 10 grams a Androgel per day. For the past 2 years my prolactin has been hanging at 72 comming down from 142 in about 6 months into treatment.

The latest lab results I recieved were Total Testosterone 322 and Free Testosterone 301 with normal values being 310-1100 and 44-224 respectively at this facility.

I am needing help in determining why I have not felt any difference in my mood, sex drive, or strength/stamina physically although I am pretty muscular and 267 Lbs at 6 foot tall. I store fat like a woman aroung the midsection/thighs/waist area and have very noticable Gynecomastia. She did not order any Estrogen test and my thyriod came back normal, but im not sure if my total test is being converted to estrogen or what.
It seems like my doc has written me off as im fine. Please help.

T levels suck, you are not absorbing well and the reason may be some degree of hypothyroidism. You may need to switch to injections!!!

You need to test TSH, fT3, fT3, rT3

You are converting a lot of transdermal T to estradiol. That plus the prolactin is a bad combo You need to report your estradiol [E2] levels and probably need to use nolvadex to tackle the gyno. Injections will result in less T–>E conversion.

Both elevated E2 and low thyroid levels can make you fat and block efforts to loose fat.

Your R2 levels should have been tracked and controlled with anastrozole. Target E2 level is 22pg/ml.

You can probably improve your response to cabergoline with small doses of deprenyl/seleginine. Suggest 2.5 mg EOD. You will need to split 5mg tabs or capsules to do that. It is a selective MAO-B inhibitor and does not have any of the classic MAO dangers unless doses exceed 10mg/day. If this fails, you may need pituitary surgery.

Suggest 100mg testosterone cypionate per week self injected twice a week or EOD. Start with 1.0mg/week anastrozole in EOD divided doses [hard to do with 1mg tabs].

You need to inject 250iu hCG EOD to avoid sterility. How long on androgel?

Add the above dose of deprenyl to increase your dopamine levels, enhancing the effects of cabergoline. Your prolactin producing cells might not be inhibited by higher dopamine, but only one way to find out.

T+AI+hCG

Read the protocol for injections sticky and some others as well.

Speaking of dopamine levels: I know that your life sort of sucks right now. But do you feel joy or satisfaction, laugh out loud, really enjoy a great tasting meal? If so, your dopamine levels are working properly to some degree. If none of the above and you really don’t care any more [apathy], dopamine could be low. Deprenyl might shift dopamine and your emotional balance.

Please report lab results with ranges. Always get and retain you lab work. You need to be manage your own health care.

I seem to be getting very directive… sorry about that.

Thank you so much for the advice and a direction to go in. Regarding the dopamine and apathy I do laugh out loud, but I tend to get depressed very easily. I have been on Androgel for 14 months now, 6 months 5g/day and 8 months 10g/day.
I was wanting to do the surgery but my tumor is no longer visible on an MRI so that is out. Since on androgel I have grown body hair and facial hair but there is no sex drive as mentioned before. I believe that my doctor just thinks I eat alot of crap and that I am better. She says that my current prolactin level is “not intrinsicly harmful” which makes me think that she is satisfied with where I am at and classifies me as a “partial responder” to Cabergoline.
I deeply appreciate your help as I now have a direction to go in, this is literally making me crazy, I obsess about it all the time.

The crazy thing is that I go to a pituitary clinic at UVA supposedly the 4th best place to go in America for endocrine disorders and they are not very concerned with dealing with the mind of a patient as well as the body.