@iron_yuppie - do you have any idea what the equivalent P5P dose would be to 300mg of the pyridoxine form of B6?
This is also what my research shows - to really lower prolactine natural stuff doesnt work or you need to take it in such bug doses that can be harmful more than the caber. And as I said I do not feel well from taking most supplements as well at least in big doses.
And from all the medicines for prolactine caber is labeled to be the purest and with least side effects
As I already said increasing blood testosterone levels does not result in decrease of prolactine like someone is suggesting. Then you end up with TRT and caber as well.
I have a LOT of experience with DAs (as a patient obviously, not a doctor).
I have a 5mm adenoma, and my prolactin has always been slightly elevated. Not as high as yours, so doctors suspect āstalk effect.ā But thatās besides the point.
I never had terrible side effects on caber, and I tried it 4x. Iāve taken up to .5mg/week and just started feeling a little tired. I did get a little nasty at times, and my libido was inching up. I never even got the āfunā side effects sexually. If anything, erectile function worsened, which is what led me to TRT.
Yours is high enough that it probably is lowering T LH and FSH. But I totally understand that caber has horrible side effects for some. I can only imagine those on Parkinsonās doses (several mg daily Iāve heard).
I would not waste any time with P5P, zinc, B6, anything else. I tried these, and blood tests showed no/barely any effect on my prolactin. And L-DOPA Iāve found leads to its own issues (your body will slow down production of dopamine, I believe via tyrosine hydroxylase, to compensate, and like with the DAs itās notoriously hard to get started again). I messed around with mucuna puriens for a month. It was fun, and it helped my sex drive. But all that plummeted for a little over a month after.
Another key thing worth testing that one endo showed me: macroprolactin. Nearly every doctor Iāve mentioned it to since has been like āoh hmmā¦good idea.ā Your body can bind prolactin to IgG, rendering it virtually biologically useless. I happen to have perfectly in range prolactin when this is tested, the rest is macroprolactin. There are some cases of macroprolactin being slightly active, but this is a real thing and will give you a much better picture of where you stand. For me, this explained why caber did nothing, and sent me on a different course.
Thereās another easy option in the US: bromocriptine. Itās an older DA, it doesnāt work as well, and you have to take it daily. The side effects for most people are worse, although there are a lot of people online who claim it was better than caber. For me, it just made me more tired. The half life is shorter than caberās, so itās easy to try it for a few days and stop if you donāt feel well. I tried it in under a weekās time.
Thereās other drugs out there that will lower prolactin, but good luck (I speak from some experience) getting a doctor to prescribe them off label. Thereās another called quinagolide that I donāt believe is an ergo derivative like caber and bromo, but good luck finding it. I begged, my doctor agreed to try it, but we couldnāt find it in the US, only Europe. Maybe thatās changed, who knows.
I gave up on my prolactin, although in my initial consult with Dr Saya, I explained all of this so he wouldnāt just ask me to try a DA. He was very understanding, and wants to test my prolactin next time around to see if TRT lowers it by increasing dopamine. Weāll see.
Best of luck, DAās suck and you are not alone in that world.
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Thanks bro. I think your oppinion backs up all my reasearch these days.
Trying to lower prolactin with supplements is mambo-jumbo and waste of time. Its like raising testosterone with supplements.
Can you however explain my a little bit more about l-dopa, I consider taking it for other reasons also?
I will continue to stick with the lower dose of caber - 2x 0.125mg. This is what I can handle. After a week I may try 3x0.125mg but I think it will suck. Yesterday evening for example I took 0.125mg. Its not terrible, but still I couldnāt sleep well last night and feel groggy today. Its a total shit.
It effects my libido well. But Im also worried what will happen with the libido and me totally when I stop this shit? This is why I wonder how long to take it. From one side I want to keep my prolactine at least around 280 where was last not to jump again, but from other side dont want to become too addicted to this drug.
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Happy to help man, itās a road Iām very familiar with!
I learned about L-DOPA a long time ago, and it sounded too good to be true. Seems to hit all the dopamine receptors, and you can get it in a ānaturalā form. Apparently taking it as mucuna puriens is better, as it has other compounds in it that balance other neurotransmitters - but thatās purely based on shit I read on reddit, so I donāt know if I trust it. If you dig up guysā stories on it, some think itās cool once in a while, but thereās a few horror stories out there. And prescription L-DOPA is no joke, my grandma takes it for Parkinsonās. Iāve just learned from all of this that artificial stimulation of dopamine pathways is actually pretty risky, as much as everyone thinks itās pretty resilient. On some nootropics forum (forget which one), a few people mentioned a particular user who vanished after playing with L-DOPA too much and going through DAWS. Look that term up if you havenāt, itās a real thing, and it can take a long time to recover from.
Some people do titrate caber up successfully, and Iāve read a lot of people saying the side effects do lighten up! The sedation seems to be the hardest to get rid of. Try messing with the time you take it too. I used to prefer taking it the second I got into bed, so by the time it started doing anything, I was fast asleep. I also tried taking it Sunday and Thursday mornings, so itād be a weekend and then a day thatās usually lighter for me at work.
The good news is that despite all the talk about DAWS, that tends to affect people at much higher doses. I think at one point I was trying 1mg/week, and when I stopped, I noticed my libido suffered, but only for about 3-4 weeks. Could be worse.
I wouldnāt be afraid to see a few more doctors. Most of the hospitals here have āpituitary centersā and they may have some specialists with better answers for your case. For me, the DAs donāt help, itās too small to surgically remove, so Iām forced to leave it for now.
Hi man. Thanks for the input.
I was planning to take supplement l-dopa with mucuna because I found credible studies it can increase a bit the LH which something I desperately need. But now seems to me better not to play with that especially while still on caber.
The thing that concerns me most is I get side effects from almost everything - supplements including. Most if them make me even more lethargic than I actually am. There are some that make me anxious and uneasy. For example I take aswagandha and zma but only small dosages - if I go to the recommended dose Im too sleepy on the next day. Otherwise on the small dosages they make me feel better.
With caber it is a different story, but Im happy not to be alone experiencing these sides. Means my body is not that crazy and overreacting to all. What Im worried though is even if decide to start TRT at some point may experience undesired reaction even to that.
The other problem is my pituitary condition is very uncommon and there is almost no information about it and the doctors do not have experience with it - empty sella. And Im tired of trying different doctors even abroad and spending a lot of money with zero or small result.
The only meaningful consultation I have was with Defy and they put me on the caber. Dr Saya suspected that the empty sella may cause the elevated prolactine and this may suppress my gonadotropins. But these are two assumptions that nobody on this planet can confirm. He also suspected there is chance to revive the pituitary cells with caber if they are nor completely dead but could not assume what time and what dosage may be needed. Now I cannot invest in another consultation because they are pretty expensive to me. Maybe when I complete six months on caber it will be the moment for that but I prefer to go with doctor Nichols for example and see if he has some annual payment plan because I like his approach more.
And even these are all great interventional endocrinologists I do not believe they have experience with this pituitary condition. And if this is what causes my low t and other symptoms I would very much prefer to fix it than go TRT. I know I need to be patient but struggling for two years with this hormonal issues depleted my patience. I want everything to be fixed like yesterday 
How do you know TRT wont fix your prolactin though? TRT isnt the huge deal you are making it out to be. You have mentioned all kinds of expiremental chemicals and Rx drugs with nasty side effects that you either have/are/ or want to take to try to fix your issues. I think it just seems crazy to most of the guys here. Just do TRT and give it a few months to get your levels right and see if your body turning back into a manās body/brain shuts down the female hormones. You can always stop and go back to being low T. Most guys dont have issues on TRT, you said the other day about āits not all sunshine and rosesā. I think you have read to much stuff here and have been led to believe that you will spend years getting ādialed inā and dealing with side effects and stuff. These forums are just a small population of guys on TRT. Guys without issues dont come to places like this so i would expect like 95% of guys here to be having trouble with TRT. The only issue I ever had was sensitive nipples for a month or two, other than thatā¦ Sunshine and beautiful flowers. Life has just improved exponentially since starting. I personally would rather just live with the prolactin and not take drugs that might end up doing things to my body and brain that make low t and high prolactin seem like a walk through a nice sunny garden. Why suffer needlessly? No amount of optimized lifestyle is going to optimize your T. You dont weigh 400lbs so its not like you can completely transform your body, you are basically talking about eating healthier and consequently fixing some minor nutritional deficiency and cutting out a minor amount of chemicals compared to your overall exposure unless you plan to move into a BPA free plastic bubble with air filtration and the correct UV filters ECT. You are grasping at straws here and looking for a pipedream. If you put off the inevitable too much longer you will just be angry at yourself when you finally do start TRT and get yourself sorted out and realize you wasted months/years chasing sasquatch and now have to wonder when the cancer and other unknown long term side effects of all these drugs are finally going to come back to haunt you.
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Because bro I believe this is the right way - first optimize your life, try to fix the root cause for low T and then commit to TRT if necessary.
Caber treatment is for few months while t is for life. Canerās side effects are almost all resembled in feeling shitty but not permanent damage at least not in the doses I take or would increase to.
TRT is for life, issues are possible and fertility is a HUGE concern for me. HCG is not tolerated well by everybody so this variable makes my equation complicated.
Also I may be able to optimize my T levels without TRT and this is what also some of the really good and prob- TRT doctors have stated to me.
So for me its necessary to go through the process of trying everything before committing to a life long routine. After all TRT is a big alteration in all your endocrine system. If you are in the 200,300 - ok, but last time I checked my total t was 600 and nobody knows if it cannot raise moreā¦
My total T was 575 at 35 yrs old and I got on trt because I could. Best decision I ever made. I have amazing energy and libido plus I look the best I have in 15 years. Oh and my prolactin is 25 (top range is 15). I donāt have a tumor so I donāt care about the high prolactin as my dick is always āready to rollā mode. Even if you fix yourself your total T will still most likely be less optimal than if you were on trt. I commend you for ādoing it the right wayā but donāt see the end justifying the means, though I hope you are right.
Fertility is huge for me too but a good doc can have you back fertile so Iām not worried about that. I have two friends on 200mg/week that blast and cruise and both have 2 kids in the last 3 years. They werenāt even trying for kids.
I also know people bro who have kids on TRT no HCG even but this is not good enough for me. I want to keep all my present fertility which I believe is not great because my FSH last time I checked was below borderline. Need to make sperm analysis but I ways postpone that not sure why.
In fact in the TOT bible it is highly recommended to take sperm analysis before TRT and also to optimize your lifestyle before TRT.
Which doc initiated your TRT?
If you were born in 88 you are 30-31. If you have a partner that wishes to have kids then maybe you two should talk about making that a priority soon. If you do not have a partner that plans to have children with you then maybe you should consider the fact that you are already 30-31 with no current prospects and maybe kids just arnt in the cards. You could always do one of those big brother situations or coachs kids sports
Of course man.
I would be especially careful mixing caber and MP. Maybe itād be fine, but it just sets off red flags to me lol.
Iāve always been sensitive to all supplements, itās kind of ridiculous. I have a giant box full of ones Iāve tried back in the day, and only low dose vitamin D and magnesium were actually non-offenders. I used to take higher doses of both, too, and had issues with each then.
I feel you on the pituitary thing. My girlfriend pushed me so far to find a doctor specializing in pituitary tumors, and none of them were of any help. It truly felt like a dead end (surprising for something relatively common too). I keep getting sent back to idiot endocrinologists who test my prolactin, want me on caberā¦rinse and repeat.
It wonāt be any day soon, but Dr Saya is hoping that TRT will help my prolactin levels too (forget if I mentioned that). Youāre welcome to hit me up down the road and Iād be happy to share if thereās any impact.
At one point, I considered having my tumor removed, and even started calling UCLA and other places renowned for handling such things. If you havenāt, you might have to really stretch and start hunting for a ābest in the worldā type doctor for you situation. At least Dr Saya is extremely knowledgable (from my experience and everything Iāve heard), so youāre in good hands there. I donāt think heāll let you down.
If I were youā¦Iād consider telling Dr Saya that you absolutely cannot tolerate caber, and ask if thereās any way for you to try something like quinagolide (if thatād help in the same way). I spent far too much time messing with endos who just offered me caber or bromo and didnāt even consider any other options, even off label.
I remember reading somewhere youāre not in the US?
Caber is great at getting your PRL down, you just need a very tiny amount. If you are getting sides, you need to lower the dosage.
Usually PRL is not high unless your E2 is high, do you know what that was?
Dopamine agonists are great if you get the right dosage, you may even have multiple climax like a female 
Either way whoever suggested getting your PRL down is absolutely correct, you have to do it.
Well you know to have kids is not somthing simple or that can be rushed for tomorrow, so this obviuously is a big drawback when deciding pro or against TRT. And when I measure the other variables also in the TRT equation like a possibility to improve my T levels other way at the end the decision is very difficult.
So you also have sides with supplements?
Everybody I tell that thinks Im crazyā¦well Im pretty sure its not a placebo effect. For example I have nasty sides from fish oil, tried 3 different brands. And I have no issue eating fish. Its a bit crazy.
For this reason Im not very confident that any other dopamin agonist medication will be better for me. For now I want to stick to 2 x 0.125 so its tollerable for me.
Iāll see if I will continue with dr Saya or go to dr Keith Nichols. If I need TRT at some point I prefer dr Nichols to manage it. In fact I maybe would like if start TRT to be managed by dr Merril Matschke, but I think he does not do telemedicine. The reason - because he is the best specialist in HCG monotherapy and this for sure will be the thing I will try before TRT. These are all great doctors but unfortunately I do not believe any of them is like a pituitary specialist and as I have researched worlwide nobody is. I mean the pituitary gland is a big mistery for the medicines. If the medicine knew how to manage it this would shut down the mental institutions at most part. And my pituitary condition is relatively rare and very unexplored. The best thing a doctor can do is guess.
But about your tumor - have you researched into gama knife? There was a point I thought I have tumor because my first MRI was read by a complete amateur. I researched about the gama knife and it seems to be a very precise and safe procedure.
Yes I do not live in USA, I live very far from there, travel to USA is extremely expensive for me so this makes things complicated.
There is another thing I consider but Im not sure this is the right topic for that.
JWell bro before I started caber my prolactine was 360, upper limit 320, after two months on caber 2x0.125 I maintain the prolactine around 280.
Which is like Dyatlov said in Chernobyl - Not terrible, not great. If I try to up the dose to further optimize prolactine I meet too nasty sides for me to handle.
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You could always freeze your sperm. Itās cheap. I work in medical device sales in NYC so Iām in the top hospitals every day and my job is to build relationships with docs. When I was thinking of getting on trt I spoke to a top fertility doc in the US who has been practicing for 30 yrs that said heās never had a patient that was on trt that he wasnāt able to get back fertile (whoās infertility was due to trt). Some are harder than others but thereās always a way.
Thats a but encouraging. Maybe the best I can do now is to test my present fertility first.
What is the name of this doctor?
Is your E2 high?